Intensive Care Research Unit

Head: Associate Professor Vineet Sarode

The Cabrini Intensive Care Unit admits approximately 1570 patients per year following procedures such as cardiothoracic and abdominal surgery as well as medical admissions requiring multi organ support. The average length of stay in our unit is 48 hours.

Director Intensive Care Unit Associate Professor Vineet Sarode

Deputy Director Intensive Care Unit, Head of ICU Research Associate Professor David Brewster

Intensive Care Physicians Professor Warwick Butt Dr Deirdre Murphy Dr Steve Philpot

ICU Research Coordinator Shannon Simpson Research in the intensive care unit (ICU) is particularly about questioning current practices and determining how we can get the best outcomes for our patients based on the evidence found. ICU research is increasingly trending towards examining patient outcomes post ICU discharge by following up patients for extended time periods to determine quality of life and disability as well as the standard outcome measures such as morbidity and mortality. Through this extended follow up of patients, we hope to ascertain the long term impacts an Intensive Care admission can have on both patients and their families – emotionally, physically, financially and socially. This would ultimately lead to standard practices and procedures possibly being changed or modified to ensure beneficial long term outcomes for our patients. The COVID-19 pandemic has presented challenges to all healthcare workers, and Cabrini ICU is no exception. It is through research that we can learn more about this virus, the immediate impact it has on patients and communities as well as the medium to long term impacts, giving us more knowledge in uncertain times.

Highlights

Cabrini ICU landmark paper leads the country in national guidelines for the airway management of patients with COVID-19 A highlight for this year has been a major publication in the face of the COVID-19 pandemic. Associate Professor David Brewster first authored an influential medical research article in Australia for 2020. The national guidelines for the airway management of patients with severe COVID-19 disease has been the most viewed, downloaded and cited article in the Medical Journal of Australia (MJA) for 2020. This article has guided the doctors from anaesthesia, emergency medicine and intensive care units in all hospitals in Australia and New Zealand to manage extremely unwell patients as they are put onto a life-saving mechanical ventilator. It has also been used in numerous other countries as their guidelines. Associate Professor Brewster authored these guidelines along with 14 other national experts on airway management through his role on both the board and clinical council for the Safe Airway Society of Australia and New Zealand.

These guidelines were widely endorsed by specialty colleges and societies including ANZICS, ASA, CICM, ACEM, NZSA, ACCCN, AHONHS and recommended by the COVID-19 collaborative. Cabrini is a part of a thriving ICU research community led by the Australia New Zealand Intensive Care Society Clinical Trials Group (ANZICS CTG). Our research team collaborates with multiple sites including Monash Partners, Australia New Zealand Intensive Care Society Research Centre (ANZICS RC), Sunnybrook Research Centre, Toronto and the Medical Research Institute of New Zealand. We are collaborating with the Cabrini physiotherapy team participating in a study investigating early mobilisation vs standard in the mechanically ventilated cohort of ICU patients. This again will aim to improve our patient outcomes for their ICU stay and beyond.

Our Research

BALANCE

RESEARCHERS: SARODE V, BREWSTER D, MURPHY D, SIMPSON S

Bacteraemia Length Actually Needed for Clinical Effectiveness. Upon confirmation of positive blood culture in the ICU, patients are randomised to receive 7 days vs 14 days of appropriate antibiotic. The purpose is to determine survival rates at 90 days and whether patients can ultimately be treated with a shorter duration of antibiotics. We are currently in the recruitment phase of this study.

TEAM

RESEARCHERS: MURPHY D, SARODE V, BREWSTER D, PHILPOT S, SIMPSON S

Treatment of invasively ventilated adults with Early Activity and Mobilisation. A prospective multicentre phase 3 randomised controlled trial of early activity and mobilisation compared with standard care in invasively ventilated patients in intensive care. We are currently in the recruitment phase for this very exciting study working in partnership with allied health including the physiotherapists.

ICU ROX TRIPS

RESEARCHERS: BREWSTER D, SIMPSON S

Standard vs Intervention use of oxygen in mechanically ventilated patients, Translating Research Into Practice

Staff from the Intensive Care Unit preparing to care for patient’s during the COVID-19 pandemic.

(TRIPS). With the ICU ROX study now having completed recruitment, the focus shifts to TRIPS. Do we change our practice in line with recommendations from research? Practice of clinicians was examined pre commencement of ICU ROX, after recruitment was completed and now that the ICU ROX study has been published. Data analysis of all three time periods is currently being completed.

SPRINT- SARI

RESEARCHERS: BREWSTER D, SIMPSON S

Short Period Incidence study of Severe Acute Respiratory Infection. SPRINT-SARI is an ambitious international collaborative project aimed at characterising SARI patients as a global problem to better inform management strategies and ultimately to improve the ability of healthcare systems to rapidly respond to emerging infectious causes of SARI. We are currently in the recruiting phase of any patients diagnosed with COVID-19.

Total research projects approved and ongoing in 2020 336

+$10.9m

IN GRANT FUNDING

31

PUBLICATIONS

4

PRESENTATIONS

2

CLINICAL TRIALS