Research is a pillar of intensive care medicine. It is essential to inform us how we best treat patients who are critically ill. Conducting research in the ICU requires a careful and considered approach to the unique aspects of this environment. Our patients are often unconscious, with acute diseases that put them at high risk of dying. Their families are particularly stressed, and dealing with their own uncertainty while trying to advocate and support their loved one.
Clinical trials currently underway at the Barwon Health ICU are investigating:
- Respiratory support after cardiac surgery
- Medications to prevent bone loss and fractures in the years after critical illness
- Choice of antibiotics and steroids for treating pneumonia
- Use of sodium bicarbonate to treat metabolic acidosis
- Lung protective strategies for ventilated patients
- Patient reported outcomes and experiences of critical illness
- Optimal blood oxygen levels to target
- Effective management of extracorporeal life support
Barwon Health ICU is a member of the Australian and New Zealand Intensive Care Society – Clinical Trials Group (ANZICS-CTG), and also conducts research that ranges from multi-centre clinical trials to observational studies, single site and healthcare registry studies.
Please reach out to the ICU research team if interested in collaborating, or for any further information.
Recent Research Highlights
- SOFTER awarded 2023 Barwon Health Research Symposium Best Paper of the Year
- iValidate reached 10 years of publication with two new papers
- commenced PROEMS ANZICS-CORE, a unique e-based, person-centred follow-up collaboration between ICU Research and ICU Safety & Quality
- A/Prof Orford received an MRFF grant for DRIVing PrEssure Limited Ventilation in Hypoxemic Respiratory Failure- Randomised Control Trial: The DRIVE Trial
Research Areas
The Barwon Health Intensive care is an international leader in research examining bone loss after critical illness. A/Prof Neil Orford is the Chief Investigator for the multicentre, MRFF funded ($1,905,282.70) BONE ZONE Trial. This trial is examining the effect of zoledronic acid or denosumab in critically ill women and men. https://www.monash.edu/medicine/sphpm/anzicrc/research/bone-zone
- Randomised embedded, multifactorial adaptive platform trial for community-acquired pneumonia (REMAP-CAP)
- A comprehensive national registry on the treatment and outcomes of patients requiring ECMO (EXCEL)
- Bone loss prevention with Zoledronic Acid or Denosumab in critically ill women (BONE-ZONE)
- Sodium bicarbonate for metabolic acidosis in the intensive care unit (SODa-BIC)
- Driving pressure ventilation in hypoxemic respiratory failure – randomised control trial (DRIVE RCT)
- ANZICS Point Prevalence Program (PPP)
- The mega randomised registry trial comparing conservative vs liberal oxygen targets (Mega-ROX)
- Short period incidence study of severe acute respiratory infection (SPRINT-SARI)
- Effect of denosumab on bone turnover markers in critically ill women (SOFTER)
- Identifying values, listening and advising high-risk patients in acute care (i-Validate)
- The epidemiology and outcomes of patients admitted to the Intensive Care Unit with an acute mental health disorder
- Factors associated with long-term survival after critical illness
- Defining patient-centred recovery after critical illness – a qualitative study
- Neuro-prognostication in Hypoxic Ischaemic Encephalopathy
- Frailty and Intensive Care outcome
Survival for critically ill patients managed has improved over the last two decades, with 90% of patients now surviving to leave hospital. As a result the focus of intensive care research has shifted to improving the health status and quality of life in this vulnerable population. We are planning to systematically determine the extent of patient recovery and obtain feedback from all survivors of critical illness. This will provide important insight into long-term outcomes and help us understand how to work with clinicians, patients, and families to improve quality of life.
Research Team
Research staff
- Neil Orford, Head of ICU Research
- Erfana Thashneem, Deputy Head of Research
- Simone Fitzgerald, ICU Research Nurse
- Jemma Trickey, ICU Research Nurse (maternity leave until April 2025)
- Stacey Hawker, ICU Research Nurse (covering until April 2025)
Research Grants
- 2023/2024: MRFF: DRIVing PrEssure Limited Ventilation in Hypoxemic Respiratory Failure- Randomised Control Trial- The DRIVE Trial. Chief Investigator: A/Prof Neil Orford
- 2023: MRFF MNHS Grant: Generating new evidence to reduce complications and improve the safety and efficacy of extracorporeal membrane oxygenation (ECMO) in patients with severe cardiac and respiratory failure: THE RECOMMEND Platform Trial. Associate Investigator: A/Prof Neil Orford
- 2023: MRFF: iCare – An interactive online portal to improve health and wellbeing for people living with complex cancers, and their informal carers: a Phase II randomised controlled trial. Chief Investigator: A/Prof Neil Orford
- 2020: MRFF RCRDUN Grant: Bone Zone. Bone loss prevention with zoledronic acid or denosumab in critically ill women – A randomised controlled trial. Chief Investigator: A/Prof Neil Orford
Featured Publications
| Wagner K, Orford N, Milnes S, et al. Prevalence and long-term outcomes of patients with life-limiting illness admitted to intensive care units in Australia and New Zealand. Critical Care and Resuscitation 2024;26(2):116-122. |
| Orford N…Blender Investigators. Conservative or Liberal Oxygen Targets in Patients on Venoarterial Extracorporeal Membrane Oxygenation. Intensive Care Medicine.2024 July Accepted for publication. |
| Cheung W, Naganathan V, Myburgh J…Orford N et al. A survey of Australian public opinion on using comborbidity to triage intensive care patients in a pandemic. Australian Health Review. 2024 Apr. |
| Tierney A, Milnes S, Phillips A…Orford N. Effect of a person-centred goals-of-care form and clinical communication training on shared decision-making and outcomes in an acute hospital: a prospective longitudinal interventional study. Int Med J. 2024 Mar 23. |
| Burrell A, Ng S, Ottosen K..Orford N etal. Corrigendum to “Blend to Limit OxygEN in ECMO: A RanDomised ControllEd Registry (BLENDER) trial: Study protocol and statistical analysis plan. Crit Care Resusc. 2024 Feb 1;26(1):60 |
| Livingston PM, Winter N, Ugalde A…Orford N et al. iCare – a self-directed, interactive online program to improve health and wellbeing for people living with upper gastrointestinal or hepato-pancreato-biliary cancers, and their informal carers: the study protocol for a Phase II randomised controlled trial. BMC Cancer. 2024 Jan 29;24(1):144. |
| Orford N, Bone A, Kotowicz M.A, et al. A pilot feasibility randomised controlled trial of bone antiresorptive agents on one turnover markers in critically ill women. Sci Rep. 2024 Jan 24;14(1):2071. |
| Nair P, Orford N, Kerschan-Schindl K. Micronutrient intake to protect against osteoporosis during and after critical illness. Curr Opin Clin Nutr Metab Care. 2023 Nov 1:26(6):557-563. |
| Eastwood G, Nichol AD, Hodgson C, et al for the TAME Study Investigators. Mild Hypercapnia or Normocapnia after Out-of-Hospital Cardiac Arrest. N Engl J Med. 2023 Jul 6;389(1):45-57. doi: 10.1056/NEJMoa2214552. https://www.nejm.org/doi/full/10.1056/NEJMoa2214552 |
| Milnes S, Hutchinson A, Kerr D…Orford N. Effect of communication skills training on documentation of shared decision-making for patients with life-limiting illness: an observational study in an intensive care unit. Crit Care and Resusc. 2023. Mar (25)1:20-26 https://www.sciencedirect.com/science/article/pii/S1441277223000054 |
| Hodgson CL, Higgins AM, Bailey MJ…Orford N, for the EXCEL Study Investigators on behalf of the International ECMO Network and the ANZICS CTG. Incidence of death or disability at 6 months after extracorporeal membrane oxygenation in Australia: a prospective, multicentre, registry-embedded cohort study. Lancet Respir Med. 2022 Nov;10(11):1038-1048. doi: 10.1016/S2213-2600(22)00248-X. https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(22)00248-X/fulltext |
| Thackeray M, Kotowicz MA, Pasco JA, Mohebbi M, Orford N. Changes in body composition in the year following critical illness: A case-control study. J Crit Care. 2022 Apr 23;71:154043. https://www.sciencedirect.com/science/article/abs/pii/S0883944122000727 |
| Low Y, Lyon C, Lakey K, Finnis ME, Orford NR, Maiden MJ. Frailty is not independently associated with intensive care unit length of stay: An observational study. Aust Crit Care. 2021 Aug 27:S1036-7314(21)00106-5. doi: 10.1016/j.aucc.2021.06.012. https://www.sciencedirect.com/science/article/abs/pii/S1036731421001065 |
| Orford N. Grief After Suicide. 2020; 323(17):1720-1721. https://jamanetwork.com/journals/jama/article-abstract/2765432#:~:text=We%20can%20share%20sorrow%2C%20sit,piece%20together%20events%20and%20emotions. |
Support Our Research
Participate in a Clinical Trial
To find out about clinical trials currently underway at Barwon Health, click here.
Donate
Clinical trials require ongoing investment and there are several ways to support this amazing work.
You can make a donation today and contribute to an item on our research wish list, consider a bequest in your will, or establish a lasting legacy fund in your name. No matter what size, your philanthropic support with deliver an immediate impact.
To donate now or for more information and further discuss your support, please contact the Barwon Health Foundation.
Wish List
- $2,000 will fund the purchase of IT software for data analysis and data presentation
- $5,000 will fund a -80 degrees freezer for storing biological samples
- $50,000 will fund the Project Coordinator who is essential to conducting of a planned Patient Related Outcomes Study.
Page last updated: December 23, 2024