Intensive Care Completed Research

Although there is a national database of cardiac arrests that happen in hospital wards in most cases it does not include the ICU. This study records all cardiac arrests happening in ICU over the course of a year. The aim is to determine how commonly cardiac arrests happen in ICU and what the impact is on patients and families.

The study is funded by the Resuscitation Council (UK) and sponsored by the Intensive Care National Audit and Research Centre.

Project Details
Principal Investigator: Dr Matt Thomas
Study Completion: 01/11/2021
Local Ref: 4549

Rib fractures are a common injury. They usually occur as a result of a serious injury, such as that suffered in a road traffic accident or fall from a height. They can also occur in less traumatic accidents, often in the elderly who have fragile bones. Rib fractures are painful, and can cause problems with breathing.

The lung tissue is just underneath the ribs and when a fracture occurs this is also often injured. As a result, rib fractures can lead to problems such as pneumonia, pulmonary effusions (fluid in the lung due to swelling) and some patients can even die as a result of the injury. Traditionally rib fracture were treated without the need for an operation. Doctors use supportive treatments such as pain relief and physiotherapy to help patients recover.

Fractures in other bones are usually fixed with an operation that secures the broken bones using metal plates and screws. Recently surgeons have found that some rib fractures can also be fixed in this way. They have found operating early on in the care pathway for these patients leads to better recovery and improved quality of life. However, surgery always carries some risk, especially in patients who have had a major injury. We don’t know if the surgical treatment, and its risks are better than the current non-operative/supportive treatments.

ORiF is a randomised controlled trial which will compare management pathways within the first 72hours of admission. These include operative treatment plus standard care versus standard care alone. The study will look at all cause mortality and assess the clinical and cost effectiveness of the treatments and will assess patients' quality of life over a 12 month period. Information about the treatment and outcomes will be collected via patient hospital records, the Trauma Research Audit Network (TARN) and research-specific patient questionnaires.

Project Details
Principal Investigator: Dr Benjamin Ollivere
Local Ref: 4645

There is some evidence that beta-blocker drugs can improve the chances of surviving after severe traumatic brain injury but there are worries about the side effect of low blood pressure. This study will use a very short acting beta-blocker and aims to find a dose that will mean patients receive the drug without an effect on blood pressure.

The study is funded by the Research for Patient Benefit Programme of the NIHR and sponsored by North Bristol NHS Trust.

Project Details
Principal Investigator: Dr Matt Thomas
Local Ref: 4535

This national observational study aimed to define the pattern of multi-organ failure in trauma centres across the UK.

This study was run by Queen Mary’s University London.

For more information about this study, visit the CT4S website.

Project Details
Principal Investigator: Dr Matt Thomas
Study Completion: 04/06/2017
Local Ref: 3540

This interventional trial compared different ways of using a ventilator in severe lung injury. It was stopped early in October 2017 after publication of a similar study raised concerns about safety of the new approach. Results from this trial will be available in due course.

The study was led by Monash University in Melbourne, Australia and the Australia and New Zealand Intensive Care Society (ANZICS).

For more information about this study, visit the Monash University website.

Project Details
Principal Investigator: Dr Matt Thomas
Study Completion: 13/10/2017
Local Ref: 3651

This national multi-centre study tested the performance of a new way of diagnosing septicaemia (blood poisoning).

Sepsis is the term used to describe serious infections. Up to half of all hospitalised patients with sepsis may die. It is caused by microrganisms (microbes), such as bacteria, and one of the most important parts of treating patients with sepsis is to give them the right antibiotics as soon as possible to treat the underlying infection. Many different microbes can cause sepsis. Currently the only way to find out for sure which one to target in any particular patient is to wait for it to grow in a laboratory from a sample of their blood, or other samples (culture).

As it takes at least 24-48 hours to grow in the laboratory, doctors choose 'best guess' antibiotics that can treat a lot of different microbes before they know which one would be the best fit. These are not always the right antibiotics for that particular individual, and sometimes patients only get the right treatment once there is a result from the laboratory.

Randox Ltd has developed a new bedside device based on technology that is able to identify bacteria in patients' blood within just one hour. Looking only for characteristic fragments of over 40 different microbes means that doctors’ decisions about which treatment to give patients will not need to wait for over a day for the microbe to grow in a laboratory. This allows treatments to be better targeted from a much earlier stage. The aim of this study was to investigate how well the new TEST-IT is able to identify microbes in comparison to blood culture, which is currently the best method of measurement (gold standard).

This study was run by the Northern Ireland Clinical Trials Unit (NICTU) and was funded by Innovate UK.

For more information about this study, visit the NICTU website.

Project Details
Principal Investigator: Dr Matt Thomas
Study Completion: 28/02/2018
Local Ref: 4006

The 65 Trial asked if reducing the dose of medication to support blood pressure (vasopressors) in shock in patients over 65 will produce a better outcome to standard practice.

This national multi-centre study was run by the Intensive Care National Audit and Research Centre (ICNARC) and funded by the National Institute of Health Research (NIHR).

Project Details
Principal Investigator: Dr Matt Thomas
Study Completion: 16/03/2019
Local Ref: 4028

This trial was a multi-centre prospective diagnostic test accuracy study assessing the performance of three rapid tests for fungal infection. The accuracy of these tests was compared and the optimal test (or combination) identified. The emphasis being on their ability to rule out infection. Although fungal infection, most often with Candida, is rare (0.6% of patients in UK ICUs) the mortality is high, hence the importance of getting the diagnosis right.

The study was run by the Northern Ireland Clinical Trials Unit and is funded by the National Institute of Health Research.

For more information about this study, visit the NIHR website.

Project Details
Chief Investigator: Dr Matt Thomas
Study Completion: 31/03/2021
Local Ref: 4111

This trial is a UK wide multi-centre randomised trial to determine whether antibiotic treatment protocols, based on daily monitoring of C-Reactive Protein (CRP) or procalcitonin (PCT), safely allow a reduction in duration of therapy. The overall duration of antibiotic treatment for infection is often not certain because clinical signs and microbiology tests are not useful to monitor a patient’s response. Proteins in blood – CRP and PCT – are often raised in sepsis and fall with antibiotic treatment. They provide an opportunity to personalise the duration of antibiotics and to provide population benefit.

The study is run by the Warwick Clinical Trials Unit and is funded by the National Institute for Health Research.

Project Details
Principal Investigator: Dr Matt Thomas
Study Completion: 30/04/2021
Local Ref: 4110

This is a randomised trial of three different sedative drugs used to help patients who need support from a ventilator. The aim is to find out whether minimising the use of the standard drug (propofol) means people spend less time on the ventilator, if this is safe and if this represents value for money.

The study is funded by the Health Technology Assessment Programme of the NIHR and is sponsored by the Academic and Clinical Central Office for Research (ACCORD) in Edinburgh.

Project Details
Principal Investigator: Dr Matt Thomas
Study Completion: 31/07/2021
Local Ref: 4308