ICU Nurse

Intensive Care Current Research

A vital branch of our Acute Care Department, the Intensive Care Clinical Research Team deliver national and international multi-centre studies in Intensive Care Medicine and related specialities, working to advance the care that we give to our patients.

The team also work closely with colleagues across the Trust and beyond to develop new and innovative research ideas that test new treatments especially in the fields of major trauma and neurosciences.

Please speak to the person treating you to find out if there is a research study that may be able to help you.

Current Studies:

EBB-TBI

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
Planned End Date: 28/06/2021
Local Ref: 4535

The Operative Rib Fixation (ORiF) Study

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
Planned End Date: 31/08/2021
Local Ref: 4645

UK-ROX

Each year, around 184,000 patients are admitted to NHS intensive care units (ICUs) and over 30% require help with their breathing using a ventilator (breathing machine). Giving oxygen through the ventilator is an essential part of this treatment. However, we do not know how much oxygen should be given to patients to optimise their recovery. Both too much, and too little, oxygen may cause harm. The concentration of oxygen given through the ventilator is adjusted according to how much oxygen can be detected in a patient’s blood, known as 'oxygen saturation'. Some studies have shown that in unwell hospitalised patients, having a lower, rather than higher, oxygen saturation may more be beneficial.

We therefore intend to conduct a large clinical trial to find out whether using a lower oxygen target (conservative oxygen therapy) to guide oxygen treatment might lead to better outcomes for patients when compared with the approach currently used in NHS ICUs (usual oxygen therapy). The study will include 16,500 patients from 100 UK NHS ICUs. Patients will be randomly assigned to either the conservative oxygen therapy or usual oxygen therapy group. We will follow all patients up to 90 days later by ‘linking’ study data with routinely collected national records. We will find out if conservative oxygen therapy was more effective than usual oxygen therapy by comparing the number of patients alive in each group at 90 days.

Patient recruitment will start in May 2021 and end in 2023. Results will have a large and immediate impact on ICU clinical practice and on patient outcomes throughout the NHS. Data from the 16,500 patients in this study will also contribute to a larger global study of 40,000 patients. The global study will answer similar questions about oxygen therapy in ICU patients but from an international perspective.

Project Details
Principal Investigator: Dr Matt Thomas
Planned End Date: 31/01/2023
Local Ref: 5028

Statins for Improving Organ Outcome in Transplantation (SIGNET)

We wish to investigate whether giving deceased organ donors a single dose of the commonly prescribed drug, Simvastatin, is beneficial for transplant recipients.

All donated organs have suffered some damage. As the brain dies chemicals are released which cause an “inflammation” of the body. Measurements of this “inflammation” link to how well the organs function after transplant.  We know that statins have many benefits, including dampening down inflammation in the body and individual organs. 

Doctors in Finland linked this information in a clinical study. Organ donors, donating their heart, were randomised to receive a statin. The recipients who received a heart from a donor who had statins had less heart damage.  This was a small study but there was a small benefit for lung and liver recipients and no disadvantage in receiving any organ from a donor who had received the drug.   

A significant number of organs offered for transplant are not used; for the heart, this figure is about 75%.  The reason for being so selective is that poor function of the donor heart in the recipient is the most common cause of death after a transplant. Any step in the donor which might improve the transplanted heart, or other organ, could have a major benefit to the recipient.

We plan to enrol 650 adult brain dead donors across the UK per year in a randomised controlled trial.  Half the donors will receive Simvastatin in addition to standard care, compared to standard care only.  The drug will be given after the donor family have consented to both organ donation and involvement in research.  

Half of the recipients will receive a heart from a donor given the drug. We will follow the results of transplant, using data already collected in the national transplant database. No extra data or blood samples will be needed.

Project Details
Principal Investigator: TBC
Planned End Date: TBC
Local Ref: 4145

Paused Studies:

Ketogenic diet in traumatic brain injury

A ketogenic (or low carbohydrate, high fat) diet is known to help in some brain diseases and may protect the brain after trauma. This study aims to determine the levels of ketones in the blood that a standard ketogenic feed can produce in patients after serious traumatic brain injury.

The study is funded by the Bristol Health Research Charity and the ICU Charitable Fund. It is sponsored by North Bristol NHS Trust.

Project Details
Principal Investigator: Dr Matt Thomas
Planned End Date: TBC
Local Ref: 4145

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About Research & Innovation

NBT Researcher

Find out more about our research and how we're working to improve patient care.

Contact Research & Innovation

Research & Innovation
North Bristol NHS Trust
Floor 3, Learning & Research Centre
Southmead Hospital
Westbury-on-Trym
Bristol, BS10 5NB

Telephone: 0117 4149330
Email: research@nbt.nhs.uk