p.p1 {margin: 0.0px 0.0px 0.0px 0.0px; font: 15.0px Times; color: #323333; -webkit-text-stroke: #323333} p.p2 {margin: 0.0px 0.0px 0.0px 0.0px; font: 18.0px Arial; color: #323333; -webkit-text-stroke: #323333} span.s1 {font-kerning: none} span.s2 {text-decoration: underline ; font-kerning: none; color: #772583; -webkit-text-stroke: 0px #772583} span.s3 {font: 14.0px Calibri; font-kerning: none; color: #000000; -webkit-text-stroke: 0px #000000} span.s4 {font: 13.0px Calibri; font-kerning: none} span.s5 {font: 9.0px 'Times New Roman'; font-kerning: none} Fluid administration is a fundamental component of the management of critically ill patients and the choice of fluid is a longstanding issue of debate. Worldwide, 0.9% saline has traditionally been the most widely used resuscitation fluid, however its use is increasingly challenged by evidence that suggests its high chloride content may have clinically important adverse effects. Two pivotal George Institute trials, the Saline versus Albumin

A prospective, multicentre, parallel group, concealed, blinded, randomised controlled trial in critically ill mechanically-ventilated adults. The aim is: To determine whether the administration of placebo (daily administration of 10 ml 0.9% saline IV) is non-inferior to standard practice (daily administration of pantoprazole 40 mg IV) when judged by the incidence of clinically important gastrointestinal (GI) bleeding?  To determine whether the administration of placebo (daily administration of 10 ml 0.9% saline IV) is superior to standard practice (daily administration of pantoprazole 40 mg IV) as it results in a reduction in net harm by reducing the incidence of serious infectious complications (ventilator-associated pneumonia and Clostridium difficile infection) and therefore "downstream" harms when measured as duration of mechanical ventilation, intensive care unit (ICU) and hospital length of stay, and 90-day mortality? 

Current status– finished recruitment – in follow-up.TRIDENT is an international medical research study which aims to determine the effect of more intensive blood pressure control to prevent recurrent stroke in patients who have had an intracerebral haemorrhage (ICH) (a stroke caused by ruptured blood vessel in the brain). The aim of this project is to test the superiority of a fixed low-dose combination blood pressure-lowering pill (Triple Pill) strategy in recurrent stroke in patients with a history of ICH.Acute ICH accounts for at least 10% of the 20 million new strokes in the world each year. ICH survivors are at high risk of recurrent stroke and other serious cardiovascular events. Numerous studies have proven the benefit of stroke survivors reducing their risk of recurrent stroke through taking blood pressure-lowering medications. However, studies have shown that many ICH survivors are either not receiving any blood pressure-lowering medication or they are receiving inadequate control.The TRIDENT stu

Chronic kidney disease (CKD) has become a growing public health problem worldwide with a serious socio-economic impact. CKD results in mortality due to progression to end-stage renal disease and a disproportionate increase in the risk of cardiovascular disease (CVD) and associated deaths. Recent advances suggest the possibility of using biologically relevant biomarkers to develop prediction algorithms for outcomes in patients with CKD. However, there are no large longitudinal studies comparing the differences in racially, geographically and genetically different populations. Aim: Project aims to establish a large cohort of Indian patients with moderate kidney failure (40-60% reduction in kidney function) by enrolling 5000 patients cared for at 8 centers nationwide, who will be prospectively followed for a minimum of five years and to develop prediction algorithms. It will be the first study to evaluate the prediction power of biologically important biomarkers on clinically relevant end

Healthcare associated infections (HAI) cause significant and life-threatening harm to patients and incur major additional costs. Patients with kidney disease are especially susceptible to HAI, due to the harm associated with central dialysis catheter use. These catheters, essential to the delivery of life-sustaining dialysis treatment, are widely used and are a major driver of bloodstream infection and increased mortality seen in patients receiving dialysis. The REDUCCTION Partnership Project has the following aims: To define the national, clinical and economic burden of dialysis catheter infections in Australia and New Zealand To implement an evidence-based and systematic intervention package using a stepped-wedge cluster design with the objective of reducing dialysis catheter-related bacteraemia. To establish a framework for monitoring dialysis catheter-related bacteraemia and sustaining improvements from the intervention phase. Current status: Data collection for our primary analysis i

One of the 12 key priorities that the New South Wales government has committed to is reducing overweight and obesity rates of children by five percent over 10 years. This project aims to estimate the costs associated with achieving this target.

Background End stage kidney disease (ESKD) occurs when kidney function has deteriorated to the point that dialysis or a kidney transplant is required to stay alive.  Research undertaken by the George Institute published in the Lancet in March 2015 shows that the burden of ESKD around the world is growing, and that most of the expected increase will be in low and middle income countries. Dialysis is a safe and effective treatment for ESKD, but it is expensive, well beyond the means of the average patient and their families.  For this reason, in wealthy countries the cost of dialysis treatment is borne by the health care system.  In India there is no national system for paying for dialysis, and in many cases patients and their families must bear the cost themselves.   Many countries maintain a national registry of the treatment of ESKD so that clinical outcomes can be measured, improvements over time tracked, and benchmarking across services in different regions and countries c

Acute kidney injury (AKI) occurs in up to 20% of patients treated in intensive care units (ICU). When severe, it requires renal replacement therapy (RRT) and is associated with high healthcare costs and a high mortality. Beyond the acute high mortality, survivors of AKI carry long-term greater risks of mortality, requirement for institutional care and the development of chronic and end stage kidney disease. There are currently no proven treatments that reduce the burden of morbidity or mortality with AKI. The acute delivery of RRT to critically ill patients with AKI is common practice; yet there have been controversies regarding the optimal delivery of RRT for these patients. A number of randomised clinical trials have examined the delivered dose/intensity of RRT, RRT modality and RRT clearance mode. However, characterisation of the optimal time to initiate RRT, in particular whether earlier initiation translates into improved clinical outcomes, remains uncertain, and is a clear priority for higher quality

BackgroundAn increasing number of elderly patients are reaching end-stage kidney disease (ESKD) in developed countries including Australia. The outcomes for elderly patients entering dialysis programs are poorer than that of younger patients, with lower survival rates, significant impacts on quality of life and high burden of time spent in hospital. There is also a comparably large number of elderly patients with ESKD who do not enter onto dialysis programs, some of which are managed in combined palliative care/renal supportive care clinics and some of which are solely managed in primary care. An understanding about differences in survival and other important patient outcomes including quality of life, symptom burden and time spent in hospital is limited, due to a lack of high-quality prospective data. In turn, individualised decision-making about treatment pathways for elderly ESKD patients is challenging and highly variable. The ELDERLY Program consists of the 4 sub-studies: OUTLOOK, TIMELY, CONTE