CABRINI’S COVID-19 RESPONSE
We currently have precautionary measures in place to protect our patients and staff. Read more

Intensive care research department

About the intensive care research department

The Cabrini Intensive Care Unit (ICU) 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. Research in the ICU is about questioning current practices and determining how we can get the best outcomes for our patients based on the evidence found.

It 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 extended follow up of patients, we hope to ascertain the long-term impacts an ICU admission can have on both patients and their families – emotionally, physically, financially and socially.

Team members

We are an active member of the Australian and New Zealand Intensive Care Society (ANZICS) research community, and collaborate closely with the ANZICS Clinical Trials Group. Notable collaborative research (and associated publications):

INternational observational study To Understand the impact and BEst practices of airway management in critically ill patients – INTUBE study
A/Prof David Brewster was the National Lead for Australia and New Zealand

Russotto V, Myatra SN, Laffey JG, Tassistro E, Antolini L, Bauer P, Lascarrou JB, Szuldrzynski K, Camporota L, Pelosi P, Sorbello M, Higgs A, Greif R, Putensen C, Agvald-Öhman C, Chalkias A, Bokums K, Brewster D, Rossi E, Fumagalli R, Pesenti A, Foti G, Bellani G; INTUBE Study Investigators. (2021) Intubation practices and adverse peri-intubation events in critically ill patients from 29 countries. JAMA. 325(12):1164-1172. doi: 10.1001/jama.2021.1727.

Restrictive or Liberal Red-Cell Transfusion for Cardiac Surgery trial – TRICSIII trial

  • Mazer CD, Whitlock RP, Fergusson DA, Hall J, Belley-Cote E, Connolly K, Khanykin B, Gregory AJ, de Médicis É, McGuinness S, Royse A, Carrier FM, Young PJ, Villar JC, Grocott HP, Seeberger MD, Fremes S, Lellouche F, Syed S, Byrne K, Bagshaw SM, Hwang NC, Mehta C, Painter TW, Royse C, Verma S, Hare GMT, Cohen A, Thorpe KE, Jüni P, Shehata N; TRICS Investigators and Perioperative Anesthesia Clinical Trials Group. (2017) Restrictive or Liberal Red-Cell Transfusion for Cardiac Surgery. N Engl J Med 377(22):2133-2144. doi: 10.1056/NEJMoa1711818.
  • Mazer CD, Whitlock RP, Fergusson DA, Belley-Cote E, Connolly K, Khanykin B, Gregory AJ, de Médicis É, Carrier FM, McGuinness S, Young PJ, Byrne K, Villar JC, Royse A, Grocott HP, Seeberger MD, Mehta C, Lellouche F, Hare GMT, Painter TW, Fremes S, Syed S, Bagshaw SM, Hwang NC, Royse C, Hall J, Dai D, Mistry N, Thorpe K, Verma S, Jüni P, Shehata N; TRICS Investigators and Perioperative Anesthesia Clinical Trials Group. (2018) Six-Month Outcomes after Restrictive or Liberal Transfusion for Cardiac Surgery. N Engl J Med 379(13):1224-1233. doi: 10.1056/NEJMoa1808561.

Australia and New Zealand Cardiac Arrest Outcome Determinants and ECMO suitability study – (ANZ CODE) trial

  • Jones D et al. (ANZ-CODE investigators). (2019) The epidemiology of in-hospital cardiac arrests in Australia: A prospective multicentre observational study. Crit Care and resusc. 21(3) 180-187.
  • Pound GM, Jones D, Eastwood GM, Paul E, Hodgson CL; Australia and New Zealand Cardiac Arrest Outcome and Determinants of ECMO (ANZ-CODE) Investigators. (2022) Long-Term Functional Outcome and Quality of Life Following In-Hospital Cardiac Arrest-A Longitudinal Cohort Study. Crit Care Med. 50(1):61-71. doi: 10.1097/CCM.0000000000005118.

ANZICS CTG research collaboration with Monash University to establish a database of COVID-19 pandemic ICU patients – SPRINT SARI trial

Burrell AJC, Pellegrini B, Salimi F, et al. (2020) Outcomes of COVID-19 Patients Admitted to Australian Intensive Care Units during the Early Phase of the Pandemic. Med J Aust. 214(1):23-30. doi: 10.5694/mja2.50883.

International database of COVID intubations to look at HCW infection transmission – IntubateCOVID

  • El‐Boghdadly K, Wong DJN, Owen R, et al. (2020) Risks to healthcare workers following tracheal intubation of patients with COVID‐19: a prospective international multicentre cohort study. Anaesthesia. 75:1437– 47. doi: 10.1111/anae.15170.
  • Wong DJN, El‐Boghdadly K Owen R, et al. (2021) Emergency airway management and complications of tracheal intubation in patients with COVID-19: a prospective international multicentre cohort study. Anesthesiology. 135(2):292-303. doi: 10.1097/ALN.0000000000003791.

ANZICS CTG research collaboration with Monash University to establish a database of COVID-19 pandemic ICU patients – COVID Recovery (2020)

The Intensive Care Unit Randomized Trial Comparing Two approaches to Oxygen Therapy: Translating Research into Practice Study – ICU ROX TRIPS (2017/18)

  • Brewster DJ, Begley JL, Marshall SD. (2020) The rise and fall of the aerosol box; and what we must learn from the adoption of untested equipment. Emerg Med J. 38(2):109-110. doi:10.1136/emermed-2020-210761.
  • Brewster DJ, Butt WW, Gordon L and Rees CE. (2020) Leadership in intensive care: a review. Anaesth Intensive Care. 48(4):266-276. doi: 10.1177/0310057X20937319.
  • Brewster DJ, Groombrige CJ, Gatward JJ. (2021) Consensus statement: Safe Airway Society principles of airway management and tracheal intubation specific to the COVID-19 adult patient group. Reply to letter. Med J Aust. 214(1):46-46.e1. doi: 10.5694/mja2.50889.
  • Brewster DJ, Nickson CP, McGloughlin S, Pilcher D, Sarode VV, Gatward JJ. (2021) Preparation for airway management in Australia and New Zealand ICUs during the COVID -19 pandemic. PLoS One. 16(5):e0251523. doi: 10.1371/journal.pone.0251523.
  • Clark M, Brewster DJ, Dhaliwal JS, Jones L, and Teng J. (2020) An early Australian experience with COVID-19 in an aged care facility: Uncertainty and fear. Sydney NSW Australia. MJAinsight. https://insightplus.mja.com.au/2020/44/uncertainty-and-fear-aged-care-in-a-time-of-covid-19/
  • Cosentino CB, Mitchell BG, Brewster DJ, Russo PL. (2020) The utility of frailty indices in predicting the risk of health care associated infections: A systematic review. Am J Infect Control. S0196-6553(20)31037-3. doi: 10.1016/j.ajic.2020.12.001.
  • Fennessy P, Greco E, Gelber N, Brewster DJ, Reeves JH. (2021) Emergency Front-of-Neck Airway Rescue Via the Cricothyroid Membrane: A High-Resolution Computed Tomography Study of Airway Anatomy in Adults. Anesthesia & Analgesia: 133(1):187-195 doi: 10.1213/ANE.0000000000005583.
  • Higgins AM, Serpa Neto A, Bailey M, Barret J, Bellomo R, Cooper DJ, Gabbe BJ, Linke N, Myles PS, Paton M, Philpot S, Shulman M, Young M, Hodgson CL, PREDICT Study Investigators. (2021) Predictors of death and new disability after critical illness: a multicentre prospective cohort study. Intensive Care Med. 47:772-781. doi: 10.1007/s00134-021-06438-7.
  • Lee S, Bradley PL, Brewster DJ, Chahal R, Poon L, Segal R, Totonidis S, Tsang D and Ng M. (2021) Airway management in the adult patient with COVID-19 – High Flow Nasal Oxygen or not? A summary of evidence and local expert opinion. Anaesthesia and Intensive Care. doi: 10.1177/0310057X211024691.
  • Maiden MJ, Bone A, Fitzpatrick M, Sarode V; George Institute for Global Health, and the Australian and New Zealand Intensive Care Society Clinical Trials Group. (2021) Physical restraint of patients in Australia and New Zealand intensive care units. Intensive Care Med. 47(2):234-236. doi:10.1007/s00134-020-06287-w.
  • Perkins EJ, Edelman DA and Brewster DJ. (2020) Australian anaesthetists reliant on smartphone for patient safety. Anaesthesia and Intensive Care. 48(5):366-372 doi:10.1177/0310057X20947427.
  • Russotto V, Myatra SN, Laffey JG, Tassistro E, Antolini L, Bauer P, Lascarrou JB, Szułdrzyński K, Camporota L, Pelosi P, Sorbello M, Higgs A, Greif R, Putensen C, Agvald-Öhman C, Chalkias A, Bokums K, Brewster DJ, Fumagalli R, Pesenti A, Foti G, Bellani G (for INTUBE Study Investigators). (2021) Intubation practices and adverse peri-intubation events in critically ill patients from 29 countries. JAMA. 325(12):1164–1172. doi:10.1001/jama.2021.1727.

BALANCE

Researchers: Vineet Sarode, David Brewster, Deirdre Murphy Shannon Simpson

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: Deirdre Murphy, Vineet Sarode, David Brewster, Steve Philpot, Shannon Simpson

Treatment of invasively ventilated adults with Early Activity and Mobilisation. A Prospective Multicentre Phase III 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.

SPRINT- SARI

Researchers: David Brewster, Shannon Simpson

Short Period Incidence study of Severe Acute Respiratory Infection. SPRINT-SARI is an ambitious international collaborative project aimed at characterizing SARI patients as a global problem to better inform management strategies and ultimately to improve the ability of health care systems to rapidly respond to emerging infectious causes of SARI. We continue to recruit for any patients diagnosed with COVID-19.

COVID RECOVERY

Researchers: David Brewster, Shannon Simpson

The objectives are to measure disability free survival and the long term outcomes of critically ill patients with COVID-19 in order to identify effectiveness of care and costs to six months. Additionally we will describe the physiotherapy interventions delivered in ICU and the patients and family experiences.

POINT PREVALENCE PROGRAM

Researchers: Shannon Simpson

Data collected on pre-determined day across multiple ICUs answering a pre-determined set of questions and practices present on the day. This data helps shape future research questions and has been conducted annually for the past 13 years.

Recent research highlights

Aerosols put healthcare workers at significant risk of COVID-19 transmission: Cabrini ICU Research leads development of national guidelines to allow safe airway practices

  • Aerosol transmission of COVID-19 is of particular concern because it can remain suspended in the air and is easily produced by actions such as coughing, sneezing, shouting and singing. This puts frontline healthcare workers at greatest risk. Common ICU procedures like intubation, extubation and tracheotomy are aerosol generating.
  • Led by A/Prof David Brewster, 14 experts were assembled in March 2020 to prepare a statement when an urgent need for guidelines was identified in preparation for the COVID-19 pandemic.
  • Our consensus statement (national guideline for intubation of adult COVID-19 patients) has had a huge impact. Over 370 citations since its publication in June 2020
  • More than 90 per cent of ICUs used these clinical guidelines in intubating COVID-19 patients both in Australia and internationally.

Download a copy of the paper