Intensive care research at Subiaco

The Intensive Care Research Group are involved in a range of projects including:

• supporting junior medical officers (JMOs) and medical students with audits
• single and multi-site research initiated at St John of God Subiaco Hospital
• large, investigator-initiated studies originating in Australia and internationally

Key research areas for intensive care medicine are cardiothoracic surgery, patient experiences and outcomes, embedding research in Clinical Quality Registries, and the treatment of community acquired pneumonia and COVID-19 related pneumonia.

In addition to contributing to national and international clinical trials, members of the Intensive Care Research Group have developed and published multiple studies conceived to address the specific needs of patients admitted to one of the busiest private intensive care units (ICUs) in Australia.

The focus has been on particular areas of interest and expertise including the use of clinical quality registry data to investigate the processes and outcomes associated with bariatric surgery, delivering the highest quality care to patients undergoing cardiothoracic surgery, support of the next of kin of patients admitted to the ICU, investigating the effect of probiotic therapy on nosocomial infection and other outcomes in critical illness, and the importance of sleep in recovery from critical illness.

The Intensive Care Research Group is also involved in REMAP-CAP, led by Prof Steve Webb as the principal investigator. This is an international adaptive randomised controlled trial of treatments for community-acquired pneumonia that also includes patients with COVID-19. The trial is supported by multiple international funding bodies including the European Union, National Institutes of Health Research in the United Kingdom, Canadian Institute for Health Research, Health Research Council of New Zealand, and the National Health Medical and Research Council in Australia, as well a $2m grant from the Minderoo Foundation.

REMAP-CAP has identified multiple effective therapies for patients with severe COVID-19, as well as identifying that several promising therapies were unfortunately not effective.

Consultant Intensivists
Prof Steve Webb (Director of Clinical Trials St John of God Healthcare Subiaco and Consultant Intensivist)A/Prof Kwok Ho
A/Prof Ed Litton (Research Fellow and Consultant Intensivist)
Dr John Lewis (Head of Department ICU and Consultant Intensivist)

Research Officers
Janet Ferrier RN
Lesley Kemp RN

1. Litton, E., Anstey, M., Broadhurst, D., Chapman, A., Currie, A., Ferrier, J., Gummer, J., Higgins, A., Lim, J., Manning, L., Myers, E., Orr, K., Palermo, A. M., Paparini, A., Pellicano, S., Raby, E., Rammohan, A., Regli, A., Richter, B., Salman, S., Strunk, T., Waterson, S., Weight, D., Wibrow, B., Wood, F. (2021). Early and sustained Lactobacillus plantarum probiotic therapy in critical illness: the randomised, placebo-controlled, restoration of gut microflora in critical illness trial (ROCIT). Intensive care medicine, 47(3), 307–315. 10.1007/s00134-020-06322-w

2. Corcoran, T. B., Myles, P. S., Forbes, A. B., Cheng, A. C., Bach, L. A., O'Loughlin, E., Leslie, K., Chan, M., Story, D., Short, T. G., Martin, C., Coutts, P., Ho, K. M., PADDI Investigators, Australian and New Zealand College of Anaesthetists Clinical Trials Network, & Australasian Society for Infectious Diseases Clinical Research Network (2021). Dexamethasone and Surgical-Site Infection. The New England journal of medicine, 384(18), 1731–1741. doi.org/10.1056/NEJMoa2028982

3. Webb, S., WHO Working Group on the Clinical Characterisation and Management of COVID-19 infection (2020). A minimal common outcome measure set for COVID-19 clinical research. The Lancet. Infectious diseases, 20(8), e192–e197. doi.org/10.1016/S1473-3099(20)30483-7

4. REMAP-CAP Investigators, Gordon, A. C., Mouncey, P. R., Al-Beidh, F., Rowan, K. M., Nichol, A. D., Arabi, Y. M., Annane, D., Beane, A., van Bentum-Puijk, W., Berry, L. R., Bhimani, Z., Bonten, M., Bradbury, C. A., Brunkhorst, F. M., Buzgau, A., Cheng, A. C., Detry, M. A., Duffy, E. J., Estcourt, L. J., … Derde, L. (2021). Interleukin-6 Receptor Antagonists in Critically Ill Patients with Covid-19. The New England journal of medicine, 384(16), 1491–1502. doi.org/10.1056/NEJMoa2100433

5. Angus, D. C., Derde, L., Al-Beidh, F., Annane, D., Arabi, Y., Beane, A., van Bentum-Puijk, W., Berry, L., Bhimani, Z., Bonten, M., Bradbury, C., Brunkhorst, F., Buxton, M., Buzgau, A., Cheng, A. C., de Jong, M., Detry, M., Estcourt, L., Fitzgerald, M., Goossens, H., … Summers, C. (2020). Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19: The REMAP-CAP COVID-19 Corticosteroid Domain Randomised Clinical Trial. JAMA, 324(13), 1317–1329. doi.org/10.1001/jama.2020.17022