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Continuous infusions of sedatives are commonly used in Australian Intensive Care Units (ICUs) to provide patient comfort and promote tolerance of ICU treatment. These infusions are occasionally stopped to allow patients to return to consciousness to enable assessment of their neurological function and sedation requirements. A routine daily interruption to sedation has been recommended as a standard of care in ICU patients (Dellinger, Crit Care Med, 2004). This recommendation is based on the work of Kress (NEJM, 2000) who enrolled 180 patients in a medical ICU in Chicago. Several aspects of this work significantly reduce the appropriateness of generalising these results to Australian ICU practice. Fully exploring the impact of a daily interruption to sedation is warranted in the context of Australian ICU practice prior to its adoption as a standard of care. In this pilot study, the standard practice of interruption to sedation on an ad-hoc basis will be compared to a routine interruption to sedation for a defined period each day in Australian ICUs. These comparisons will be based on the length of time that mechanical ventilation, ICU and hospital treatment is required and psychological well being 6 months after discharge from ICU. All patients enrolled in the study will be given an infusion replacing their prescribed sedation for a defined period each day. The replacement infusions will be either normal saline or identical to the patients prescribed sedation. This pilot study will test the proposed blinding procedures and facilitate an appropriate power calculation.

In this study we are testing a public health intervention to reduce the incidence of childhood asthma. The two interventions that we are testing, that is housedust mite allergen avoidance and omega-3 fatty acid supplementation, are based on the strongest risk factors for asthma that have been identified in observational studies to date. This is the first trial in the world to test whether interventions directed at a potent causative factor (housedust mite allergens) or a protective factor (omega-3 fatty acids) can halt or reverse the increasing prevalence of childhood asthma. If either of these interventions is effective, we will have the potential for the very first time to significantly reduce the incidence of asthma in young children.

A Phase II study of efficacy and safety of Pegasys® in patients with chronic myeloid leukaemia (CML) in complete or near complete cytogenetic remission but persisting molecular positivity at 600 mg or maximum tolerated dose of Glivec Patients with Ph+ve CML with complete or near complete cytogenetic responses to Glivec® at 600 mg or maximum tolerated dose, but with persisting molecular positivity. Primary Objective: To assess whether adding Pegasys® to Glivec® in these patients improves molecular response status (by PCR quantification of bcr-abl transcripts)

This study is designed to assess whether a new technique called facilitated endoscopic retrograde cholangiopancreatography (ERCP) is or is not superior to conventional ERCP to remove stones found in the bile duct at the time of laparoscopic cholecystectomy. ERCP is an endoscopic procedure used to facilitate the radiological examination and subsequent manipulation of the common bile duct (eg. opening it up, which is called sphincterotomy). Both facilitated and conventional ERCP are performed as a separate procedure after the initial gallbladder surgery. This is a comparative study of these two techniques in a randomised clinical trial. The aim of this randomised clinical trial is to enable surgeons to decide whether placement of a plastic stent at the time of laparoscopic cholecystectomy will improve the success rate and safety of subsequent ERCP and sphincterotomy.

Multicentre prospective double blind randomized controlled trial comparing 3 surgical procedures for gastro-oesophageal reflux. All groups will undergo a clinically acceptable operation, according to standard clinical indications. The study will be performed in multiple centres throughout Australia and New Zealand. The study will be coordinated from FMC and RAH in SA. Patients will be recruited over a 2 year period. Follow-up will continue for up to 20 years.

The need for supplying fluids in paediatric bronchiolitis (severe viral airway infection of the infant) is frequent, and is the consequence of reduced feeding, sweating, and fever., There are currently 2 means of supplying fluids, intravenous or nasogastric. Nasogastric rehydration (NR) means giving fluids through a feeding tube inserted through the nostrils into the stomach thus eliminating the effort of drinking. It is generally effective and has few complications. Intra venous rehydration (IR) means giving fluids directly into a vein through a drip. It is often difficult to insert a drip in this particular age group, whereas the nasal feeding tube is generally easier to insert. The potential complications of IR are water overload and electrolyte imbalances. The main possible complications of NR is vomiting. The role of NR in bronchiolitis is, however, controversial. It is, for example, an accepted treatment in Scandinavia and Switzerland, whereas IR is the accepted treatment at the RCH Melbourne. Even within Australia there is no standard of care as such among the different hospitals with most hospitals using a combination of NR and IR, without any guidelines. The little existing evidence shows that NR in bronchiolitis is safe and well tolerated. The major concern raised with NR is the partial obstruction of the airway, by cousing ablockage of the nostril in young children who mostly breathe through the nose, thus theoretically causing further breathing problems. But its clinical significance, especially in bronchiolitis, is not clear and has not been the subject of clinical trials. In this prospective study we will compare Nasogastric and Intravenous treatment in bronchiolitis.