Challenges we meet

One in two Australians will be admitted to an ICU during their lifetime.

Intensive care is the last line of defence when health goes seriously wrong; the most vulnerable patients are found in Intensive Care Units (ICUs), where they receive around the clock care from dedicated teams of specially trained clinicians, including doctors, nurses, physiotherapists, nutritionists and other allied health professionals. Each year, 63,000 Australians are admitted to an ICU.

In Australia, the cost of caring for patients needing mechanical ventilation is more than $1.5 billion per year, and the mortality rate remains higher than the annual road toll.

The high levels of staffing required, and costly life-saving technologies supporting patients, mean that costs per patient have sky-rocketed.

We’re working to improve patient outcomes and reduce overall costs, through a suite of research projects that will identify and streamline best care practices. Our work in synthesising evidence, creating clinical guidelines and driving translation into practice will support these goals.

Better use of emerging life support technologies will improve patient outcomes.

Invasive life support is a key area of research for our Centre.

Mechanical ventilation is common in ICU.

A breathing tube is inserted into the patients’ airways to allow air and oxygen to be pushed into the lungs under positive pressure. It is costly, and prolonged mechanical ventilation has been associated with lung injury and long-term functional impairment. It is also unclear what fraction of inspired oxygen is best to deliver via mechanical ventilation, and it is possible that different types of patients respond differently to a higher or lower fraction of inspired oxygen.

Extracorporeal membrane oxygenation (ECMO) is an emerging technology.

It offers an alternative means of respiratory or cardiac support, whereby blood gasses are exchanged outside the body. Whilst holding great promise, it is expensive, and adoption has exploded globally at a rate that has outpaced our ability to support best practice with evidence. Given the high rate of mortality for ECMO patients – 43 per cent for acute respiratory failure and 68 per cent for cardiac failure – optimising use is crucial.

Following up patients will enable treatments that support their long-term goals and needs.

Long-term physical and mental health outcomes of patients discharged from ICUs is another focus area for our team. ICU survivors often face months of intensive recovery and disability, some of which may be irreversible. They may face huge psychological challenges as they come to terms with new disability, and impacts on work, family and quality of life.

Our patient-first research program will provide objective evidence around physical outcomes, and subjective evidence around long-term outcomes that matter most to our patients. Both of these will inform future care.