CRE ACTIONS

In December 2014, the Critical Care Research Group (CCRG) was awarded a prestigious $2.5 million National Health and Medical Research Council, Centre of Research Excellence (CRE) in Advanced Cardio-respiratory Therapies Improving OrgaN Support (ACTIONS). CRE ACTIONS is a unique, global level collaboration of clinical, engineering and scientific experts in Ventricular Assist Devices (VAD) and Extra Corporeal Membrane Oxygenation (ECMO) who together with patients supported by these therapies, is addressing the range of key challenges associated with the clinical implementation of these technologies, to accelerate the translation of knowledge from the laboratory to the bedside.

About

The Critical Care Research Group (CCRG) at The Prince Charles Hospital, Brisbane, Australia is the largest multidisciplinary critical care research team in Australasia.

Cardiovascular disease is responsible for 11 per cent of health expenditure in Australia (2008/9); the burden of disease it imposes in terms of disability and premature death is second only to cancer. It is responsible for more deaths (30 per cent of all deaths) in Australia than any other disease group (Heart Foundation). The gold standard treatment for end-stage heart and lung failure is transplant however falling organ donation numbers gives rise to the need for artificial hearts and lungs to support our most critically ill patients in the management of acute and chronic end stage cardio-respiratory disease and as a bridge to transplantation.

Artificial hearts and lungs are increasingly used to support our most critically ill patients. The rapid and continuous expansion of these Mechanical Assist Devices (MADs), such as Extra Corporeal Membrane Oxygenation (ECMO) and Ventricular Assist Devices (VADs), in the management of acute and chronic end stage cardio-respiratory disease highlights the potential benefit to patients from research in this field. The barriers of complexity, cost and risk combine to inhibit the more widespread use of these devices.

As the ageing and ailing community of the 21st century increasingly depends on mechanical assistance in many forms, a greater understanding of patient-machine interaction is essential if this technology is to deliver its full potential. In December 2014, the CCRG was awarded a prestigious $2.5 million National Health and Medical Research Council, Centre of Research Excellence (CRE) in Advanced Cardio-respiratory Therapies Improving OrgaN Support (ACTIONS). CRE ACTIONS is a unique, global level collaboration of clinical, engineering and scientific experts in Ventricular Assist Devices (VAD) and Extra Corporeal Membrane Oxygenation (ECMO) who together with patients supported by these therapies, is addressing the range of key challenges associated with the clinical implementation of these technologies, to accelerate the translation of knowledge from the laboratory to the bedside.

CRE ACTIONS is the first mechanical cardio-respiratory support CRE in Australia based in a hospital and is researching device-related complications, improving device components, developing clinical practice guidelines, training clinical and engineering researchers and exploring the cost benefits of this technology ensuring all Australians can access state-of-the-art mechanical life support.

CRE ACTIONS has leveraged its research funding to over $9 million in conjunction with The University of Queensland, Metro North Hospital and Health Service, The Prince Charles Hospital Foundation, The Alfred, RPA, Monash University, The Queensland University of Technology, Griffith University, University of New South Wales and The Baird Institute for Applied Heart and Lung Surgical Research.

About CRE ACTIONS

 

CRE ACTIONS has also evolved into a multi-national collaborative extending across Australia, USA, United Kingdom, Germany, France, Russia, Scandinavia, Malaysia, Singapore, China, Japan, Korea, Taiwan and Taipei which has now led to PhD scholarships from the world’s best mechanical support hospitals all coming to work at CRE ACTIONS – including Belfast, Toronto, The Alfred, and the Pitié-Salpetriere Hospital, Paris.

The assembled team of clinicians, nurses, scientists, engineers, allied health practitioners and research staff and students in the fields of critical care, paediatric intensive care, cardiothoracic and general surgery, cardiology, anesthesia, transplantation and thoracic medicine, internal medicine, emergency medicine, radiology, pathology, haematology, physiotherapy, speech therapy, perfusion, transfusion medicine, molecular and cellular science, echocardiography, pharmacological science and health care economics mirrors the large inter-disciplinary team that works with a patient and provides the perfect opportunity to work in a silo-free environment to achieve best research outcomes that lead to improved clinical outcomes for a critically ill patient.

CRE ACTIONS aims to ensure that not only do MADs achieve their full potential, but that the knowledge gained is put into practice in an optimal way, with appropriate training for patients and clinical staff. In addition there is a full understanding of health care costs which may be attributable to treating patients with these devices. Through this, CRE ACTIONS aims to advance the understanding in this field, and in doing so, improve the lives of patients – today and into the future.

Key Research Objectives:

  • Understand the high impact pathological changes resulting from the body-device interface in patients supported by MADs.
  • Improve the physiological interface of cardio-respiratory mechanical devices.
  • Describe the changes in pharmacokinetics of drugs and nutrients essential to MAD therapy.
  • Improve the patient experience of these physically and psychologically challenging interventions through consumer participation in research.
  • Support development of public health policy with clinical practice guidelines and economic cost effectiveness analysis of MAD therapy.

 

Multi-faceted approach
CRE ACTIONS consolidates a multi-faceted approach

The patient is the ultimate beneficiary of CRE ACTIONS research as innovations driven by clinical needs and cutting edge research into advanced organ support techniques with equal emphasis on qualitative aspects of intensive care patient management all lead to better clinical outcomes for a critically ill patient.

In 2015, the CRE ACTIONS successfully bid and won the right to host the third meeting of the Asia-Pacific Chapter of the Extracorporeal Life Support Organization (ELSO) in Brisbane in 2017.

ELSO was founded in 1989 and is an international consortium of health care professionals and scientists who are dedicated to the development and evaluation of novel therapies for support of failing organ systems. The Asia-Pacific Chapter endeavours to promote the safe practice and science of ECLS in the region, while engaging other centers worldwide in collaborative research. 

AP ELSO 2017 – “ECMO and Beyond” will bring together an international consortium of health care professionals and scientists who are dedicated to the development and evaluation of novel therapies for support of failing organ systems and will showcase the work of CRE ACTIONS to the world.

                                      Asia-Pacific Chapter of the Extracorporeal Life Support Organization

Collaborators

CRE ACTIONS logoOur centre is proud to partner with many organisations in undertaking its mission to accomplish improved outcomes for people with heart failure and advanced cardiovascular disease.

 

 

 

 

 

 

Collaborators

Research

Overview

Cardiovascular disease is a leading cause of death, and is responsible for 17% of health expenditure in the USA and 11% in Australia (2008/9); the burden of disease it imposes in terms of disability and premature death is second only to cancer. It is responsible for more deaths (30% of all deaths) in Australia than any other disease group (Heart Foundation). The gold standard treatment of end-stage heart failure, heart transplantation, is limited by falling organ donation numbers.

The rapid and continuous expansion of the use of Mechanical Assist Devices (MADs), such as Extra Corporeal Membrane Oxygenation (ECMO) and Ventricular Assist Devices (VADs), in the management of acute and chronic end stage cardio-respiratory disease highlights the potential benefit to patients from research in this field. The barriers of complexity, cost and risk combine to inhibit the more widespread use of these devices.

Our research brings together expertise from around the world to investigate how to make mechanical hearts (MADs) more clinically viable.

By breaking down barriers across medical disciplines and geographic divides, CRE ACTIONS brings together researchers, clinicians educators and patients under a united cause: to conduct multi-disciplinary, collaborative research at the physiological and biological cardio-respiratory interface.

Our centre will undertake eight major research projects to make mechanical hearts a clinical reality.

Projects

  • Project 1 - Scientific interrogation of the clinical complications of clotting, bleeding and blood transfusions associated with mechanical assist devices (MADs) through an in-vivo ovine model.

Led by Professor Fraser, the objective of this project is to understand the high impact pathological changes in patients supported by MADs resulting from the body-device interface.

  • Project 2 - Infections & biofilm formation after VAD implantation

Led by Professor McGiffin and Associate Professor Barnett, the objective of this project is to understand the high impact pathological changes in patients supported by MADs resulting from the body-device interface 

  • Project 3 - Extend the use of echocardiography (ECHO) to improve visualisation of ventricular function, complications and cannula-cardiac interactions during mechanical assist device (MAD) therapy.

This projevt aims to understand the high impact pathological changes in patients supported by MADs resulting from the body-device interface.

  • Project 4 - Improving the patient-device interface of cardio-respiratory mechanical assist devices (MADs)

The aim of this project is to improve the physiological interface of cardio-respiratory MADs therapy.

  • Project 5 - (a) pharmacokinetic analysis of key drugs in patients using ex-vivo circuits and an in-vivo animal model; and (b) investigation of nutrients and trace element levels in ECMO patients

The objective of this project is to explicitly describe the changes in pharmacokinetics of drugs and nutrients essential to MAD therapy.

  • Project 6 - Develop informed, trained consumer groups whose members participate as partners in our CRE research projects and processes

The objective is to improve the patient experience of physically & psychiologically challenging MAD interventions through consumer participation in CRE research.

  • Project 7 - Develop an NHMRC clinical practice guideline on the use of MAD therapy for the Australian healthcare setting, which incorporates evidence and new knowledge generated by the ACTIONS CRE

The aim of this project is to support development of public health policy with MAD NHMRC clinical practice guidelines & economic cost effectiveness analysis of MAD therapy.

  • Project 8 - Determining the economic cost effectiveness of MAD therapies in Australia

The objective is to support development of public health policy with MAD NHMRC clinical practice guidelines & economic cost-effectiveness analysis of MAD therapy.

Contact

The Clinical Sciences Building
The Prince Charles Hospital
627 Rode Road
Chermside Queensland 4032
Australia

Office Hours
8:30am - 4:30pm, Monday to Friday

General enquiries
Phone:  +61 (7) 3139 6880