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Research

 

Health and Care Research Wales is a website focused on improving the health and care of people and their communities. They aim to facilitate research into diseases, treatments, services and outcomes which can lead to discoveries and innovations to improve, and potentially, save people’s lives. Their website is linked here: https://healthandcareresearchwales.org/.

There is a blog post on Health Care Research Wales which talks about some research we are doing with people who have been admitted to Critical Care to look at how we can better support our patients. To find out more, click the link here: https://healthandcareresearchwales.org/withoutresearch/blog/how-lived-experiences-shape-studies.

GenOMIC Genomicc

This study is exploring whether genetics play a role in critical illness.

Patients will be eligible for this study if they are admitted to intensive care with:

  • Covid
  • Influenza
  • Pneumonia
  • Pancreatitis
  • Group A streptococcal infection
  • Burns
  • Other emerging infections or suspected vaccine reactions

DNA strands The study involves taking a blood sample from patients and comparing the DNA with that of the general population.

Some information is collected about each patient regarding their illness and their progress. This is all anonymised and kept securely.

This study has had great success in identifying genes that make people susceptible to life-threatening covid-19.  We have then been able to trial drugs that target the actions of the genes.

ADAPT Sepsis

sepsis adapt biomarker-guided antibiotic duration for sepsis This study is investigating whether treatment protocols based on monitoring biomarkers (small molecules in the blood) can reduce the duration of antibiotic therapy in a safe way.

Patients will be eligible for this study if they are admitted to intensive care with suspected sepsis, within 24h of initiation of antibiotics.  Likely to remain hospitalised on intravenous antibiotics for at least 72h.

The study involves taking blood samples every day which are sent to the laboratory.  Patients are randomly allocated to have different biomarkers measured so that we can see which one is more useful in telling us when we should stop antibiotic treatment. We receive advice from the study team based on the blood test results each day. This advice will tell us to continue our usual care or to consider stopping antibiotics.  We do not have to follow this advice if we don’t agree with it.

This study may help others in the future, if we can find better ways of deciding when to stop antibiotics and avoid prolonged courses which could cause side effects or promote development of bacterial resistance to antibiotics.

All information collected about participants will be anonymised and kept securely.

Participants can withdraw from the study at any time.

MOSAICC

MOSAICC This study is evaluating the effectiveness of a particular salty fluid infusion (sodium bicarbonate) for critically ill patients with kidney failure.

Critically ill patients with kidney failure can develop increased acid levels in the blood and this has very poor prognosis (59% don’t survive). This study is exploring whether correcting the acidity with bicarbonate avoids the need for dialysis (‘washing’ the blood through a special machine) and improves survival.

Patients are eligible for this study if they are admitted to ITU with acute kidney injury causing increased blood acidity.

Because it is important to start the intervention as soon as possible, this study has a deferred consent model.  This means that the study team can put the patient in the study if they are too unwell to discuss the study and make a decision for themselves.  The team will then speak to the patient’s family as soon as possible to see if they think the patient would wish to be involved.  Patients can be withdrawn from the study at any time.

Patients in the study will be randomly allocated to receive sodium bicarbonate to normalize the blood acidity, or not to receive sodium bicarbonate.

Information collected about patients will be anonymized and kept securely.

i-Rehab

i-Rehab remote rehabilitation after intensive care This study is comparing a new type of rehabilitation support with our standard care for patients who are recovering from critical illness.

Patients will be eligible after they have left the intensive care unit. 

The study compares a 6 week multicomponent rehabilitation intervention delivered remotely with usual care, which is no structured rehabilitation.

Patients will be randomly allocated to each group.

There are 4 components to the rehabilitation programme: weekly symptom management, targeted exercise, psychological support and information/peer support.

The outcome measured will be health related quality of life 8 weeks post randomisation.

RECOVERY

RECOVERY Randomised Evaluation of COVID-19 Therapy This study investigates different treatments for Covid-19.  It has been the main study looking at this in the UK and has resulted in all the treatments that we currently use for our patients.

Effective Treatments:

  • Dexamethasone, tociluzimab/sarilumab, monoclonal antibodies, baricitinib

Ineffective Treatments:

  • Azithromycin, hydroxychloroquine, lopinovir-ritonovir, aspirin, convalescent plasma

Still Awaiting Results:

  • Dimethyl fumarate, high dose corticosteroids, empagliflozin, sotrovimab, molnupiravir.

Patients admitted to hospital with Covid-19 are eligible to participate in this study and will then be randomly allocated to receive one or more of the treatments currently being tested.  All information collected will be anonymised and kept securely.

REMAP-CAP

REMAP - CAP This study aims to determine and continuously update the optimal set of treatments for community acquired pneumonia.

It is also investigating treatments for covid-19 and influenza.

Patients are eligible for this study if they are admitted to intensive care with pneumonia, covid-19 or influenza.

They will be randomly allocated to receive different combinations of treatments including different antibiotics, different durations of antibiotics, antivirals and steroids.  Information will be collected about their progress, anonymised and stored securely.

SIGNET

SIGNET This study is exploring whether drugs used for treatment of high cholesterol (statins) can improve the organ outcome in transplantation.

Patients who have died and are suitable for organ donation may be included in this study.

The study will be discussed with the family during the conversations about organ donation.

It aims to see whether statin drugs improve the outcomes of recipients of the donated organs.

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