When is a dead heart truly dead? The Dead Heart project aims to improve the quantity and quality of donor hearts available for transplantation, through identifying and characterising new donor sources, and extending organ storage times. This includes increasing the understanding around ischaemia-induced molecular damage to cardio-myocytes during transplant, and investigating novel therapies to increase viability of donor hearts. The Dead Heart Project is run by CCRG in collaboration with a multi-disciplinary team across Australia’s three largest cardiac hospitals.
Ventricular assist devices (VADs) have been developed to support the left (LVAD) or right (RVAD) side of the heart for patients with heart failure requiring circulatory support. Right ventricular failure (RVF) is considered one of the most serious complications following LVAD implantation. This project will explore the effect of LVADs on ventricular interaction, haemodynamics and physiological response. The results of this study will assist in determining which patients are at highest risk of developing RVF after LVAD implantation, and also develop strategies to improve heart failure patient survival rates
Recent retrospective studies propose that there are two different manifestations of Acute Respiratory Distress Syndrome (ARDS) – hyperinflammatory and uninflamed – yet all patients are currently treated the under the same guidelines. The STARDUST project aims to characterise differences in physiology, disease progression, biochemistry, and responses to treatment in the two endotypes. The results of this project will assist in characterising patients into the correct subgroup in the hospital, and contribute to more efficient and effective patient care.
Oxygen therapy used during artificial heart/lung machine (ECMO) support is necessary for the survival of the sickest patients. However, the harmful effect of current high-dose oxygen practice in ECMO is of concern and no guidelines are available. The Blender study aims to assess the effect of different oxygen levels on the immune system using a pre-clinical ECMO model. A better understanding of the immune mechanisms will provide guidance for amending current oxygen management of ECMO, in order to promote safer practice and better outcomes for patients.
In cases of serve cardiac dysfunction, ECMO is used to maintain circulation and generates a continuous oxygenated blood flow. The UFO study aims to determine whether differential levels of oxygen in the aorta, distributed by ECMO, contribute to hypoxic brain injuries. It will explore the affect of changing ECMO flow pressure and oxygen concentrations on cerebral oxygenation levels. The results of this study will assist in creating guidelines for more informed management of ECMO and reduce the risk of short- and long-term cerebral complications .
The clinical team of the CCRG is developing a program of research surrounding ECMO cannula dressing, and securement to reduce the incidence of cannula migration, dislodgement and infection. Currently there is very little evidence to guide practice, and consequences for the patient can be devastating if cannula-related complications occur. The research so far has included in vitro studies, global surveys, point prevalence studies and observational studies, with a view to conduct a pilot RCT in the next couple of years.