Monash research changing emergency intubation of critically ill children

Professor Simon Craig

Monash Health Paediatric Emergency Physician and Monash University Adjunct Clinical Professor Simon Craig is one of a team of chief investigators who were awarded NHMRC funding to undertake two new paediatric multi-centre studies through the Paediatric Research in Emergency Departments International Collaborative (PREDICT) Network.

Prof Craig and colleagues were awarded $1.6 million to support a study of nasal high flow apnoeic oxygenation during paediatric emergency intubation. The collaborative project, led by A/Prof Andreas Schibler from Lady Cilento Children’s Hospital, will compare usual care to the use of Transnasal Humidified Rapid-Insufflation Ventilatory Exchange (THRIVE) in over 800 children within emergency departments and intensive care units across Australia and New Zealand with the support of the Paediatric Critical Care Research Group – PCCRG, the Paediatric Study Group - PSG and the PREDICT network.

A positive result of this trial will likely lead to a worldwide change of practice in emergency intubation of critically ill children. Site investigators at Monash Health include Dr Felix Oberender (PICU) and Prof Craig (Emergency).

 The NHMRC also provided nearly $560,000 to support a phase III international multicentre trial in infants presenting to the emergency department with bronchiolitis. The study, led by A/Prof Ed Oakley from the Murdoch Children’s Research Institute, will be conducted in Canada, New Zealand and Australia by the PREDICT and Pediatric Emergency Research Canada (PERC) research networks. It aims to compare the use of adrenaline and dexamethasone to placebo in over 1600 children with bronchiolitis.

Although previous exploratory Canadian research has suggested this combination of treatments may lead to a 35% relative reduction in hospitalisation rate and improvement in symptoms, a definitive trial is lacking. Bronchiolitis is the most common reason for infants <1 year of age to be admitted to hospital in the developed world. If this study confirms that adrenaline and corticosteroids reduce hospital admission, this simple, inexpensive treatment will become widely used throughout NZ.

 “From a personal viewpoint, it’s a privilege to be part of the team for these multicentre studies,” said Prof Craig. “However, what’s really exciting is that our ED, PICU and paediatric wards are all able to build on recent successful research contributions and continue our involvement in world-leading paediatric studies.”