ICC-CTN

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The Critical Care Reviews Meeting 2021 will feature the results session of the HRB ICCCTN endorsed REST trial, investigating extracorporeal CO2 removal in acute respiratory failure, as well as presentations of other ICCCTN supported trials, including STARRT-AKI and REMAP-CAP steroid domain.

The Irish Critical Care - Clinical Trials Network co-published some new important COVID evidence on September 2nd. The steroid domain of the REMAP-CAP trial found that hydrocortisone given to critically ill patients with organ failure improves outcomes (primary outcome - organ support free days). This evidence was used in a WHO meta-analysis, also published in the same issue of JAMA.

These studies all say the same thing - steroids (as a class, not a specific agent) improves outcome in critically ill COVID-19 patients. This work (and others) have been used to update the WHO COVID-19 guidelines. We were able to provide that evidence. Clinicians can have confidence that the administration of steroids is beneficial in critically ill COVID patients.

The CTN co-ordinated this work in Ireland and 3 sites took part in the steroids domain (John and his team in Galway and Danny, Patrick & Team in the Beacon in addition to the St Vincent's University team). This project has grown since 2014 when our group helped put it together and now over 200 ICU's globally are recruiting.

This will, hopefully, be the first of many publications from our REMAP-CAP team, who are also looking at antivirals, immunomodulatory agents, full anticoagulation, mechanical ventilation, convalescent plasma etc. These will all be used to guide our care to improve patient outcomes with this illness. There are a further 5 hospitals signed up to these ongoing new domains. Thanks for the support and enthusiasm!!!!!!. We are very grateful to the HRB for their support, including additional research nurse time for each participating Irish site.

A big thanks to the whole team, the ICU docs, nurses and pharmamacisits who made this possible, and, of course, the ICU research teams (who do all the work!).

Prof Alistair Nichol

Director ICC-CTN

Dissemination

Alistair Nichol spoke with Newstalk about the significance of these results.
Rob Mac Sweeney discusses the results of the REMAP-CAP steroid domain with senior investigators Profs Derek Angus and Anthony Gordon on the Critical Care Reviews Podcast.

The Irish Critical Care Clinical Trials Network supported STARRT-AKI trial, investigating the timing of renal replacement therapy in acute kidney injury, was published in the New England Journal of Medicine in July 2020.

SPRINT-SARI (Short PeRiod IncideNce sTudy of Severe Acute Respiratory Infection) is an international, multi-centre, prospective, short period incidence observational study of patients in participating hospitals and intensive care units (ICUs) with severe acute respiratory infection (SARI).

The primary aim of this study is to establish a research response capability for a future epidemic / pandemic through a global SARI observational study. The secondary aim of this study is to investigate the descriptive epidemiology and microbiology profiles of patients with SARI. The tertiary aim of this study is to assess the Ethics, Administrative, Regulatory and Logistic (EARL) barriers to conducting pandemic research on a global level.

SARI continues to be of major relevance to public health worldwide. In the last 10 years there have been multiple SARI outbreaks around the world. The 2009 H1N1 pandemic was estimated to result in more than 200,000 respiratory deaths globally. The World Health Organization (WHO) defines SARI as an acute respiratory infection of recent onset (within 10 days) requiring hospitalisation, manifested by fever (≥38°C) or a history of fever and cough. There is international consensus that it is important to undertake observational studies of patients with SARI as an essential component of pandemic and epidemic research preparedness.

SPRINT-SARI Ireland was set up to during the COVD-19 pandemic to capture irish patients Contact: For further information about this study, please email This email address is being protected from spambots. You need JavaScript enabled to view it.

Reports

ISARIC Reports November 9th

Irish Critical Care-Clinical Trials Network

The HRB funded Irish Critical Care-Clinical Trials Network (ICC-CTN) was established in 2015 to support research being conducted by the Irish Critical Care-Clinical Trials Group (ICC-CTG). The CTN aims to support efforts to conduct high quality clinical trials on the Island of Ireland, based on the opportunity, the science, the feasibility and the ability to enhance the standing of our network locally and internationally. Our approach is to energetically grow the network accessibility, size, geographical coverage and scope, to grow the portfolio of CTN supported studies (investigator initiated and industry studies), to develop a reputation for high quality work and establish a sustainable CTN for long term success.

We have an open and inclusive approach to requests for collaboration and assistance. In the CTN we aim to build collaborations for local and national investigator led studies and to develop industry collaborations into our portfolio.