High Flow Nasal Cannula treatment for viral Bronchiolitis, a randomised controlled trial

Acute respiratory disease is the leading cause for infants and children needing hospital admission. The main focus of hospital treatment is oxygen therapy beside disease specific treatment like inhalers for asthma or antibiotics for pneumonia. 10 to 20% of these infants or children need higher level of care at some point of their illness and will be transferred to a children’s hospital intensive care unit. This is not only expensive and imposes a huge burden on health care costs but more importantly is very stressful for these children and families because they are taken out of their familiar environment. Recent research suggests that with early optimal respiratory support the need for transfer can be significantly reduced and many of these patients could be cared in their regional hospital allowing the family to be the main support group. This concept of “keeping the patients in their regional centre” is not only from a psychosocial aspect of advantage but will have as well a great impact on health care costs. Our research group has recently investigated the role of high flow therapy in infants with bronchiolitis and we were able to demonstrate a 40% reduction in intensive care admission. Early respiratory intervention is a fundamentally new approach, which has the potential to prevent progression and deterioration of respiratory illness. The aim of this study is to investigate the role of high flow therapy in infants with bronchiolitis, but future research and trials will also include other conditions such as asthma and pneumonia.

Tissue Doppler Evaluation of Diastolic Dysfunction in Emergency Department Acute Coronary Syndromes: The TEDDy-ED pilot study.

Chest pain is a common reason for presentation to the emergency department and admission to hospital. Even when this chest pain is due to acute coronary syndrome (heart attack), it is not always clear how dangerous this might be. Australian guidelines propose a number of features that help judge severity and guide treatment. However, there is increasing evidence that impaired heart relaxation is an early sign of heart attack. This can be diagnosed using ultrasound and might be a very sensitive test to identify patients in danger.

This project aims to perform detailed ultrasound assessment of heart relaxation and filling, so we may grade the level of risk in emergency department patients admitted to hospital with suspected heart attack. Comparison will be made with common laboratory tests including troponin and b-type natriuretic peptide (BNP).