The ICU Team (from left to right) : Anne Tuner, Sally Hurford, Lean Navarra and Di Mackle

Di what’s your favourite part of your job?

Oh difficult question! Probably the people I work with and the fact that I continually learn something every day. I love working with a group of people and in the ICU environment. I was previously an ICU nurse in Wellington 20 years ago, originally a staff nurse then a charge nurse and finally a research nurse and moved into this project manager role 3 years ago. I have overall responsibility for the ICU team at MRINZ

What are you working on at the moment?

I am working on ICU-ROX which is the oxygenation study. I am also going to be doing my PhD in knowledge translation (around ICU-ROX).

Who else do you work with Di?

We have a great team working on ICU research at MRINZ

I work closely with Paul Young – he’s the programme director for ICU here at MRINZ, and is an intensive care specialist, and is running lots of ICU research trials.

There are three other project managers,

• Sally is managing the TARGET study in New Zealand. She also runs RELIEF, which is about liberal versus restrictive fluid in surgical patients and TRICS, which is about blood transfusions in patients who have had cardiac surgery, and also some observational studies
• Anne has just begun and is working on a platform study called REDMAP-CAP about community acquired pneumonia, as well as a fever study called REACTOR
• Lean is managing a fluid study called PLUS, and a study called PEPTIC about stress ulcer prophylaxis in ICU as well

We also work a lot with the research staff in ICU.

Can you tell me about the ICU-ROX study?

ICU-ROX is a study about oxygenation in ICU patients that are mechanically ventilated or on a breathing machine, or it’s often known as life support.

We want to see whether it is better or worse for patients if we give them more oxygen than necessary to achieve a normal oxygen level in their blood (which is what is commonly done at the moment), compared to using the least the amount of oxygen necessary to achieve normal oxygen levels.

Why are you doing this study?

We don’t currently know how much oxygen should be given to adults who need life support. Although there are guidelines, usually the individual clinician decides how much oxygen to use. We know from observational data that clinicians tend to use more oxygen than they think they will.

There have also been other studies in people who have had strokes, COPD or heart attacks.

How big is the study?

We have already done a pilot study of 100 patients which was to check that the systems in place work. The whole study will be 1000 patients across Australia and New Zealand there will be 20 ICUs involved. It’s important that there are multiple ICU centres involved as we aim to make the study results relevant and applicable to many ICUs across the world (generalisability).

So far are there any results from the pilot study?

No, we are still in the analysing phase.

How long did it take to recruit 100 patients in the pilot study?

About three months in nine centres. For the main study we are hoping it will take about a year to recruit 900 patients.

What are the exclusion criteria?

The patients in this study are reasonably sick but to be in this study the participants need to be expected to be on a breathing machine for at least 2 days. The participants also need to be enrolled within 2 hours of being admitted to ICU, which can be challenging for staff in some situations.

Another exclusion criteria would be if the patient had a disease in which they required a specific amount of oxygen.

What’s going well with the study?

We have had really positive feedback from the sites and therefore we are hopeful we can get all 20 sites involved in the larger study. We aim to start the main part of the study in March of next year.

Any negatives?

There are none! We are really busy at the moment with lots of studies, but that’s good too!

Do you get to travel?

I get to go to meetings in Australia three times a year, but I mostly just travel within New Zealand visiting different ICU centres which I really love as I get to see everyone.

The ICU Team (from left to right) : Anne Tuner, Sally Hurford, Lean Navarra and Di Mackle

Di what’s your favourite part of your job?

Oh difficult question! Probably the people I work with and the fact that I continually learn something every day. I love working with a group of people and in the ICU environment. I was previously an ICU nurse in Wellington 20 years ago, originally a staff nurse then a charge nurse and finally a research nurse and moved into this project manager role 3 years ago. I have overall responsibility for the ICU team at MRINZ

What are you working on at the moment?

I am working on ICU-ROX which is the oxygenation study. I am also going to be doing my PhD in knowledge translation (around ICU-ROX).

Who else do you work with Di?

We have a great team working on ICU research at MRINZ

I work closely with Paul Young – he’s the programme director for ICU here at MRINZ, and is an intensive care specialist, and is running lots of ICU research trials.

There are three other project managers,

• Sally is managing the TARGET study in New Zealand. She also runs RELIEF, which is about liberal versus restrictive fluid in surgical patients and TRICS, which is about blood transfusions in patients who have had cardiac surgery, and also some observational studies
• Anne has just begun and is working on a platform study called REDMAP-CAP about community acquired pneumonia, as well as a fever study called REACTOR
• Lean is managing a fluid study called PLUS, and a study called PEPTIC about stress ulcer prophylaxis in ICU as well

We also work a lot with the research staff in ICU.

Can you tell me about the ICU-ROX study?

ICU-ROX is a study about oxygenation in ICU patients that are mechanically ventilated or on a breathing machine, or it’s often known as life support.

We want to see whether it is better or worse for patients if we give them more oxygen than necessary to achieve a normal oxygen level in their blood (which is what is commonly done at the moment), compared to using the least the amount of oxygen necessary to achieve normal oxygen levels.

Why are you doing this study?

We don’t currently know how much oxygen should be given to adults who need life support. Although there are guidelines, usually the individual clinician decides how much oxygen to use. We know from observational data that clinicians tend to use more oxygen than they think they will.

There have also been other studies in people who have had strokes, COPD or heart attacks.

How big is the study?

We have already done a pilot study of 100 patients which was to check that the systems in place work. The whole study will be 1000 patients across Australia and New Zealand there will be 20 ICUs involved. It’s important that there are multiple ICU centres involved as we aim to make the study results relevant and applicable to many ICUs across the world (generalisability).

So far are there any results from the pilot study?

No, we are still in the analysing phase.

How long did it take to recruit 100 patients in the pilot study?

About three months in nine centres. For the main study we are hoping it will take about a year to recruit 900 patients.

What are the exclusion criteria?

The patients in this study are reasonably sick but to be in this study the participants need to be expected to be on a breathing machine for at least 2 days. The participants also need to be enrolled within 2 hours of being admitted to ICU, which can be challenging for staff in some situations.

Another exclusion criteria would be if the patient had a disease in which they required a specific amount of oxygen.

What’s going well with the study?

We have had really positive feedback from the sites and therefore we are hopeful we can get all 20 sites involved in the larger study. We aim to start the main part of the study in March of next year.

Any negatives?

There are none! We are really busy at the moment with lots of studies, but that’s good too!

Do you get to travel?

I get to go to meetings in Australia three times a year, but I mostly just travel within New Zealand visiting different ICU centres which I really love as I get to see everyone.