SRMRC nursing team off to great start with REST trial recruitment

Trauma research nurses at the Queen Elizabeth Hospital Birmingham (QEHB) have begun recruiting patients into a new trial which aims to improve the outcomes of those with respiratory failure.

The pRotective vEntilation with veno-venouS lung assisT in respiratory failure (REST) trial is investigating whether removing carbon dioxide from blood outside of the body can reduce the burden of mechanical ventilation during treatment.

University Hospitals Birmingham is one of a number of NHS Trusts taking part in the study, which is being led by the Northern Ireland Clinical Trials Unit at The Royal Hospitals in Belfast.

The aim is to recruit 1,120 patients by April 2020 and NIHR Surgical Reconstruction and Microbiology Research Centre nurses in Birmingham are off to a flying start, with five patients enrolled in the first two months.

“Respiratory failure is common in the UK, about 100,000 people each year need treatment with mechanical ventilation,” said critical care consultant Bill Tunnicliffe, who is one of the co-investigators and the UHB lead for the trial.

“Although there is evidence that mechanical ventilation does save lives, it can be linked with damage to the lungs.

“A mechanical ventilator acts like bellows as air is forced into the lungs under pressure. If the pressure needed to help the patient breathe, or the size of the breaths is too high this can cause lung damage.”

“New devices are now available to help reduce the need for mechanical ventilatory support.  These devices help remove carbon dioxide from the patients’ blood, which is one of the main functions of the lungs.

“This may allow more gentle mechanical ventilation, causing less harm and improving outcomes.”

With the new devices, blood is removed from the body and ‘washed’ to remove the carbon dioxide before being returned to the patient, in a process very similar to kidney dialysis.

In the trial, patients with respiratory failure will randomly be allocated either the new treatment or the existing standard care and outcomes compared to see if the new method results in significant improvements.

“We are delighted to be involved in this important trial at UHB,” added Dr Tunnicliffe. “And the effort and commitment of the SRMRC nursing team to recruit patients so quickly has been superb.”