Centre for peri-operative medicine and critical care research
This centre for peri-operative medicine and critical care research was established at the start of the Academic Health Science Centre in late 2007. The Centre conducts clinical research into critical illness and its care, the management of patients who are undergoing surgical or radiological interventions, and those people requiring resuscitation. The research focuses on creating knowledge which we can use to improve the care of our patients. Most of the research is clinical research, very closely associated with patients and their care. Some of the research that we perform is more associated with basic laboratory science, and we have established strong links with other academic groups within the Trust and Imperial College London, in particular the section of anaesthetics, pain medicine and intensive care within the College. Examples of the research that we do are listed on our current research page and we have also listed some recent publications.
To help us conduct the research we have a group of research nurses and research fellows who play a major role in identifying patients suitable for particular studies, approaching the patients or their families to ask permission to include the individual in the study, performance of the study and collection of data. These nurses are based across all of the major sites of Imperial College Healthcare NHS Trust. Taking responsibility for the overall conduct of the studies are consultant staff who are principal investigators.
There is a variety of different types of projects which we conduct:
- Observational studies are straight forward studies which involve the collection of information and sometimes samples to allow us to study patients illnesses and to understand how patients respond to their underlying illness or the care that we give them
- Clinical trials are studies in which new medicines or pieces of equipment are used, under close supervision and observation, to see whether they benefit patients and improve their recovery
- Epidemiological studies involve the use of large amounts of data from often very many patients to allow us to understand the long term impact and consequences of an operation or major illness
- Technology evaluation is the assessment of pieces of new equipment or technology to see whether it functions in line with the original concept and appears to offer advantages for the patients or occasionally allows the hospital to run more efficiently
The research that we do can be initiated either by the consultant staff who make up the clinical departments developing a research question. These research questions are then turned into research projects. Commercial research involves the centre performing the evaluation of some new drug, device or technique on behalf of a commercial manufacturer. All of the research projects are carried out with appropriate independent ethical committee oversight and where necessary patients give informed consent. Sometimes patients who are very ill are not in position to give consent themselves and there are mechanisms to allow us to enroll these people into studies whilst respecting their wishes and their autonomy. Normally we would discuss their enrolment with a close family member or carer and then when the patient recovers we would ask them if they are happy to continue in the study. Under some circumstances, such as very severe acute illness or resuscitation, we have to enroll the patient into the study before it is possible to speak with anybody else. These studies are the subject of very specific ethical committee approval and oversight.
Most of the funding support which allows us to conduct the research comes from the National Institute for Health Research. This organisation was created within the National Health Service to allow clinical research to take place, and it pays for support costs which are required to help run these projects. The work of the Centre is also supported by the National Institute for Health Research biomedical research centre.