New research involving patients in intensive care has highlighted that propofol, an anaesthetic drug commonly used to facilitate invasive mechanical ventilation, increases cardiovascular complications risk in the critically ill.  This collaborative international study, led by Professor John Laffey at NUI Galway and researchers at the University of Milan-Bicocca, sought to understand the impact of airway management in critically ill patients.  Dr John Laffey, Professor of Anaesthesia and Intensive Care Medicine at the University’s School of Medicine and Consultant in Anaesthesia and Intensive Care Medicine at Galway University Hospitals, has led an international research team investigating the causes and impact of peri-intubation cardiovascular instability in almost 3,000 critically ill patients. This research is part of the International Observational Study to Understand the Impact and Best Practices of Airway Management in Critically Ill Patients (INTUBE) which is investigating global practice in performing tracheal intubation in patients from 29 countries.  The paper was published in the American Journal of Respiratory Care Medicine. As part of this research, the investigators identified important modifiable, previously poorly understood risk factors that increase the risk of critically ill patients developing shock and cardiovascular instability when undergoing urgent tracheal intubation to permit invasive mechanical ventilation, commonly referred to as ‘life support’.   The identification of variables that can be modified through changes in clinical practice was explored as part of this study and evidence suggests that one commonly used anaesthetic agent has a major role in the incidence of cardiac arrest and hypertension after intubation.  Professor Laffey explains: “Airway management is universal but prior to the INTUBE study data on the management of intubated patients has been scarce. Identifying risks is the first step in developing safer management approaches.  “Tracheal intubation is one of the most high-risk and frequently performed procedures in patients who are critically ill. Cardiovascular adverse events like low blood pressure and even cardiac arrest can be frequent after intubation. Different factors play a role in the increased risk in patients who are critically ill compared with patients undergoing the procedure for elective surgical procedures.  “To date, the research agenda on interventions to reduce risk in these patients in critical care has mainly focused on oxygenation optimisation and on methods to achieve intubation at the first attempt. “In our recent research as part of the INTUBE study we have identified that the commonly used anaesthetic drug – propofol – is strongly associated with an increase in the incidence of cardiac arrest and severe hypotension after intubation. This is an important discovery, and the first time that this has been investigated in a truly global patient cohort such as the INTUBE study. “As a result of this study it is our intention to conduct further clinical trials to develop and test alternative strategies to reduce the risk and severity or cardiovascular adverse events in critically ill patients requiring urgent tracheal intubation. In the meantime, our data strongly suggests that propofol use should be restricted in this patient group and even avoided where possible.  “Training in the use of this specialised drug is key. The drug suppresses reflexes which makes it particularly good for intubation, but equally it appears to be be this suppression that is causing risks for patients.”  Ends

NUI Galway and Queen’s University Belfast collaborate under Shared Island fund to tackle issue of hospital acquired infections Researchers at NUI Galway and Queen’s University Belfast are investigating how attaching sugar molecules to plastics could give medical devices a new layer of protection from infection. The SUGARCOAT project is among 62 research collaborations supported by the Government’s Shared Island fund.  Early-career researchers Dr Joseph Byrne, NUI Galway, and Dr Matthew Wylie, Queen’s University Belfast, are working together to tackle the issue of hospital acquired infections associated with devices by taking preventative science to a new level.  The team is attempting to harness the science behind the interaction of sugar molecules with bacterial proteins to make fluorescent materials which glow at first, darkening when they become compromised by bacteria. The technology would be attached to plastics which coat medical devices - such as urinary catheters or endotracheal tubes - allowing clinicians to spot potential infection at an early opportunity and react faster.  Dr Byrne, Honorary Research Lecturer in the School of Biological and Chemical Sciences, NUI Galway, explained the concept: “Prevention of bacterial infections is key to fighting the challenge of antimicrobial resistance and if this isn't possible, then early detection through innovative sensing materials could act as an alarm, allowing devices to be removed and replaced before infection becomes a more serious risk to patient health.” Dr Wylie, Lecturer in Pharmaceutical Materials Science in Queens University Belfast, said: “Like many humans, sugar is something bacteria can’t resist getting a taste of. Many types of bacteria contain special proteins, which allow them to seek out and attach to sugar molecules, which they can use to grow and cause infection within the human body. Our new sugar-decorated coatings will exploit this interaction as an early warning, which has the potential to lead to the development of a new generation of medical devices, giving doctors and nurses tools to reduce risks of infection, bring down healthcare costs and decrease the need for antibiotic use in hospitals.” The project is being supported with €193,000 from the Government’s Shared Island initiative. The research team is supported by senior colleagues Professor Abhay Pandit, Director of CÚRAM, the SFI Research Centre for Medical Devices at NUI Galway, and Professor Colin McCoy, Head of School of Pharmacy in Queen’s University Belfast.  Medical device-associated infections account for up to half of healthcare-associated infections and people who are immunocompromised people and those with cystic fibrosis (CF) are particularly at risk, with the island of Ireland having one of the highest number of people with CF per capita. These infections are a major health concern to patients and incur significant expense to healthcare systems, requiring longer stays and increased antibiotic usage. The rise of antimicrobial-resistant bacteria is an urgent problem, decreasing the effectiveness of existing antibiotics. It is estimated that across EU/EEA countries, 33,000 deaths per year in EU/EEA countries are associated with antimicrobial resistance, costing more than €1 billion to health services.  This project hopes to minimise the impact of this challenge by producing innovative coatings, which will prevent or detect bacterial build-up on widely-used medical devices before they lead to infection in a patient.  Dr Byrne, a CÚRAM collaborator, added: “Hospital-acquired bacterial infections are a major issue across the entire island of Ireland, and I’m excited to forge a new and lasting relationship with counterparts in Belfast to deliver meaningful new tools in fighting this challenge. “The research allows me to combine my chemistry research with more patient-facing researchers and healthcare stakeholders to increase our societal impact. Building all-island collaborations through this scheme will help us to unlock Ireland’s potential for innovation and cutting-edge science.” Dr Wylie added: “We are delighted to be able to pursue this innovative research under the Shared Island fund. Not only is it support for two early-career researchers, but it will open up opportunities for collaboration with industry and clinicians in both the North and South of Ireland, particularly as Galway is a global hub for major medical device companies and Queen’s has vast experience of collaborating with medical device companies across the UK and Ireland.” Ends

NUI Galway has announced the recipients of the inaugural Dr Karzan Sabah D Ahmed Memorial Research Bursary, which was established to remember the researcher who died with his wife Shahen Qasm and their baby daughter Lina in a road accident in 2021.  The successful students are Aoife Murphy, from Loughrea, Co Galway, who has completed her BSc in Environmental Science, and Niamh Nolan, from Listowel, Co Kerry, who is a final year student of BSc in Environmental Science.  The students were awarded the summer scholarship created in partnership with NUI Galway and the National Parks and Wildlife Service and the Department of Housing, Local Government and Heritage. Both students will undertake a three month research scholarship in High Nature Value farmland during the summer of 2022.  Andy Bleasdale, Director of Scientific Advice and Research, National Parks and Wildlife Service and the Department of Housing, Local Government and Heritage, said: "Honouring the memory and legacy of Karzan is particularly important to NPWS. We are delighted to partner with NUI Galway in developing the skills and expertise of new generation of ecologists, through research bursaries in High Nature Value farmland.” Speaking on behalf of NUI Galway, Julie Stafford, Director of Development, Community & Alumni Relations at the University, said: “We are delighted to partner with NPWS to remember Karzan, Shahen and Lina in such an appropriate way by continuing Karzan important work. Karzan was a great colleague and friend to many at NUI Galway and this bursary will continue his legacy. It is our hope that students who are awarded the bursary will contribute in a small way to continuing the legacy of Karzan at our university.” Ends