Cool Topics 2023

Brett is a consultant neonatologist at the Women's and an Associate Professor in the Department of Obstetrics and Gynaecology at The University of Melbourne, He leads and collaborates on multicentre clinical trials to improve outcomes for sick and preterm infants. In his spare time, he wrangles Buddy the dog, Apollo the cat, and four kids whose names temporarily escape him. One of them might be Jayden. Or Brayden? 

Abstract of presentation

We are very excited to present, for the first time anywhere in the world, the results of the PLUSS trial. 

PLUSS is an international, multicentre trial of intratracheal budesonide mixed with surfactant to increase survival free of BPD in extremely preterm infants born <28 weeks' gestation.

Commencing in 2018, PLUSS enrolled 1061 infants in 21 centres across 4 countries (Australia, New Zealand, Canada and Singapore) and completed enrolment in March 2023. PLUSS is a pragmatic trial with broad inclusion criteria that have allowed most extremely preterm infants to be eligible.

The intervention is intratracheal budesonide (0.25 mg/kg) mixed with poractant alfa (Curosurf), with infants receiving 1-2 doses 6-12 hours apart depending on their clinical condition. The control group received surfactant alone in the same doses. The treatments could be given via an endotracheal tube or thin catheter (LISA/MIST). The primary outcome of the trial is survival free of BPD at 36 weeks' post-menstrual age (PMA); secondary outcomes include the infants' respiratory condition at 40 weeks' PMA, important neonatal morbidities, and potential adverse effects of corticosteroids. Infants in the trial will be followed-up at 2 years as part of the PLUSS2 study. 

Jeanie is a neonatologist who is interested in life beyond discharge from the neonatal nursery. She is an internationally recognised clinician-researcher on the long-term health and development of high-risk newborns, especially those born preterm. She heads the Victorian Infant Collaborative Study, the longest running epidemiological study of extremely preterm cohorts, as well as the NHMRC Centre of Research Excellence in Newborn Medicine. 

Abstract of presentation

Are prospective longitudinal cohort studies merely observational? This presentation highlights the “state-of-the-art” next steps that springboard from knowledge gained from longitudinal cohort studies on health and development of infants born extremely preterm or extremely low birth weight. 

Rose is a postdoctoral neonatal nurse researcher and perinatal educator. Her research and clinical interests are perinatal epidemiology and neonatal transport, with a focus on improving outcomes of babies born extremely preterm in non-tertiary hospitals and paramedic practice.

Rose led the inaugural development of statewide guidance for management of extremely preterm births at 22-25 weeks’ gestation in Victoria, published in December 2020. She is currently appointed as Senior Project Officer at Safer Care, Data Lead in the Preterm Birth Prevention Jurisdiction Program.

Louise is a consultant neonatologist at the Women's and an Associate Professor in the Department of Obstetrics and Gynaecology at The University of Melbourne.

As a clinician-researcher at the Women’s, Louise leads a program of research focused on newborn resuscitation and respiratory support for preterm infants. Her experience has included multiple randomised trials of respiratory support in the delivery room and in the NICU. She also has an interest in consent in newborn research.

Abstract of presentation

This session will focus on the use, acceptance and controversies of using various types of consent in neonatal research. We will hear from experts in the ethical and practical use of various consent modes, as well as trialists who are currently using innovative consent modes in their studies.

We will hear about the rationale, approval process and hurdles faced when trying to embed newborn research into clinical care supported by diverse consent approaches. 

Neil was a consultant neonatal paediatrician at the Women’s from 1975-2007, including Director of Newborn Services (1995-2007). He was Founding Director of the Newborn Emergency Transport Service (NETS) 1976-99. He was Newborn Advisor to the Victorian Maternity and Newborn Clinical Network (2008-2011).

His special interests were in emergency transport of sick and premature newborn babies, the organisation of perinatal services, hospital design and infant nutrition including breastfeeding. He maintains an interest in the history of care of the newborn, as well as being a keen golfer and choral singer. 

Abstract of presentation

"History of Neonatology: Development of incubators and infant feeds" 

This illustrated talk traces the development of incubators from late 19th century France to the modern day, including a description of their slow acceptance into hospital practice and some of the complications of their use, and discusses the development of nutritional practices over the same period with specific references to breast vs. bottle feeding, the role of marsupials in our understanding of premature baby nutritional requirements and a description of some of the early work on intravenous supplemental nutrition. 

Alicia is a paediatric physiotherapist at the Women's and the Associate Dean Research within the Faculty of Medicine, Dentistry and Health Sciences at the University of Melbourne. Her research and clinical work focuses on early detection and early intervention for babies born preterm and/or at risk of developmental impairments, including cerebral palsy. 

Rod is the Financial Markets Foundation for Children Chair in Neonatal Paediatrics at Monash University, and the Director of Research in Victoria for the Cerebral Palsy Alliance.

His research has focussed on neuroprotection, neuroimaging and neurodevelopment in the high-risk newborn infant. Most recently he has been focussing on optimising seizure management in the newborn period - through a combination of targeted neuromonitoring and improved therapeutics. 

Kate is a physiotherapist and post-doctoral researcher at the University of Melbourne and the Victorian Infant Brain Studies Group at Murdoch Children’s Research Institute.

Kate’s research focuses on improving outcomes for children born high-risk, with an interest in working with children and families to understand their perspectives and preferences for healthcare and support. Kate is currently involved in the Knowledge Translation of Early Cerebral Palsy (KiTE-CP) study, exploring parent and healthcare professional experiences of early screening for cerebral palsy.  

Mark is Director of the Department of Neurology and the Paediatric Stroke Program at the Royal Children’s Hospital, Melbourne, Australia. He is a Clinician-Scientist Fellow at the Murdoch Children's Research Institute, Melbourne, where he leads the paediatric stroke research group. He is on the Board of the International Pediatric Stroke Organization, is a member of the International Pediatric Stroke Study Executive Committee, is a member of the Stroke Foundation of Australia Clinical Council.

Mark established a dedicated paediatric stroke program at RCH in 2004; the first of its kind in Australia. His research focuses on understanding causes of and consequences of neonatal and childhood stroke, and improving accuracy and timeliness of stroke diagnosis. He has authored 7 book chapters and over 200 publications, and has secured more than 7 million dollars in research funding.

He chaired the development of the Australian best-practice guidelines for the acute management of childhood stroke. He is co-chairing statewide perinatal stroke guidelines, which are due for completion in late 2023. He is the lead investigator on the NHRMC funded multi-centre NIMBUS study, which aims to answer important questions about cause and consequences of perinatal stroke, by looking at blood proteomic signatures and using advanced MRI imaging to study brain networks in 50 babies with stroke.

David is a clinical neonatologist and respiratory physiologist at the Melbourne Children’s Campus (Australia) whose work aims at improving the respiratory outcomes of newborn infants. David currently leads the Murdoch Children’s Research Institute Neonatal Research Program. This is an interconnected program of molecular and clinical science aiming to better understand lung injury and develop new neonatal critical care respiratory support strategies.

David is the current Chair of the Respiratory Failure Section of the European Society of Paediatric and Neonatal Intensive Care and a commissioner for the Lancet Commission on the Future of Neonatology. David’s research has developed guidelines on neonatal ARDS, chest imaging and Paediatric COVID-19 therapies, and is lead investigator of the international POLAR Trial of PEEP strategies to support the preterm lung at birth and the BLUEPRINT Study to map the phenotypes and evolution of preterm lung injury.

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