News

– to investigate if non-anaesthetic noble gas helium induces preconditioning and post conditioning in patients undergoing coronary artery bypass graft (CABG) surgery was approved for Inspire funding by the Innovation Council in June 2008.

Ass. Prof. Benedikt Preckel and his team are working at the Academic Medical Centre, University of Amsterdam, Netherlands. The study will provide the initial demonstration of whether helium acts as a cardioprotectant in humans, preventing the damage to the heart muscle tissue that is caused by interruption (ischaemia) and restoration (reperfusion) of blood supply. The HiPP-CABG study will be looking specifically at whether helium inhalation can reduce the damage to the heart tissue that is caused during heart bypass (CABG) surgery, which involves planned ischaemia/reperfusion. Not only will it establish whether helium could be used as a pre-conditioning agent (to be given before cardiac ischaemia to prevent damage), but it will also give the first indication of whether Helium could be used post-ischaemia to limit damage. This could have huge implications for conditions such as heart attack, if helium is shown in humans to be effective at reducing cardiac damage when given post-ischaemia

Ass. Prof. Preckel was awarded the Inspire Award trophy and certificate by Ruud Schmeink (Business Unit Director for Benelux), Dr Hubert Bland (Head of Clinical Development and Medical Affairs, I & D, LGT-BOC) and Dr David Crosby (Head of Clinical Information, I & D, LGT-BOC) at a ceremony in Amsterdam Medical Centre, Amsterdam on 9th Oct, 2008. During the ceremony presentation Ass. Prof. Preckel said:

“We are grateful that we have the opportunity to investigate whether helium induces active cardio protection in patients undergoing cardiac surgery. We think that positive results will be of great benefit to cardiovascular risk patients undergoing surgical as well as non-surgical procedures. We are very glad that Linde saw the significance of the work and chose to fund it. We thank the members of the committee who came to the AMC to handout the certificate and the beautiful Inspire Award trophy, which will be placed in our laboratory.”

The study will enrol 125 CABG patients, in 5 different arms - 25 patients per group. Dr Preckel will be analysing myocardial (heart) tissue samples after the surgery, as well as measures of heart function during it. Blood samples will be taken to check for enzymes known to be involved in cardio protection. Dr Preckel’s team will measure established markers for myocardial and other tissue damage which are known to increase following coronary artery bypass.

It is hoped that the results of the study will demonstrate for the first time in humans that inhalation of a helium-containing gas mixture causes protection of heart tissue from the damage caused by ischaemia/reperfusion.

From left to right:
Sjoerd Alkema (Medical Account Manager), Dr David Crosby (Head of Clinical Information), Ruud Schmeink (Business Unit Director for Benelux), Professor Wolfgang Schlack (Head of Department of Anaesthesiology), Associate Professor Benedikt Preckel (Principle Investigator), professor Markus Hollmann (Professor of experimental anaesthesiology), Dr Hubert Bland (Head of Clinical Development and Medical Affairs), Dr Gezina Oei (study investigator), Dr Kirsten Smit (study investigator).

New Extreme Everest update
Guildford, UK May 12, 2008

The Caudwell Extreme Everest team have published another paper explaining why the team went to Everest and what they hope to learn. It also discusses some of the key studies.

The basis of the project was that people who cope well at high altitude seem to share part of a gene with those who do better when critically ill. By understanding the physiology seen at altitude in greater detail, the results could be applied to helping those who are critically ill. This will be by identifying, in healthy subjects, some of the physiological and biological mechanisms seen when the body is subjected to extremely low oxygen (hypoxic) conditions and the relationship to genetic variation, exactly the same hypoxic conditions tht can occur in cells in the critically ill. Therapies may then be able to be developed to improve oxygen efficiency in patients.

The project involved 34 ethically-approved protocols including more than 40 separate experiments in more than 220 individuals, including nine children.

Exercise test analysis is expected to be completed by June 2008.

Pain Relief Inspire Award Update
Guildford, UK October 2007

The anaesthesia team at Imperial College led by Professor Mervyn Maze are working on devising a safe and efficacious method for controlling pain in patients with burns who require frequent wound dressing changes. It is well-established that these patients rapidly become resistant to the pain-relieving properties of even the strongest analgesics such as morphine. Other analgesics, including nitrous oxide, may also be less effective when this occurs.

In 2006 Prof Maze won an Inspire award to investigate a novel idea that the reduced effect of either morphine or nitrous oxide can be reversed by the concurrent application of an alpha-2 agonist such as clonidine, thus improving long term pain management for burns patients.

The team has now completed the first stage of the project, which involved conducting two questionnaire based audits in burns patients.

The first study, involving 23 burns patients investigated the relationship between pain and anxiety trends and analysed how it varies with dressing changes. Results showed a significant correlation between pain and anxiety at all timepoints measured, with peak scores for total pain ratings occurring immediately after dressing changes. The results also indicated that the high levels of anxiety and pain may cause sleep disturbance, leading to increased pain on the following morning. These results highlight the need for effective pain and anxiety management during burn dressings not only to alleviate high procedural pain, but also to avoid continuing consequential effects.

The second study, involving 100 patients investigated what effects pain management for burn dressing changes have on pain, drugs given and side effects. The audit found a wide range of analgesic drugs are currently in use and a large variation in pain and response to drugs, indicating there is an opportunity to improve pain relief both before and during dressing changes.

The results of these two studies will be used to inform the next stage of the project which is to design and conduct a randomised controlled clinical trial to explore whether clonidine exhibits “anti-desensitising” properties in burns patients receiving morphine or nitrous oxide when having their dressing changed.





Inspire Award a major boost to clinical enquiry. Medical award set to reward gas based clinical research
Guildford, UK, 15 June 2006

Pioneering research into the use of specialised gases for the treatment of a range of life threatening illnesses has been given a ‘shot in the arm’ with the launch of a BOC Medical award for clinical research.

The BOC Inspire Award invites applications for research projects that add to our understanding of how medical gases - such as oxygen, nitrogen, Heliox or nitrous oxide - can be used to treat a range of respiratory and other illnesses.

Awards may be made up to twice yearly and the amount and frequency of the award will be dependant on the quality of proposals received. This is the first open invitation for research funding from BOC Medical.

BOC is a major exponent of medical research in the UK, supporting studies undertaken by the British Lung Foundation, sponsoring the chair of anaesthesia at Addenbrookes hospital, Cambridge, as well as managing a major trial of heliox at St Mary’s hospital, Paddington in London.

Launching the award BOC clinical director, Dr Hubert Bland said: “BOC has long been at the forefront of the development of specialist medical gases and gas mixtures which have proven beneficial in the treatment of a range of illnesses.

“BOC produces many different medical gases and mixtures and is a major provider to NHS hospital trusts throughout the UK. Backed by clinical evidence these gases have become fundamental for the medical community, giving clinicians and patients a range of lifesaving and palliative treatments.”

Said Dr Bland: “The role of BOC’s clinical research is to constantly test the knowledge we have of medical conditions and by so doing, attempts to advance our understanding of how patients respond to specific treatments.

“Because medical conditions and our understanding of them continue to evolve, there is always the opportunity for a new ‘application’ to be developed. By championing robust clinical enquiry the BOC Inspire Award aims to help build new bodies of evidence for medical gases from which new applications can then be explored.”

Coinciding with the launch, BOC has also announced the first two recipients of an Inspire Award. These are: The Centre for Aviation, Space and Extreme Environment Medicine (CASE) based at University College London (UCL) and Professor Mervyn Maze, Professor of anaesthetics at Imperial College, London.

The award to CASE will fund a team of mountaineering doctors, who plan to measure blood oxygen levels and conduct tests on the summit of Everest to see how well their brains, lungs and metabolisms function at extreme altitude. The results will help CASE create specialised breathing equipment for the chronically ill and attain a better understanding of disease processes so that new respiratory and cardiac treatments can be developed.

The anaesthesia team at Imperial College led by Professor Mervyn Maze are working with Entonox (nitrous oxide) and are devising a safe and efficacious method for controlling pain in patients with burns who often experience resistance to analgesia. Professor Maze’s team are examining the use of Clonidine to overcome this resistance and thereby enhance pain alleviation.

Said Dr Bland: “The team at BOC Medical is very proud to be supporting two important clinical projects. Our hope is that the BOC Inspire Award will further promote the use of medical gases for the treatment of patients as well as generate a global network of interest in the medical community for new gas based treatments.”