AAGBI/Anaesthesia Departmental Project Grants
The effect of intravenous iron on postoperative transfusion requirements in hip fracture patients - a pilot study
Dr Iain Moppett
Low blood counts (anaemia) following hip fracture are common. This elderly group of patients has a poor outcome, with poor mobility, low rates of return to their own home and a 10% chance of dying in the first month after operation. Anaemia is associated with a higher risk of these poor outcomes. Blood transfusion can be used to treat anaemia but is expensive, and may have its own risks such as increased infection rates. Around the time of surgery and fracture, patients not only lose blood but can also fail to make red blood cells as fast as they should. Intravenous iron has been shown by studies from Spain to be very effective at improving red blood cell production, as well as reducing the need for transfusion and reducing infection rates. There are problems with these studies, and UK practice is somewhat different to Spain. We would like to perform a large (400 patient) randomized trial of intravenous iron. Before we do that, we need to undertake a smaller pilot study to see whether this is feasible and whether intravenous iron appears to have the same effects on stimulating red blood cell production as seen in the Spanish studies.
Investigating the mechanisms of neuropathic pain induced by paclitaxel: role of oxidative stress-induced mitochondrial damage and protection by targeted antioxidants
Professor Helen Galley
Some drugs used to treat cancer have the unpleasant side effect of severe nerve pain. There is some evidence that this pain might be caused by release of certain toxic chemicals which damage nerve cells. The chemicals are produced by the body as a normal process and the body's antioxidant systems usually control any damage. We think that these antioxidants become overwhelmed by the amount of toxic chemicals which are produced during treatment with cancer drugs. We propose to use a nerve cell culture system to see if, firstly, the toxic chemicals are involved and whether newly developed forms of antioxidants that are targeted at the exact place in the cell where damage occurs, are able to protect the nerve cells from the damage caused by the cancer drug, better than non-targeted antioxidants. These targeted antioxidants may be able to be used as a treatment for pain caused by cancer drugs and allow higher doses of the drugs to be used. However it is possible that the antioxidants may reduce or enhance the effectiveness of the cancer drugs, so we will also assess the ability of the cancer drugs to kill cultured cancer cells in the presence of the targeted antioxidants.
