Sympathetic Autonomic Dysfunction and the risk of Hypotension AfTer Surgery (SADHATS)

The SADHATS study is a prospective observation study of patients at risk of postoperative hypotension at the Royal Melbourne Hospital (RMH), Victoria, Australia (with an estimated 45 participants). Postoperative hypotension is common, associated with patient harm including myocardial, kidney and brain injury and mortality, and has few treatment options. Current physiological models of postoperative hypotension imply the development of sympathetic autonomic dysfunction as part of the pathological process, but this link has not been carefully examined in surgical patients. It is well known that sympathetic autonomic dysfunction causes orthostatic hypotension, which shares many features of postural hypotension, but a direct mechanistic link has not been explored. This project seeks to explore a potential association between sympathetic autonomic dysfunction and postoperative hypotension. On this project, you will work with experienced academic anaesthetists and intensive care specialists, PACU staff and research nurses at RMH to enrol up to 50 participants. Responsibilities for the successful student would include all aspects of the research process including: - Recruitment of study participants (training will be provided) - Data collection, entry, and management - Prospective follow up of study participants at 30 days and 12-months following index surgery - Data analysis - Authorship of publication (a planned sub-study) Ethical and governance approval will be completed before commencement of study. The responsibilities are a substantial commitment. Successful students will need to be present for the majority of the working week (Monday-Friday) and demonstrate substantial initiative and responsibility in the conduct of the study. In return for this commitment, we expect that students will gain substantial experience in the conduct of high-quality trial procedures, and learn from the very experienced research team. Precise days and hours of attendance can be negotiated. The study would suit a student who is interested in critical care, and particularly anaesthesia, intensive care medicine or perioperative medicine as a future career. The program offers exposure to anaesthesia practice at one of Victoria’s busiest operating theatres, with a particular role as a state referral centre for trauma, stroke, oncology and cardiothoracic surgical work. Clinical experience in theatre can be organised during the placement, but applicants should note that this is not the focus of the placement. The student can attend medical student and intern teaching to remain in touch with non-anaesthetic medicine during the placement. The primary supervisor is A/Prof. Jai Darvall, an anaesthetist and intensive care specialist with over 80 publications, supported by Prof. Kate Leslie, one of the world’s most experienced anaesthesia researchers who has authored over 270 publications. Dr Ned Douglas is the principal investigator for the project. All three supervisors work full time at RMH and are available at all times while the project is running. Supervision meetings will occur weekly, and immediate support is available from one of the investigators or the research nurse team at all times. The supervision team has supported a series of Monash BMedSci students over the last decade and understands the requirements of the program in detail. The supervisors are looking for students who are highly motivated, organised, honest and with a high degree of professionalism and ability to work with others. Students will be required to liaise directly with consultant anaesthetists, surgeons, PACU nurses and research nurses, and to do so in a reliable and professional manner. It is expected that students will follow the project protocol precisely at all times. Students will be required to have had a full course of COVID vaccinations, be fit tested for N95 masks and have completed Good Clinical Practice training (which can be organised through RMH) before commencing work on the project. If further information would be helpful, please contact: 1. Dr Ned Douglas at ned.douglas@mh.org.au or 2. A/Prof. Darvall at jai.darvall@mh.org.au