Dr Marianne Chapman BMBS,  FFARCSI, FANZCA, FJFICM

Current Appointments | Biography | Staff & Students | Publications

Current Appointments

Biography

Marianne Chapman was appointed as Coordinator of Research in the Intensive Care Unit at the Royal Adelaide Hospital in 1998.  In this role she is responsible for co-ordinating research activity, both medical and nursing, and funding ongoing research projects.  Her principle research interest is in gastrointestinal dysfunction underlying problems with the administration of nutrition to the critically ill. This work is the result of a very successful collaboration with the Departments of Medicine and Gastroenterology in the University of Adelaide, the Royal Adelaide Hospital and the Repatriation General Hospital. This activity has been profitable in terms of generating funding over the past 6 years including NH&MRC, Australian & New Zealand College of Anaesthetics and Royal Adelaide Hospital and University of Adelaide funding. They have published in numerous high quality journals which has attracted editorials, have won prizes for presentations at national and international meetings and have 3 ongoing PhD students at various stages. Her work, in collaboration with the University Department of Medicine, and in particular A/Prof Robert Fraser, forms part of a Centre of Clinical Research Excellence grant from the NH&MRC, awarded this year. Two research staff are employed from monies supplied by these grants. She is currently completing a PhD thesis on this work, under the supervision of Prof Robert Fraser and Prof Michael Horowitz.

Other ICU research activities can be divided into pharmaceutical company, multicentre (Australian & New Zealand Intensive Care Society - ANZICS) clinical trials group, and local studies. She presently employs an additional 1.6 research staff in ICU. Previously these research assistant positions have been funded solely by pharmaceutical company research, however now one salary is supported by the Royal Adelaide Hospital. An important part of her work is her participation in multicentre trials, set-up and run by the ANZICS, Clinical Trials Group. She was the treasurer and South Australian representative of this group 1999-2002. Her involvement in these studies varies, but at times, as well as being a site investigator, she have been involved in the set up and organisation of these trials and have been on the writing committees of two.

Current research projects are investigating:

• The effect of varying doses of glucose on entero-gastric feedback and gastric emptying in the critically ill
• Manipulation of enteral feed formulae to optimize gut function and glucose control in the critically ill
• The place of GLP-1 administration in blood glucose control in critical illness
• The mechanisms of disordered gastrointestinal  function in the critically ill
• The relationship between cytokines and deranged gastric function in critical illness
• Examination of the effects of various prokinetics to improve gastric emptying and feeding during critical illness
• Small bowel motility and function in critical illness
• Measurement of arterial pressures in ICU patients
• Pharmacokinetic measurements of opiates in the critically ill

Key techniques include:
• Gastrointestinal Manometry
• Scintigraphy
• Breath tests for gastric emptying
• Breath tests for sucrose absorption
• 3-OMG levels for glucose absorption
• Assays for gut peptides (GLP-1, CCK, PYY)
• Assessment of feed tolerance

Staff

Ms Laura Besanko, Research Manager
Ms Carly Burgstad, Research Assistant
Ms Stephanie O’Connor, Research Manager
Ms Justine Rivett, Research Assistant

Higher Degree Students

Dr Adam Deane – PhD

Current Fuded Research

2005-7 NH&MRC Grant. R Fraser, J Dent, M Horowitz, R Holloway, K Jones, R Young.  Associate Investigator M Chapman.
Project Title; Oesophageal, gastric and small intestinal motility in critical illness. Value $491,700

2007 ANZCA grant 07/032. M Chapman, R Fraser.
Project Title: Effects of glucagon-like peptide -1 on glucose levels and small intestinal transit in critically ill patients. Value $40,000

2007 Intensive Care Foundation Grant:
Project Title: Absorption and upper gastrointestinal motility in critical illness. M Chapman. Value: $20,000. Not taken, as received Dawe’s scholarship instead for Dr Deane’s stipend.

2007 Royal Adelaide Hospital Special Purposes Fund
M Chapman, A Deane, N Nguyen, R Holloway, R Fraser.
Project title: Glucose feedback inhibition of gastroduodenal motility in critical illness. Value $16,700.

2008-10 Current Application for NH&MRC Funding
Fraser R, Chapman M, Rayner C, Holloway RH, Holtman G, Horowitz M. Project Grant: Impact of gastrointestinal dysmotility on enteral nutrition in the critically ill.
Value: $ 618,105.

Recent Publications

Journal Articles

Rice AJ. Scroop GC. Thornton AT. McNaughton NS. Rogers KJ. Chapman MJ. Greville HW. Scicchitano R. Gore CJ. Arterial hypoxaemia in endurance athletes is greater during running than cycling. Respiration Physiology 2000. 123(3):235-46.

Chapman MJ, Fraser RJ, Kluger MT, Buist MD, De Nichilo DJ.  Erythromycin improves gastric emptying in critically ill patients intolerant of nasogastric feeding. Crit Care Med. July 2000, Volume 28, Number 7, pages 2334-2337

Bellomo R. Chapman M. Finfer S. Hickling K. Myburgh J. Low-dose dopamine in patients with early renal dysfunction: a placebo-controlled randomised trial. Lancet. 2000  56(9248):2139-43,

Ritz MA, Fraser R, Edwards N, Di Matteo AC, Chapman M, Butler R, Cmielewski P, Tournadre JP, Davidson G, Dent J. Delayed gastric emptying in ventilated critically ill patients: measurement by 13 C-octanoic acid breath test. Critical Care Medicine. 2001 29(9):1744-9.

de Beaux I, Chapman M, Fraser R, Finnis M, De Keulenaer B, Liberalli D, Satanek M. Enteral nutrition in the critically ill: A prospective survey in an Australian intensive care unit. Anaesth & Int Care 2001. 29 (6):619-622.

French CJ. Bellomo R. Finfer SR. Lipman J. Chapman M. Boyce NW. Appropriateness of red blood cell transfusion in Australasian intensive care practice. Medical Journal of Australia 2002. 177(10):548-51.

Sanap M, Chapman MJ, Pain R. Severe Ethanol Poisoning Treated with Rapid Resuscitation and Renal Replacement Therapy: A Case Report. Critical Care and Resuscitation 2003; 5: 20-23

Chapman M, Fraser R, De Beaux I, Creed S, Finnis M, Butler R, Cmielewski P, Zacharkis B, Davidson G. Cefazolin Does Not Accelerate Gastric Emptying In The Critically Ill  Intensive Care Medicine 2003 29:(7)1169-1172.

ANZICS Clinical Trials Group and Institute for International Health SAFE Study Investigators. The Saline vs. Albumin Fluid Evaluation (SAFE) Study (ISRCTN76588266): Design and conduct of a multi-centre, blinded randomised controlled trial of intravenous fluid resuscitation in critically ill patients. BMJ.com http://bmj.com/cgi/content/full/326/7389/559/DC1 (Accessed 17th March 2003). (Steering Committee & Site Investigator).

The SAFE Study Investigators. A Comparison of Albumin and Saline for Fluid Resuscitation in the Intensive Care Unit. NEJM 2004 Volume 350: 2247-2256. (Steering Committee & Site Investigator)

Nind G, Chen W-H, Protheroe R, Iwakiri K, Fraser RJ, Young R, Chapman M, Nguyen N, Sifrim D, Rigda R, Holloway RH.  Mechanisms of Gastroesophageal Reflux in Critically Ill Mechanically Ventilated Patients. Gastroenterology 2005;128:600-606.

Young RJ, Chapman MJ, Fraser R, Chorley D, Creed S. A novel technique for nasoduodenal feeding tube placement in critically ill patients. Anaesthesia and Intens Care 2005 33;2.

Ritz MA, Chapman MJ, Finnis ME, Butler RN, Cmielewski P, Davidson GP, Rea D, Fraser RL. Erythromycin dose of 70mg accelerates gastric emptying as effectively as 200mg in the critically ill. Intensive Care Medicine. 31(7):949-54, 2005.

Chapman MJ. Myburgh JA. Kluger MT. Runciman WB. Crisis management during anaesthesia: pulmonary oedema. Quality & Safety in Health Care. 14(3):e8, 2005.

Myburgh JA. Chapman MJ. Szekely SM. Osborne GA. Crisis management during anaesthesia: sepsis. Quality & Safety in Health Care. 14(3):e22, 2005.

Paix AD. Runciman WB. Horan BF. Chapman MJ. Currie M. Crisis management during anaesthesia: hypertension. Quality & Safety in Health Care. 14(3):e12, 2005.

Bacon AK. Paix AD. Williamson JA. Webb RK. Chapman MJ. Crisis management during anaesthesia: pneumothorax. Quality & Safety in Health Care. 14(3):e18, 2005.

Chapman M, Fraser R, Vozzo R, Bryant L, Tam W, Nguyen N, Zacharakis B, Davidson G, Butler R, Horowitz M. Antro-pyloro-duodenal motor responses to gastric and duodenal nutrient in critically ill patients. Gut. 54(10):1384-90, 2005. Followed by editorial.

MERIT Study Investigators. Introduction of the Medical Emergency Team (MET) System; A cluster randomised controlled trial. Lancet 2005; 365; 2091-2097.
Ho JT. Al-Musalhi H. Chapman MJ. Quach T. Thomas PD. Bagley CJ. Lewis JG. Torpy DJ. Septic shock and sepsis: a comparison of total and free plasma cortisol levels. Journal of Clinical Endocrinology & Metabolism. 91(1):105-14, 2006.

Nguyen NQ, Chapman MJ, Fraser RJ, Ritz MA, Bryant L, Butler R, Davidson G, Zacharakis B, Holloway RH.  Longstanding Type II Diabetes Mellitus is not a risk factor for slow Gastric Emptying in Critically Ill Patients. Int Care Med. 2006 32(9):1365-1370.

The SAFE Study Investigators. Effect of baseline serum albumin concentration on outcome of resuscitation with Albumin or Saline in patients in Intensive Care Units – analysis of data form the saline versus albumin evaluation (SAFE) study. BMJ Doi:10.1136/bmj.38985.398704.7C (Steering Committee & Site Investigator). In print BMJ 2006;333:1044. Followed by editorial.   

Venkatesh B, Prins J, Torpy D, Chapman M, Joyce C, Cooper DJ, Cohen J, Hickman I, Jones D, Higgins A.  Relative adrenal insufficiency in sepsis match point or deuce? Crit Care Resusc. 2006  8(4): 376-80.

Nguyen NQ, Ng MP, Chapman M, Fraser RJ, Holloway RH. The impact of admission diagnosis on gastric emptying in critically ill patients - a retrospective study.  Critical Care Feb 2007 8;11(1):R16.

Nguyen NQ, Fraser RJ, Bryant LK, Chapman M, Holloway RH, Feinle-Bisset C. Proximal gastric motility in critically ill patients with type 2 diabetes mellitus. World Journal of Gastroenterology. 2007 14;13(2):270-275.

Nguyen NQ, Chapman M, Fraser RJ Bryant L, Holloway RH. Erythromycin is more effective than metoclopramide in the treatment of feed intolerance in critical illness. Crit Care Med. 2007 Feb;35 (2):483-489.
Nguyen NQ, Fraser RJ, Chapman M, Bryant LK, Wishart J, Holloway RH, Horowitz M. Fasting and nutrient-stimulated plasma peptide-YY levels are elevated in critical illness and associated with feed intolerance: a randomised controlled trial. Crit Care 2006; 10(6): R 175.
Nguyen NQ, Fraser RJ, Chapman M, Bryant L, Holloway RH, Vozzo R, Wishart J, Feinle-Bisset C, Horowitz M. Feed intolerance in the critically ill is associated with increased plasma cholecystokinin concentrations. Critical Care Medicine. 2007;35(1):82-88.

Nguyen NQ, Fraser RJ, Chapman M, Bryant L, Holloway RH, Vozzo R, Feinle-Bisset C. Proximal gastric response to small intestinal nutrients is abnormal in mechanically ventilated critically ill patients.  World J Gastro, 2006 Jul 21;12(27):4383-4388.

Chapman MJ, Nguyen NQ, Fraser RJ. Gastrointestinal motility and prokinetics in the critically ill. Current Opinion in Critical Care. April 2007. 13(2):187-94.

Nguyen NQ, Mangoni AA, Fraser RJ, Chapman M, Bryant L, Burgstad C, Holloway RH. Prokinetic therapy with erythromycin has no significant impact on blood pressure and heart rate in critically ill patients. Br J Clin Pharmacol (accepted for publication June 2006).

Myburgh JA, Cooper DJ, Finfer S, Venkatesh B, Jones D, Higgins A, Bishop N, Higlett T and the ANZICS Clinical Trials Group ATBIS Investigators. Epidemiology and 12-month outcomes from traumatic brain injury in Australia and New Zealand. Submitted to J Trauma 2006
The SAFE Study Investigators. Resuscitation with saline compared to albumin in traumatic brain injury. N Engl J Med 2007;357:874-84. (Steering Committee & Site Investigator).

Cretikos M, Chen J, Hillman K, Bellomo R, Finfer S, Flabouris A and the MERIT study investigators. The objective medical emergency team activation criteria: A case-control study. Resuscitation, 2007, 73(1): 62-72.

Cretikos MA, Chen J, Hillman KM, Bellomo R, Finfer SR, Flabouris A and The MERIT Study Investigators. The effectiveness of implementation of the medical emergency team (MET) system and factors associated with use during the MERIT study. Crit Care Resusc; 2007; 9(2): 206-12. (site Principal Investigator).

Nguyen NQ, Chapman M, Fraser RJ, Bryant L, Holloway RH. Prokinetic therapy for feed intolerance in critical illness: one drug or two? Accepted for publication by CCM. July 2007

Lam SW, Nguyen NQ, Ching K, Chapman M, Fraser RJ, Holloway RH. Gastric feed intolerance is not increased in critically ill patients with type II diabetes mellitus. Intensive Care Med 2007 [Epub ahead of print].

Chapman M, Fraser R, Bryant L, Vozzo R, Nguyen N, Tam W, Zacharakis B, Davidson G, Butler R, Horowitz M. The organization of antro-duodenal pressures in the critically ill – relationship to gastric emptying. Accepted for publication by Neurogastroenterology & Motility. June 2007.

Nguyen NQ, Ching K, Bryant L, Fraser RJ, Chapman MJ, Holloway RH. Risk of Clostridium difficile diarrhoea in critically ill patients treated with erythromycin-based prokinetic therapy for feed intolerance. Submitted to Intensive Care Medicine.

Campbell V, Peake SL, Chapman M, Faull R, Finnis M, Moran JL. Intravenous N-acetylcysteine for the prevention of contrast nephropathy in at-risk critically ill patients. A pilot study. Submitted to Intensive Care Medicine.

Hockley SJG, Hamilton V, Young RJ, Chapman MJ, Taylor J, Edwards J, Rivett J, Creed S, Chorley D, Williams D, Tippett M. Efficacy of the CathRite™ system to guide bedside placement of peripherally inserted central venous catheters in critically ill patients: a pilot study. Critical Care & Resuscitation 2007 9(3) 251-255.

Deane A, Chapman MJ, Fraser RJ, Bryant L, Burgstad C, Nguyen N. Mechanisms underlying feed intolerance in the critically ill: Implications for treatment. World J Gastroenterol 2007 13(29) 3909-3917.

Nguyen NQ, Fraser RJ, Chapman M, Bryant L, Burgstad C, Bellon M, Horowitz M, Holloway RH. The impact of early enteral feeding on gastric emptying and small intestinal absorption in critically ill patients. Submitted to Crit Care Med.