A career spent collaborating across continents to improve intensive care

28 September 2021

In September 2021, Professor Jeffrey Lipman AM will retire from an intensivist career that has spanned more than 30 years and revolutionised practices in intensive care systems globally. While Professor Lipman is retiring from his clinical role in intensive care, he is increasing his commitment to trauma research in Queensland, emphasising that the way to improve research is to collaborate. Professor Lipman started working in intensive care in 1978 when it was in its infancy. To begin, doctors applied concepts from the theatre complex to intensive care, extrapolating what they knew about anaesthesia and other areas of medicine to intensive care. They soon realised that intensive care patients were different, and the systems needed improving. In the early 1980s, Professor Lipman started his research into antibiotic dosing. He realised that in animal models, you could dose aminoglycosides differently. In the 1990s, he conducted a large clinical trial in Soweto, South Africa. The results showed that instead of giving patients three divided doses of antibiotics, it was more effective and safer to give them the combined doses in one. The next breakthrough for Professor Lipman and his research team was to show that giving the standard dose of antibiotics to young trauma patients was not enough because of their augmented renal clearance. These two research breakthroughs have changed antibiotic dosing guidelines worldwide for critically ill patients. By improving antibiotic dosing, patients respond faster to the drug and antibiotic resistance is prevented. In 1997, Professor Lipman was brought to Brisbane from South Africa to help establish the new intensive care department at the Royal Brisbane Women’s Hospital, Queensland's largest teaching and research hospital. Here, he has nurtured a team dedicated to continuing his research into infection management in intensive care. He was also instrumental in developing the anaesthesiology and critical care component of the graduate medical program for The University of Queensland. Professor Lipman is recognised internationally as an expert in this field, receiving an MD from the Chinese University of Hong Kong for pharmacokinetics of antibiotic dosage in 2006. Professor Lipman is adamant that to progress research and improve science, you need to collaborate widely. Over the course of his career he has collaborated with the research unit in Hong Kong and has set up collaborations across Europe, Asia and North America. “In ICU research, it’s do or die. It’s not enough these days to publish single centre studies,” Professor Lipman said. “With worldwide developments, big databases and the volume of scientific publications, you must collaborate to be able to show generalisability. To show the findings from your study group can be translated to other health systems in other countries.” “One of the most important elements in research collaboration is ownership by others of the systems that you’re trying to improve,” Professor Lipman said. “Unfortunately, from my experience, it is harder to collaborate across Queensland than across 68 ICUs in Europe. Bureaucracy in Queensland is stunting research growth.” Committed to increasing collaboration and reducing bureaucracy in research, Professor Lipman leads BDHP’s Trauma, Critical Care and Recovery theme. Although Professor Lipman sees that BDHP has connected the various institutions across South East Queensland, he recognises that there is more work needed to streamline translational research in Queensland. And that there is enormous societal benefit in doing so. In particular, by reducing the requirements for the use of de-identified patient data in research. Professor Lipman has received several national and international awards in recognition of his significant service to medicine, anaesthesiology and critical care, and education, including a Member of the Order of Australia in 2020 and honorary membership of the European Society of Intensive Care Medicine. After more than 20 years as the Director of the Intensive Care Services at the Royal Brisbane and Women’s Hospital, Professor Lipman now concentrates on research, including introducing new concepts for trauma care with the Jamieson Trauma Institute.

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