Manchester Academic Critical Care (MACC)

Conducting high-quality research in the critically ill.



Manchester Academic Critical Care (MACC) is a collaboration between The University of Manchester’s teaching hospitals. Our research focuses on data synthesis and hypothesis testing in the critically ill.

We develop research skills in local researchers and trainees through placements on our projects. We conduct novel and innovative primary research, partner with industry, and support recruitment to NIHR portfolio studies.

MACC is led by Professor Paul Dark.


Our research

We focus on improving the short and long-term outcomes of the critically ill. Our vision is to establish Manchester as one of the UK’s leading academic centres for critical care research. 

Our purpose is to develop a collaborative academic centre of excellence with an international reputation, delivering significant benefits to critically ill patients in Manchester and beyond.

Our priority areas are:

  • rapid diagnosis and optimal precision management of infection;
  • optimal management of acute and chronic respiratory failure;
  • optimal management of tracheostomy and the airway;
  • preparation, perioperative management and rehabilitation of high-risk surgical patients who require critical care.
Precision diagnostics

Infection and sepsis are the biggest killers in the critically ill. Patients are vulnerable to common and opportunistic infections and rapid, accurate diagnosis of infection is vital when time is short.

Critical illness and its treatment can change the physiology of the body significantly, meaning that conventional therapies have to be adapted to be effective when patients have organ failures, fluid overload or extra-corporeal support such as dialysis or extracorporeal membrane oxygenation (ECMO).

What we do

MACC researchers deliver cutting edge research at the bedside and lead on national strategies to detect infection faster than ever before, and to tailor our therapies to be maximally effective and minimise antibiotic resistance.

We have led on developing bedside blood tests to rapidly detect bacteria and identify maximally effective antibiotics, both in the blood and exhaled breath.

Our work has led to major collaborations and funding to develop new labs, techniques and technologies to detect and treat infection with precision right here in Manchester.

Examples of our work include:

Acute respiratory failure

Critical illness is commonly associated with respiratory failure, where the body’s ability to take in oxygen and exhale carbon dioxide is overwhelmed.

Simple strategies such as delivering increasing concentrations of oxygen aren’t always enough, and in critical care patients, we often have to supplement additional oxygen therapy with invasive or non-invasive pressure support to help breathing.

Conventional strategies involve intubation of the trachea and mechanical ventilation, but ventilation of inflamed lungs can cause its own problems, leading to (worsening of) acute lung injury.

What we do

We are involved in trials to help patients who develop acute respiratory failure. These trials involve:

  • developing and testing rapid infection diagnostics in blood or exhaled breath to promptly detect infection;
  • tailoring antibiotic therapies in the critically ill to ensure adequate levels of antibiotics in the right tissues when organ failures complicate treatment;
  • strategies to reduce the requirements for patients to need mechanical ventilation, including extra-corporeal oxygenation and CO2 removal;
  • strategies to reduce the amount of ventilation that patients require, including extra-corporeal oxygenation and CO2 removal, allowing us to be more gentle to the lungs;
  • immune therapies and stem cell therapies to reduce inflammation in acute lung injury.
Improving tracheostomy care

Between 10% and 15% of all ICU admissions will require a tracheostomy. This artificial airway can be lifesaving, but it can also cause serious problems if the tube becomes blocked or displaced.

Patients tell us that the worst thing about having a tracheostomy is not being able to speak, eat or drink properly, especially when recovering from critical illness.

What we do

Tracheostomy care is a great example of the multidisciplinary team working together, and MACC collaborates widely with research-active colleagues in related specialities, with strong representation from nursing, physiotherapy and speech and language therapy.

We also pride ourselves on having patients and their families embedded at the core of what we do.

MACC has attracted significant funding to research the problems with tracheostomies, develop solutions and resources to improve care, and develop new technologies to improve communication.

Examples of our work can be seen on the National Tracheostomy Safety Project website and the Global Tracheostomy Collaborative website. You can also watch a video from the National Tracheostomy Safety Project.



Support for trainees

We support trainees in our region who are interested in research into critical illness, typically from anaesthesia, critical care medicine, respiratory or acute medical backgrounds.

Trainees and students can collaborate with us for short projects during relevant placements or join us for more substantial placements as part of formal research attachments. This does not necessarily need to be part of a formal academic training pathway.

We welcome FY, ACCS and ST trainees at junior and senior level. We also have projects for Clinical Fellows from a variety of backgrounds.

We can offer experience and guidance in all aspects of research, including:

  • study setup and design
  • negotiations with potential funders and industry
  • grant applications
  • Research Ethics Committee (REC)
  • Health Research Authority (HRA) approvals
  • recruitment, delivery, data synthesis and analysis.

We encourage and support our trainees to present work at local, national and international meetings and to publish in high profile journals.

Placements that are three, six or 12 months long are available. We are supported by Health Education England North West in providing specific research modules for trainees.

We encourage trainees to consider formal higher degrees, typically MPhil or MRes programmes at The University of Manchester. This will require out-of-programme approval from your base speciality heads of school, but we have found schools to be extremely supportive of our research programmes for trainees.

We can typically offer research clinical fellowship posts on our ICUs to support you during out-of-programme research placements.

To find out more, contact us by emailing



Collaborate with us

Our researchers hold a balanced portfolio of commercially funded research, grant-funded projects and NIHR portfolio studies.

We have attracted grant income of over £17 million since 2012, funding a diverse portfolio from lab-based research through to bedside clinical research, hypothesis testing, data synthesis and analysis, implementation science and quality improvements.

We welcome collaborations with other organisations locally, nationally and around the world. We have successfully collaborated with industry in the fields of infection diagnostics, optimal antimicrobial therapies, invasive ventilation and airway management.

To find out more, contact us by emailing



Contact us

We are happy to hear from trainees who are interested in our placements, as well as from potential research collaborators.

You can get in touch with MACC by emailing