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LED light for examination and minor surgery SOLED15/15-F Bologna – ITALY Tel +39 051 721844 info@acem.it − www.acem.it INTENSIVE CARE Delivering respiratory support and cardiopulmonary bypass New MRI system results in bigger throughput Extracorporeal technology eases stress Children distracted by DVDs in scanner Conventional therapy for ARDS patients and for patients with exacerbation of chronic obstructive pulmonary dis- ease (COPD) has relied on invasive mechanical ventilation. Mechanical ventilation, however, has several major drawbacks: sedation has to be induced and the air being pressed into the lungs with positive pressure can damage the pulmonary alveoli or the diaphragm. Moreover, even maximum ventilation frequently does not pro- vide adequate gas exchange. Innovative artificial lungs, which breathe for the patient, offer less trau- matic treatment for severe diseases such as acute respiratory distress syn- drome (ARDS) or chronic obstructive pulmonary disease (COPD) 2013, German firm Xenios AG was founded by the two medical device companies Novalung GmbH and Medos Medizintechnik AG. Its focus lays on developing and manufactur- ing innovative devices for minimally invasive lung and heart support and offering groundbreaking solutions for lung failure as well as surgical and interventional solutions for the treat- ment of heart disease. The Novalung product family is the first complete product range of state-of-the-art solutions for minimally invasive treatment of acute and chron- ic lung failure without mechanical ventilation and without the need for The Royal Sussex County Hospital, in Brighton, has installed a Siemens Healthcare Magnetom Aera 1.5-Tesla system incorporating special fea- tures to help relax younger patients. Within months of the installation of the wide bore machine, which has comfort enhancing features, there has been a significant fall in the number of patients aged 4-17 requiring general anaesthetic ahead of undergoing an MRI scan. Other devices to help children relax include a TV – donated by Rocking Horse Children’s Charity – to watch DVDs, and lighting control for young people to select the ambi- ent hue. John Wilkinson, the hospi- tal’s Imaging Services Manager, explained that in the nine months since the Siemens machine was installed, clinicians have found the number of children needing general anaesthetic for their MR procedure has fallen by between one third and a half due to the increased compli- ance and comfort. This has led to increased capacity, falling anaesthetic costs, and ben- efits to younger patients. In the bore, TV is key to patient relaxation Under general anaesthetic (GA), the hospital can conduct MRI scans on three children per session, but up to ten children per session – depending on the nature of the scan – when they do not require GA because they feel more relaxed with the Aera’s enhanced child- friendly features. ‘This negates any anaesthetic risk for the children completely,’ he said. ‘The in bore TV is key, enabling children to lie down and watch their favourite DVD during a scan, while the wider bore makes the scanner much more tolerable from a claustrophobic point of view. ‘It is also quiet, which is much more acceptable to a child and this Siemens model has a variable LED lighting system, where children can say if they want blue, yellow or purple lighting. This way they feel as though they have more control of the scanning environment and as a result they are happier and more relaxed.’ One of the main benefits is a reduction in waiting times. If a child needs anaesthetic, anaesthetic and radiology teams must be coordi- nated, with the child admitted to hospital as a day patient, and the wait for an MRI slot can be up to five weeks. ‘Without GA, the wait is around two weeks and sometimes only three to four days, so we have been able to increase our capacity for paediatric scanning,’ Wilkinson added. ‘It is less resource intensive and from a patient – and parent – experience, so much better with the new Scanner. It creates a more acceptable environment for a child to go into an MRI scenario.’ The trust has located the scanner between the adult hospital and The Royal Alexandra Children’s Hospital, to use the equipment also for adults, and finds it has improved patient flow. This particular move is part of the hospital’s threefold operation to provide enhanced MR access to paediatric patients, and relocate the neurology department as well as ensure a better experience for the in-patients. Two further Aera 1.5-Tesla sys- tems have been installed as part of the planning to upgrade technol- ogy and further enhance the facili- ties within the hospital’s radiology department. Systems will be in use for seven days a week The systems are intended to be used for a range of services which include cardiac, breast, orthopaedic and prostate, and will also be used to ensure better throughput for neurosurgery patients following the move of neurosurgical procedures to the Royal Sussex County Hospital campus. ‘We will be using the systems seven days a week, which will great- ly impact the out-of-hours MR ser- vice with patients being seen more rapidly.’ Wilkinson pointed out. The three new Magnetom Aera will support a twenty percent rise in demand at The Royal Sussex County Hospital for imaging services com- pared to nine percent nationally in the UK. patient sedation and mobilization. XENiOS novalung products enable therapies for lung failure that are adapted to specific indications and patients. The duration and intensity of extrapulmonary lung support can be selected and adapted based on individual needs. Thomas Bein, MD, University of Regensberg Medical Center:“Novalung’s lung support ther- apies can be dosed as required in order to individualize to a patient’s specific needs, which is a very signifi- cant clinical benefit.” This new and easy-to-use alterna- tive to invasive and trauma associated mechanical ventilation is usually com- prised of a pump-driven pulmonary support system that removes carbon dioxide and adds oxygen. A key component of such a device is the so-called membrane ventilator, which ‘breathes’ outside the patient’s body to perform some of the gas exchange work of the native lung, at the same time relieving the respiratory muscles. A plasma-tight diffusion membrane is connected femorally, for example, to the body via a vascular access. The blood pump can be adjusted pre- cisely and instruments control blood flow. The membrane ventilator can be used on a patient for up to 29 days. Because the lung assist system does not require sedation, in that period the patient is actively involved in the ther- apy and can eat and communicate. The hardware fits on a trolley, providing patient mobility during the therapy, the manufacturer adds. The membrane ventilator height can be adjusted quickly, for example, when the patient wants to lie down, sit up or be moved around. In addi- tion, subsequent therapies can follow sooner, bringing length of stay reduc- tions and thus reduced costs. The next generation of lung assist systems might well be portable, the report continues. The platform-based technology enables further develop- ments, such as smaller and other types of vascular access plus increased effi- ciency as state-of-the-art gas exchang- ers provide better performance with a smaller footprint. What might the far-off future bring? Perhaps bio-hybrid systems that mimic nature and are even colonised with cells. Information: Xenios AG Measures to improve the MRI scanning experience for young patients have had a dramatic impact on waiting times for a British hospital, Mark Nicholls reports Radiographer John Wilkinson is Imaging Services Manager at Royal Sussex County Hospital, Brighton, which is part of Brighton and Sussex University Hospitals, in the south of England. He is the professional lead for radiography within the hospital Trust. Interventional lung assist is efficacious and allows a broad range of application. In 2012, Kluge and colleagues examined the role of extracorporeal interventional lung assist in four centres 26 EUROPEAN HOSPITAL  Vol 25 Issue 2/16 Tel +39051721844 info@acem.it − www.acem.it

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