News https://www.rbht.nhs.uk/ en ‘Simple’ innovation to ventilators could increase oxygen supplies at hospitals https://www.rbht.nhs.uk/news/simple-innovation-ventilators-could-increase-oxygen-supplies-hospitals <span>‘Simple’ innovation to ventilators could increase oxygen supplies at hospitals</span> <span><span>S.Anand</span></span> <span>Tue, 27/10/2020 - 10:48</span> <div class="field field--name-field-date field--type-datetime field--label-hidden field--item"><time datetime="2020-10-27T12:00:00Z">27 October 2020</time></div> <div class="field field--name-body field--type-text-with-summary field--label-hidden field--item"><p><span><span><span><span>A ‘simple’ modification of domiciliary (i.e. designed for use at home) non-invasive ventilators could significantly reduce oxygen consumption by hospitals treating Covid-19-related respiratory failure, a study by engineering and medical specialists at Royal Brompton Hospital has found. </span></span></span></span></p> <p><span><span><span><span>Domiciliary ventilation is commonly used as a non-invasive way to help patients with chronic respiratory conditions breathe while they sleep. </span></span></span></span></p> <p><span><span><span><span>Additional oxygen is often added into the circuit of ventilation machines through an oxygen inlet connected to an oxygen source (in a hospital setting, this is typically a central reservoir). However, not all of the oxygen that is delivered to patients on ventilatory support goes into the patient. While the oxygen is used when they breathe in (the inspiration phase), when they breathe out (the expiration phase) much of the oxygen is released back into the atmosphere, which can result in a large amount of wasted oxygen. </span></span></span></span></p> <figure role="group" class="align-right"><img alt="Modified ventilator" data-entity-type="file" data-entity-uuid="38e156e9-23c4-4061-8ef7-d8c9d5b95932" src="https://www.rbht.nhs.uk/sites/nhs/files/thoraxjnl-2020-215487-F1.large4.jpg" /><figcaption>A modified domiciliary ventilator (the vivo two). A - oxygen inlet connected to wall oxygen at 15/L/min. B - reservoir for the capture of expiratory phase. C -T-piece allows ingress of room air (protected by a filter). D - air inlet contained 3D printed adapter. E - duplicate air inlet adapter.</figcaption></figure><p><span><span><span><span>Dr Yoseph Mebrate, lead clinical engineer, and colleagues at Royal Brompton Hospital looked at how this wasted oxygen could be captured and redistributed to patients during the expiration phase. To do this, the team designed and produced an inlet adapter (pictured</span><span>) using 3D printing that would form the basis for new apparatus applied to two commonly available devices for domiciliary ventilation. The findings, published in leading respiratory medicine journal </span><a href="https://thorax.bmj.com/content/early/2020/10/15/thoraxjnl-2020-215487"><em><span>Thorax</span></em></a><strong><em><span>,</span></em></strong><span> showed that the modified ventilators were able to successfully capture the oxygen released in the expiration phase that would have otherwise been discarded. As a result, the ventilators delivered a higher fraction of inspired oxygen (</span><span>FiO</span><span><span><span>2</span></span></span><span>) – or oxygen-enriched air – compared with standard use of the devices. </span></span></span></span></p> <p><span><span><span><span>Describing what the findings could mean in light of the Covid-19 pandemic, </span><a href="https://www.rbht.nhs.uk/specialists/professor-michael-polkey"><span>Professor Michael Polkey</span></a><span>, consultant chest physician at Royal Brompton Hospital and one of the lead authors of the study, said: </span></span></span></span></p> <p><span><span><span><span>“One of the problems of Covid is that patients sometimes require large quantities of oxygen. This relatively simple modification of two standard,<strong> </strong>commonly used domiciliary ventilators presents a possible solution to shortages in medical-oxygen supplies that have overwhelmed some hospitals in their fight against Covid-19. Although not without their limitations, the results of this study prove that there are viable ways for hospitals to become more ‘oxygen efficient’. </span></span></span></span></p> <p><span><span><span><span>“The key here is understanding how oxygen released during the expiration phase can be safely re-used by the patient so as to ensure less or no oxygen is wasted. As a result, this should leave hospitals with enough oxygen supply to treat more patients at any given concentration of oxygen-enriched air (F</span><span>iO</span><strong><span><span><span>2</span></span></span></strong> <span>). Increasing the amount of oxygen hospitals can deliver through one ventilator increases the number of ventilators that can be used, and in light of what we have seen during the Covid-19 pandemic globally, these findings may be timely.</span></span></span></span></p> <p><span><span><span><span>In their <a href="https://thorax.bmj.com/content/early/2020/10/23/thoraxjnl-2020-216117">commentary</a> of the study, the editors of <em>Thorax</em> congratulated the team on “engineering a turbocharged non-invasive ventilator.”</span></span></span></span></p> <p><span><span><span><em><span>Royal Brompton Hospital houses the largest centre in Europe to provide domiciliary non-invasive ventilation to patients with respiratory conditions, including chronic obstructive pulmonary disease (COPD) and cystic fibrosis (CF). We treat and care for over 1,800 adults and children who use domiciliary ventilators at home.</span></em></span></span></span></p></div> Tue, 27 Oct 2020 10:48:36 +0000 S.Anand 2771 at https://www.rbht.nhs.uk What we are doing to help protect you https://www.rbht.nhs.uk/news/what-we-are-doing-help-protect-you <span>What we are doing to help protect you</span> <span><span>S.Anand</span></span> <span>Fri, 23/10/2020 - 13:08</span> <div class="field field--name-field-date field--type-datetime field--label-hidden field--item"><time datetime="2020-10-23T12:00:00Z">23 October 2020</time></div> <div class="field field--name-body field--type-text-with-summary field--label-hidden field--item"><p><span><span><span><span><span><span>New</span></span></span></span> <span><span>measures have been put in place at our hospitals for patients who <span>are</span> coming in for an appointment, test or procedure. </span></span></span></span></p> <p><span><span><span><span><span><span>For example:</span></span></span></span></span></span></p> <ul><li><span><span><span><span>Appointments are staggered to ensure social distancing is maintained</span></span></span></span></li> <li>Chairs in waiting rooms are spaced two metres apart and we have a limited number of people in these areas at any one time </li> <li><span><span><span><span>Staff are required to wear appropriate personal protective equipment (PPE) in line with government guidelines</span></span></span></span></li> <li><span><span><span><span><span>All patients will go through a pre-screening Covid-19 questionnaire with a clinical nurse specialist to identify any symptoms before coming into </span><span>our hospitals </span></span></span></span></span></li> <li><span><span><span><span>All patients are required to wear a face covering while in our buildings, and sanitise their hands on arrival </span></span></span></span></li> </ul><p><span><span>This video explains these, and other measures, in more detail. You will hear from Lucy Everett, matron and lead nurse in infection control, Paul Lidgate, senior nurse and matron, and Itayi Chinehasha, senior staff nurse, who talk you through what to expect during your visit. </span></span></p> <div class="video-embed-field-provider-vimeo video-embed-field-responsive-video form-group"><iframe width="854" height="480" frameborder="0" allowfullscreen="allowfullscreen" src="https://player.vimeo.com/video/470984545?autoplay=0"></iframe> </div> </div> Fri, 23 Oct 2020 12:08:05 +0000 S.Anand 2770 at https://www.rbht.nhs.uk Trust consultant leads global trial into coronary artery disease https://www.rbht.nhs.uk/news/trust-consultant-leads-global-trial-coronary-artery-disease <span>Trust consultant leads global trial into coronary artery disease </span> <span><span>S.Anand</span></span> <span>Fri, 16/10/2020 - 11:06</span> <div class="field field--name-field-date field--type-datetime field--label-hidden field--item"><time datetime="2020-10-16T12:00:00Z">16 October 2020</time></div> <div class="field field--name-body field--type-text-with-summary field--label-hidden field--item"><p><span><span><span><span lang="EN-US" xml:lang="EN-US" xml:lang="EN-US"><span>New findings from a multi-national clinical trial, published in the </span></span><span lang="EN-US" xml:lang="EN-US" xml:lang="EN-US"><a href="https://www.onlinejacc.org/content/early/2020/10/03/j.jacc.2020.09.603?utm_medium=social&utm_source=twitter_post&utm_campaign=tct20"><em><span>Journal of the American College of Cardiology (JACC)</span></em></a></span><span lang="EN-US" xml:lang="EN-US" xml:lang="EN-US"><span> and authored by Royal Brompton Hospital consultant cardiologist, Dr Jonathan Hill, shows that patients with an advanced form of coronary artery disease (CAD) can benefit from a treatment using sonic pressure waves to break up hardened blockages in the heart. Dr Hill was the trial’s co-principal investigator and has trained cardiologists on the innovative procedure across the world. </span></span></span></span></span></p> <p><span><span><span lang="EN-US" xml:lang="EN-US" xml:lang="EN-US">As people with CAD grow older and their disease progresses, plaque in the heart’s arterial wall can grow into bone-like calcium deposits, which make the artery narrower and rigid. This makes the disease more difficult to treat and can sometimes result in serious complications for patients. </span></span></span></p> <p><span><span><span lang="EN-US" xml:lang="EN-US" xml:lang="EN-US">The trial tested innovative technology called Shockwave Intravascular Lithotripsy (IVL) which generates sonic pressure waves – or shockwaves - to fracture these calcium build-ups. The narrowed artery can then be expanded and blood flow can be restored with the placement of a stent, a small tube inserted into a blocked passageway to keep it open.</span></span></span></p> <p><span><span><span><span lang="EN-US" xml:lang="EN-US" xml:lang="EN-US"><span>The <span>Disrupt CAD III trial, facilitated and co-ordinated by Dr Hill, enrolled 384 patients at 47 sites in the United States, France, Germany, and the UK. </span>The trial aims to generate the data needed to obtain approval from the US Food and Drugs Administration to use Shockwave IVL to treat patients in the US<em>.  </em></span></span></span></span></span></p> <p><span><span><span lang="EN-US" xml:lang="EN-US" xml:lang="EN-US">Royal Brompton’s cardiology team has been pivotal in leading research into this new technology’s effectiveness both in the UK and Europe in recent years, which has led to the technology being trialled for use in the US.<span> Professor Carlo Di Mario, </span>honorary c<span>onsultant cardiologist, was the </span>c<span>o-</span>p<span>rinciple </span>i<span>nvestigator of earlier Disrupt CAD I and II studies that trialled the new Shockwave IVL technology on  patients across the UK and Europe.</span> Dr Hill was an investigator on these studies<span>. </span></span></span></span></p> <p><span><span><span><span lang="EN-US" xml:lang="EN-US" xml:lang="EN-US"><span>Dr Hill said: “I am delighted to have been part of this important global trial. <span>The results of this study show that the procedure is safe and effective for patients with moderate to severe calcification. It will make a huge difference to clinicians’ treatment of CAD. It also has quick recovery times for the patient, which is key.”</span></span></span></span></span></span></p></div> Fri, 16 Oct 2020 10:06:55 +0000 S.Anand 2769 at https://www.rbht.nhs.uk “I became like family”: recovered nurse thanks Harefield Hospital for ‘incredible’ care during Covid-19 https://www.rbht.nhs.uk/news/i-became-family-recovered-nurse-thanks-harefield-hospital-for-incredible-care-during-covid-19 <span>“I became like family”: recovered nurse thanks Harefield Hospital for ‘incredible’ care during Covid-19</span> <span><span>R.Dalton</span></span> <span>Tue, 29/09/2020 - 10:17</span> <div class="field field--name-field-date field--type-datetime field--label-hidden field--item"><time datetime="2020-09-29T12:00:00Z">29 September 2020</time></div> <div class="field field--name-body field--type-text-with-summary field--label-hidden field--item"><p><span><span><span>Maureen Clements was admitted to Harefield Hospital at the height of the Covid-19 pandemic.</span></span></span></p> <p><span><span><span>A senior nurse at Northwick Park Hospital, Maureen contracted Covid-19 and was admitted to the hospital with respiratory failure.</span></span></span></p> <p><span><span><span>She later spent a month on Harefield Hospital’s Intensive Therapy Unit (ITU) and a further month on its wards, and has since spoken about her experience recovering from the virus and the care she received.  </span></span></span></p> <p><span><span><span>“As a senior nurse I have been involved in delivering patient care for years as well as assessing nursing practice. I am absolutely blown away by the care I received and continue to get from Harefield Hospital. Incredible is the only word,” she said.</span></span></span></p> <p><span><span><span>“The standard of care I received and standard of practice I witnessed was second to none. From the moment I woke up to the moment I left, it didn’t falter.”</span></span></span></p> <p><img alt="" data-entity-type="file" data-entity-uuid="45b26cb2-9003-4dfc-8548-c0f622cfb33f" src="https://www.rbht.nhs.uk/sites/nhs/files/Banner%20images/Maureen%20Clements_resized.jpg" class="align-right" /></p> <p><span><span><span><span>Maureen was one of an unprecedented number of critically ill patients admitted to Northwick Park Hospital at the height of the pandemic who needed mechanical ventilation, which is provided to patients with acute respiratory failure when they are unable to breathe for themselves.</span></span></span></span></p> <p><span><span><span><span>The hospital’s A&E department admitted one of the highest numbers of Coronavirus patients in the UK and, despite trebling ITU capacity was unable to manage the sheer volume of patients requiring ITU. Hospitals with available ITU bed capacity were able to help out via the North West London Critical Care Network, which co-ordinated transfers of critically ill patients between hospitals. </span></span></span></span></p> <p><span><span><span><span>Via this network Maureen was transferred to Harefield Hospital on 10 April 2020 and admitted to its ITU. </span>Harefield’s lead nurse and associate general manager, Peter Doyle, said: “When Maureen came to us she was seriously ill. She was ventilated and had very low oxygen levels.”</span></span></span></p> <p><span><span><span>While in ITU Maureen’s condition worsened as she suffered kidney failure and did not respond to proning, a procedure where patients in intensive care are placed on their stomach to help treat acute respiratory distress syndrome.</span></span></span></p> <p><span><span><span>Peter said: “There were a number of times when Maureen’s condition gave us real cause for concern, and on more than one occasion she deteriorated after showing signs of recovery. The fact that she didn’t initially respond to proning was also in itself a real cause for concern.</span></span></span></p> <p><span><span><span>“We had a large number of Covid patients in ITU It really was a highly emotional and traumatic time for many of our staff, who had seen Northwick Park overwhelmed and were desperate to support them in any way possible.”</span></span></span></p> <p><span><span><span>After a month in ITU with several close calls and further recovery on ‘step-down’ Covid wards, Maureen was discharged on 9 June 2020.</span></span></span></p> <p><span><span><span>“It’s always an incredible moment to see someone who was so very ill recover and go home to their loved ones,” Peter said.</span></span></span></p> <p><span><span><span>“So many of our staff got to know Maureen during her time with us and were involved in her care. I know that she has a story to tell about so many of our staff of all disciplines. The thing we’ll always remember about Maureen, and her husband Jay, is their great sense of humour at such a stressful time in their lives. I’m not sure whether she realises how much she helped our morale at a time when we were all feeling real pressure. It was an emotional and joyous day when she was discharged, and lots of staff gathered to clap her out of the hospital.”</span></span></span></p> <p><span><span><span>Maureen’s husband, who had also contracted Covid-19 and was hospitalised at Northwick Park, was able to be present and helped clap her out of the hospital with cymbals. </span></span></span></p> <p><span><span><span>Now continuing her recovery at home, Maureen has no memory of getting sick or the ordeal she went through in ITU.</span></span></span></p> <p><span><span><span>Her first memory is of waking up in the CT scanner: “When I woke up I didn’t know anything about what had happened to me or where I was. Immediately the caring staff at Harefield put me at ease. I was made to feel like a guest of the hospital and there wasn’t anything they wouldn’t do for me. I became like family.</span></span></span></p> <p><span><span><span>“It sounds strange to say it was a good experience being in hospital, but it really was. Of course it was challenging and frightening, but within the realms of that it really was such an enjoyable experience. All the teams that cared for me – the nurses, physiotherapists, psychologists and occupational therapists – treated me like I was someone very important.”</span></span></span></p> <p><span><span><span>Recalling the extra lengths staff went to during her long stint in hospital, Maureen said: “I had only ever seen the staff who were taking care of me in full PPE, which can be really disorientating. One day, a group of nurses and physiotherapists got together and stood apart outside my window so they could take their masks off and I could see their faces. I won’t ever forget that.</span></span></span></p> <p><span><span><span>After leaving hospital, Maureen continues to be cared for by teams at Harefield Hospital via the post-Covid-19 clinic. Like many Covid-19 survivors she continues to experience a number of long-term effects of the virus, including reduced mobility and use of her hands due to the length of time she spent on ITU. </span></span></span></p> <p><span><span><span>The clinic, run by consultant in intensive care and respiratory medicine Dr Sundeep Kaul, is providing vital-follow up for the hospital’s discharged Covid-19 patients and patients from the local community. The clinic assesses patients for a whole host of issues ranging from shortness of breath to fatigue to joint problems and focuses on patients’ long-term recovery and rehabilitation.</span></span></span></p> <p><span><span><span>Dr Kaul said: “Like many of our Covid-19 patients who spent a long time on ITU, Maureen has found her quality of life considerably impacted after recovering from the virus.</span></span></span></p> <p><span><span><span>“Our specialists are working with her to assist her with rehabilitation and to address her specific health issues so she can get back to nursing and to all the other things she loves to do.”</span></span></span></p> <p><span><span><span>Maureen said: “The clinic has been a fantastic experience and the help I continue to receive from Harefield is fantastic. The clinic is so well organised and a very thorough one-stop-shop, meaning I can get all my necessary checks and tests done in one day. </span></span></span></p> <p><span><span><span>“Everything ran to time, I was so well looked after and I felt completely safe being onsite – it was superb.</span></span></span></p> <p><span><span><span>Maureen continues to recover at home and is looking forward to returning to nursing at Northwick Park Hospital.</span></span></span></p></div> Tue, 29 Sep 2020 09:17:12 +0000 R.Dalton 2766 at https://www.rbht.nhs.uk Royal Brompton Hospital ranked in world’s top ten hospitals for cardiology https://www.rbht.nhs.uk/news/royal-brompton-hospital-ranked-worlds-top-ten-hospitals-for-cardiology <span>Royal Brompton Hospital ranked in world’s top ten hospitals for cardiology</span> <span><span>R.Dalton</span></span> <span>Mon, 28/09/2020 - 15:01</span> <div class="field field--name-field-date field--type-datetime field--label-hidden field--item"><time datetime="2020-09-28T12:00:00Z">28 September 2020</time></div> <div class="field field--name-body field--type-text-with-summary field--label-hidden field--item"><p>A<span><span><span> global survey among tens of thousands of medical professionals (doctors, health care professionals and hospital managers) has identified Royal Brompton hospital in the top ten hospitals worldwide for cardiology.</span></span></span></p> <p><span><span><span>The ‘World's Best Specialized Hospitals 2021’ survey, published by American weekly news magazine <em>Newsweek</em>, has ranked the world’s best hospitals in a number of specialised fields. Royal Brompton Hospital was ranked tenth in the cardiology listing, the only UK hospital to appear in the list’s top 50, with Harefield Hospital also rated in the top 200 - only 8 UK units in total achieved this milestone.</span></span></span></p> <p><span><span><span>The ranking is based on peer recommendations for specific areas of expertise from doctors, health care professionals, hospital managers and administrators from over 20 countries. <em>Newsweek</em> partnered with global market research and consumer data firm Statista Inc. to run the survey, which saw more than 40,000 medical experts recommend and assess various hospitals within their respective specialisations. The results of the survey were then validated by a global board of renowned medical experts.</span></span></span></p> <p><span><span><span>Commenting, Dr Mark Mason, Royal Brompton & Harefield NHS Foundation Trust’s medical director, said: “Our Trust has long been a destination centre for professionals from around the globe and we have taught and continue to train some of the best and most talented clinicians in Europe and beyond.  Our expert teams of clinicians, academics and researchers have a clear focus on innovation, enabling us to improve the care and outcomes for patients through multi-disciplinary collaboration. Receiving an endorsement like this from peers around the world is extremely encouraging and will be welcomed enormously by colleagues.”</span></span></span></p> <p><span><span><span>Read the full Newsweek report <a href="https://www.newsweek.com/worlds-best-specialized-hospitals-2021">here</a>.</span></span></span></p></div> Mon, 28 Sep 2020 14:01:02 +0000 R.Dalton 2764 at https://www.rbht.nhs.uk Royal Brompton Hospital team performs pioneering heart procedure in UK first https://www.rbht.nhs.uk/news/royal-brompton-hospital-team-performs-pioneering-heart-procedure-uk-first <span>Royal Brompton Hospital team performs pioneering heart procedure in UK first</span> <span><span>R.Dalton</span></span> <span>Thu, 17/09/2020 - 11:54</span> <div class="field field--name-field-date field--type-datetime field--label-hidden field--item"><time datetime="2020-09-17T12:00:00Z">17 September 2020</time></div> <div class="field field--name-body field--type-text-with-summary field--label-hidden field--item"><p>A pioneering procedure to treat an aneurysm in the aortic arch, using minimally invasive keyhole surgery, has taken place for the first time in the UK at London’s Royal Brompton Hospital.</p> <p><span><span><span><span><span>The aortic arch is a section of the aorta</span><span lang="EN-US" xml:lang="EN-US" xml:lang="EN-US">, the largest blood vessel in the body.</span> <span lang="EN-US" xml:lang="EN-US" xml:lang="EN-US">An aortic arch aneurysm is an abnormal swelling of the aorta which, if left untreated, can burst and be life-threatening. </span><span>Typically, treatment for this type of aneurysm involves complex, open-heart surgery. However, </span><span lang="EN-US" xml:lang="EN-US" xml:lang="EN-US"><span>the hospital’s experts</span></span><span lang="EN-US" xml:lang="EN-US" xml:lang="EN-US"> have used </span><span><span><span>keyhole surgery</span></span></span><span lang="EN-US" xml:lang="EN-US" xml:lang="EN-US"> to insert a stent, a </span><span><span><span>tube inserted into a blocked passageway such as a blood vessel to keep it open,</span></span></span><span lang="EN-US" xml:lang="EN-US" xml:lang="EN-US"> to repair an aortic arch aneurysm in a 78-year-old patient</span><span><span><span>, who was deemed too fragile for traditional open-heart surgery. The stent used is specifically designed to treat problems in this part of the aorta.</span></span></span></span></span></span></span></p> <p><span><span><span><span><span lang="EN-US" xml:lang="EN-US" xml:lang="EN-US">The team, led by consultant interventional cardiologist Professor Christoph Nienaber and consultant cardiac surgeon Mr Ulrich Rosendahl, carried out the procedure in Royal Brompton Hospital’s hybrid operating theatre, a traditional operating theatre but with the imaging capabilities of a catheter laboratory. </span></span></span></span></span></p> <p><span><span><span><span><span lang="EN-US" xml:lang="EN-US" xml:lang="EN-US">It was performed in two stages while the patient was under light general anaesthetic. In the first stage, consultant vascular surgeon Mr Maziar Mireskandari performed carotid to carotid artery crossover bypass surgery, a procedure used to maintain blood flow to the brain and prevent stroke – one of the major problems associated with keyhole surgery.</span></span></span></span></span></p> <p><span><span><span><span><span lang="EN-US" xml:lang="EN-US" xml:lang="EN-US">In the second stage two Nexus stent components, which are custom-sized to each individual patient, were inserted into the aortic arch using keyhole surgery through the patient’s groin to repair the aneurysm and prevent it from rupturing. <span>Due to the minimally invasive nature of the procedure, the patient was able to leave her bed very quickly and was discharged in a few days, with her recovery time reduced from several weeks. </span></span></span></span></span></span></p> <p><span><span><span><span><span><span><span>The team is the first to use this stent in the UK, and the first to treat an aneurysm encompassing the entire aortic arch by combining crossover bypass surgery with keyhole surgery.</span></span></span></span></span></span></span></p> <p><span><span><span><span><span lang="EN-US" xml:lang="EN-US" xml:lang="EN-US"><span>Professor Nienaber said: </span></span><span><span>“We’re delighted that this combined procedure went so well and achieved such a terrific result for our patient. It took careful planning and was made possible through a highly skilled, multidisciplinary team, involving </span></span><span><span>surgeons, anaesthetists, radiologists and cardiologists, and lots of supportive team spirit.”</span></span></span></span></span></span></p> <p><span><span><span><span><span lang="EN-US" xml:lang="EN-US" xml:lang="EN-US"><span>“We’re proud to be the first in the UK to complete this pioneering procedure and look forward to establishing this innovative technique at the Trust so more patients can benefit.”</span></span></span></span></span></span></p></div> Thu, 17 Sep 2020 10:54:22 +0000 R.Dalton 2756 at https://www.rbht.nhs.uk Lung transplant recipient on life after transplant: “Organ donation has given us normality back” https://www.rbht.nhs.uk/news/lung-transplant-recipient-life-after-transplant-organ-donation-has-given-us-normality-back <span>Lung transplant recipient on life after transplant: “Organ donation has given us normality back”</span> <span><span>S.Anand</span></span> <span>Fri, 11/09/2020 - 11:30</span> <div class="field field--name-field-date field--type-datetime field--label-hidden field--item"><time datetime="2020-09-11T12:00:00Z">11 September 2020</time></div> <div class="field field--name-body field--type-text-with-summary field--label-hidden field--item"><p><span><span><span>A year on from a double lung transplant at Harefield Hospital, 48-year-old Tim van Someren says his life has been completely ‘re-set’ by organ donation.</span></span></span></p> <p><span><span><span>Tim was discharged from Harefield Hospital in August 2019 after a double lung transplant in June 2019, following years of worsening health due to Chronic Hypersensitivity Pneumonitis, a form of interstitial lung disease that causes slow and irreversible scarring of the lungs.</span></span></span></p> <figure role="group" class="align-right"><img alt="Tim and his family" data-entity-type="file" data-entity-uuid="6e4b4895-e3a9-4802-a39d-dada76977d3d" src="https://www.rbht.nhs.uk/sites/nhs/files/Tim%20van%20Someren%20and%20family3_0.jpg" /><figcaption>Tim with his wife, Chloe, and children, Felix and Oscar</figcaption></figure><h3><span><span><span>Journey to transplant</span></span></span></h3> <p><span><span><span>Tim was recommended for transplant in December 2017. His condition steadily worsened until he was too weak to get out of bed and he was placed on the transplant waiting list in April 2018. </span></span></span></p> <p><span><span><span>In June 2019 his lungs were failing and he was admitted to Harefield Hospital’s intensive therapy unit (ITU). He was put on Extracorporeal Membrane Oxygenation (ECMO), a type of life support, to try to help him gain enough strength for future transplant surgery, and was placed on the urgent waiting list. </span></span></span></p> <p><span><span><span>“At this point it was a pretty close call,” Tim recalled. “I had almost no muscle mass, I’d gone into heart failure a couple of times and I couldn’t breathe on my own, so the ECMO was vital in keeping me alive and well enough for the transplant I hoped was coming.”</span></span></span></p> <p><span><span><span>After news came of a suitable set of lungs, Tim had his transplant operation, which he said “gave me a second chance at life.”</span></span></span></p> <p><span><span><span>Post-transplant, he struggled to swallow, speak and move around. Harefield Hospital physiotherapists worked with him as he progressed from ITU to the transplant ward until, two months after his transplant operation, he was able to climb a flight of stairs and walk 100 metres. He was able to go home in late August 2019.</span></span></span></p> <p><span><span><span>Recalling his time at the hospital, Tim said: “It’s clear that Harefield attracts the best staff. Everyone – the surgeons, consultants, cleaners, catering staff, physiotherapists – does their bit to make you feel at ease. I actually miss going in, being at Harefield was a real bonding experience and I miss catching up with the staff! It’s an amazing place.”</span></span></span></p> <p><span><span><span>After his transplant, Tim spent the final months of 2019 recovering at home. In February, as his recovery continued, he was told it was safe for him to be outside more and he began walking to the shops again and going out for dinners. He had his first piece of work in over two years lined up for late March, filming a live performance for London’s National Theatre.</span></span></span></p> <h3><span><span><span>Covid-19</span></span></span></h3> <p><span><span><span>The Covid-19 pandemic put an end to this long-awaited return to work and, temporarily, his life in London. As a transplant recipient he was in the clinically extremely vulnerable group and in March, was advised to start shielding. He left his wife and children in London and isolated in the Cotswolds at his father-in-law’s property.</span></span></span></p> <p><span><span><span>Throughout his period shielding Tim continued to receive remote support from Harefield Hospital.</span></span></span></p> <p><span><span><span>“The staff at Harefield have been so accessible throughout lockdown. I’ve been able to have check-ups via Zoom and email or phone through any questions I might have. They also held a fantastic webinar for lung transplant patients which re-assured a lot of us who were a bit anxious at this time.”</span></span></span></p> <h3><span><span><span>Looking to the future</span></span></span></h3> <p><span><span><span>Asked about what the future looks like, Tim is keen to get back to work as a freelance television director. He is enjoying being back in London and returning to a normal life.</span></span></span></p> <p><span><span><span>Commenting on how organ donation has changed his life, he said: “What’s most dramatic about life post-transplant is the undramatic – being able to walk up the street to the shops, cooking dinner for friends, taking my kids to school again. </span></span></span></p> <p><span><span><span>“The biggest change for me is the ability to do all those normal things you take for granted. To go from not knowing if I’d ever be able to do those things again, to the life I’ve got now – it’s been really extraordinary.</span></span></span></p> <p><span><span><span>“After an organ transplant, it’s not just the recipient who benefits either – things are now getting back to normal for my family and friends. My wife and I can now share parenting again, I can get back to cooking, which I love, and do school runs again. Organ donation has given us normality back.”</span></span></span></p> <p><span><span><span>“It’s a really remarkable experience that I’ve gone through, and I’m conscious of making the most of it and taking care of the lungs I’ve been given.”</span></span></span></p> <p><span><span><span><em>Tim is currently raising money for Royal Brompton & Harefield Hospitals Charity via its Team Heart vs Team Lungs challenge. You can find out more and support Tim’s efforts </em><a href="https://www.rbhcharity.org/Fundraisers/5k-every-day"><em>here</em></a><em>. </em></span></span></span></p></div> Fri, 11 Sep 2020 10:30:27 +0000 S.Anand 2754 at https://www.rbht.nhs.uk “The most important thing is talking”: Harefield Hospital staff and patients mark Organ Donation Week 2020 https://www.rbht.nhs.uk/news/harefield-hospital-staff-and-patients-mark-organ-donation-week-2020 <span>“The most important thing is talking”: Harefield Hospital staff and patients mark Organ Donation Week 2020</span> <span><span>S.Anand</span></span> <span>Mon, 07/09/2020 - 15:27</span> <div class="field field--name-field-date field--type-datetime field--label-hidden field--item"><time datetime="2020-09-07T12:00:00Z">7 September 2020</time></div> <div class="field field--name-body field--type-text-with-summary field--label-hidden field--item"><p><span><span><span>Harefield Hospital’s heart and lung transplantation unit is the UK’s largest and most experienced centre for heart and lung transplants. More than 3,000 transplant operations have been performed at the hospital since Professor Sir Magdi Yacoub carried out the first heart transplant there in 1980.</span></span></span></p> <p><span><span><span>To mark Organ Donation Week 2020, staff and patients from the transplant unit speak about the life-changing impact of organ donation and the transplantation services offered at the hospital.</span></span></span></p> <p><span><span><span>We hear from staff including a cardiac surgeon, transplant dietitian and clinical psychologist about their roles, the power of organ donation and the importance of discussing the subject with family and loved ones.</span></span></span></p> <p><span><span><span>Patient Chris Bartlett, who recently had a heart transplant at Harefield Hospital, said: “About four years ago I was cycling home from work and my heart stopped. I was told I really needed a transplant, otherwise I wasn’t going to live for very long. </span></span></span></p> <p><span><span><span>“All I can say is I was very, very lucky. I’d like to appeal to anyone out there…please, give everyone a chance.”</span></span></span></p> <div class="video-embed-field-provider-vimeo video-embed-field-responsive-video form-group"><iframe width="854" height="480" frameborder="0" allowfullscreen="allowfullscreen" src="https://player.vimeo.com/video/454789028?autoplay=0"></iframe> </div> <p><span><span><span>Harefield Hospital cares for patients awaiting assessment for transplantation, or who have been accepted onto the transplant waiting list, as well as patients who have had organ transplants or who need re-admission with complications following transplantation. </span></span></span></p> <p><span><span><span>The hospital has the UK's largest ventricular assist device (VAD or 'artificial heart') service. Many patients receive VADs while they wait for a transplant and Harefield Hospital has the largest population of patients 'bridged' to transplant with an artificial heart in the UK. It also has the best long-term survival rates in the UK for patients who have had a heart or lung transplant.</span></span></span></p> <p><span><span><span>Read more about Harefield Hospital’s <a href="https://www.rbht.nhs.uk/our-services/heart/transplantation">heart</a> and <a href="https://www.rbht.nhs.uk/our-services/lung/transplantation-lung">lung</a> transplantation services. </span></span></span></p></div> Mon, 07 Sep 2020 14:27:49 +0000 S.Anand 2751 at https://www.rbht.nhs.uk Specialist clinics opened for patients suffering long-term effects of Covid-19 https://www.rbht.nhs.uk/news/specialist-clinics-opened-for-patients-suffering-long-term-effects-covid-19 <span>Specialist clinics opened for patients suffering long-term effects of Covid-19</span> <span><span>S.Anand</span></span> <span>Tue, 25/08/2020 - 11:24</span> <div class="field field--name-field-date field--type-datetime field--label-hidden field--item"><time datetime="2020-08-25T12:00:00Z">25 August 2020</time></div> <div class="field field--name-body field--type-text-with-summary field--label-hidden field--item"><p><span><span><span><span>Royal Brompton & Harefield NHS Foundation Trust has established innovative post-Covid-19 clinics at its hospitals to help survivors of the virus with their long-term recovery.</span></span></span></span></p> <p><span><span><span>As a specialist cardio-respiratory centre, with additional expertise in intensive care, the Trust’s clinicians cared for some of the sickest Covid patients with severe acute respiratory failure. Many of these patients <span>continue to experience long-term effects after being discharged.</span></span></span></span></p> <p><span><span><span><span>Consultant in intensive care and respiratory medicine Dr Sundeep Kaul, who runs Harefield Hospital’s clinic, said: “There are a whole host of issues that require attention in post-Covid-19 patients, ranging from shortness of breath to fatigue to joint problems. Many patients find their quality of life is considerably impacted after recovering from the virus and they struggle to carry out activities they used to do with ease, such as driving or using a computer.</span></span></span></span></p> <p><span><span><span><span>“Optimising a person’s health by assessing and treating their whole body is one of the cornerstones of successful high-quality, patient-centred healthcare and that’s what is at the heart of this service.”</span></span></span></span></p> <figure role="group" class="align-right"><img alt="Vanessa Vyapooree" data-entity-type="file" data-entity-uuid="32b5e71b-636c-4f65-8321-0b3d221095eb" src="https://www.rbht.nhs.uk/sites/nhs/files/Vanessa%20Vyapooree%20ECMO%20patient_3_0.jpg" /><figcaption>Vanessa Vyapooree, pictured, was treated at Royal Brompton Hospital for Covid-19 and received life support via extracorporeal membrane oxygenation (ECMO)</figcaption></figure><p><span><span><span>To date, the clinics have seen more than 100 patients. <span>After initial visits in person to the hospitals, patients are then</span></span></span></span><span><span><span><span>treated remotely via video and telephone calls. The clinics offer personalised care based on patients’ specific rehabilitation needs and involve teams from across both hospitals to treat a variety of issues.</span></span></span></span></p> <p><span><span><span><span>Respiratory registrar Lydia Finney, who coordinates Royal Brompton Hospital’s clinic, explained: “The clinics have evolved to involve a multidisciplinary team as it has become apparent that the virus has wide-ranging effects on survivors.” </span></span></span></span></p> <p><span><span><span><span>Patients who are suffering from breathlessness, for example, benefit from pulmonary rehabilitation and are referred to the Trust’s pulmonary rehabilitation service at Harefield Hospital, the only nationally accredited pulmonary rehabilitation service in the UK.</span></span></span></span></p> <p><span><span><span><span>Some patients experience shoulder issues and hand weakness, impacting their ability to return to work or drive, and are referred to specialist musculoskeletal physiotherapists and other specialists for strengthening exercises.</span></span></span></span></p> <p><span><span><span>Others are treated for issues ranging from respiratory problems, blood clots and cardiac issues to musculoskeletal problems, lethargy, hair loss, skin and nails issues. </span></span></span></p> <p><span><span><span><span>The clinics are supported by staff from a variety of clinical disciplines including respiratory medicine, critical care, cardiology, imaging, haematology, occupational therapy, physiotherapy, lung function, nutrition and dietetics, psychology, speech and language, pulmonary rehabilitation and the outpatients departments.</span></span></span></span></p> <p><span><span><span><span>Consultant chest physician Dr William Man, who runs Royal Brompton Hospital’s clinic, explained: “Through collaboration with a variety of teams we offer complete follow-up assessment and care for our patients. We </span></span><span>have designed the clinic based on the needs of patients and are really proud to be offering specialist, personalised <span>care and attention. </span></span></span></span></p> <p><span><span><span><span>“Our follow-up clinic is unique in that we are seeing patients soon after discharge so we can make a holistic and multidisciplinary impact early in their recovery.”</span></span></span></span></p> <p><span><span><span><span>The clinics have proved critical to addressing the rehabilitation needs of many patients. </span></span></span></span></p> <p><span><span><span>Vanessa Vyapooree was treated at Royal Brompton Hospital for Covid-19 and received life support via extracorporeal membrane oxygenation (ECMO). As a result of an extended period in intensive care, Vanessa has struggled with movement in one of her arms and with ongoing fatigue after being discharged, among other issues. </span></span></span></p> <p><span><span><span>Vanessa commented: "The follow up clinic was fantastic. Being home from hospital can be somewhat daunting and there is a level of anxiety as to whether I was progressing positively in my recovery. Having the follow up clinic gave me confidence that I would know either way and if it wasn't great, there would be some immediate help on hand to get me on the right track. </span></span></span></p> <p><span><span><span>“From the moment I arrived, everything was smooth. I was escorted to my own room and then given a schedule of who I would see during the clinic. Transitions between departments were easy and each person conducting the tests remembered me from my time when I was admitted.</span></span></span></p> <p><span><span><span>“Dr Man contacted me the next day and gave me all my results and discussed follow up steps, such as working with the physiotherapy team to regain full use of my arm. I really couldn't ask for anything more from the clinic and the team."</span></span></span></p> <p><span><span><span>Teams at Royal Brompton & Harefield NHS Foundation Trust have treated more than 250 Covid-19 patients throughout the first phase of the pandemic. These include more than 50 patients on ECMO, a form of life support. Royal Brompton Hospital is one of five centrally-funded adult ECMO centres in England. </span></span></span></p></div> Tue, 25 Aug 2020 10:24:31 +0000 S.Anand 2746 at https://www.rbht.nhs.uk Trust’s allergy service achieves national accreditation https://www.rbht.nhs.uk/news/trusts-allergy-service-achieves-national-accreditation <span>Trust’s allergy service achieves national accreditation</span> <span><span>S.Anand</span></span> <span>Mon, 24/08/2020 - 10:21</span> <div class="field field--name-field-date field--type-datetime field--label-hidden field--item"><time datetime="2020-08-24T12:00:00Z">24 August 2020</time></div> <div class="field field--name-body field--type-text-with-summary field--label-hidden field--item"><p><span><span><span>Royal Brompton & Harefield NHS Foundation Trust’s allergy service recently achieved national accreditation by The Royal College of Physicians’ (RCP) Improving Quality in Allergy Services (IQAS) accreditation scheme.</span></span></span></p> <p><span><span><span>Led<span><span> by Professor Stephen Durham and Dr Guy </span></span></span></span></span><img alt="Allergy service" data-entity-type="file" data-entity-uuid="ed88c32e-2bd8-471e-a15b-a6601d633b2f" src="https://www.rbht.nhs.uk/sites/nhs/files/IQAS1_3.jpg" class="align-right" /><span><span><span><span><span>Scadding, the Trust’s allergy service</span></span> <span><span>diagnoses and manages all types of suspected allergic conditions relating to asthma, rhinitis (hay fever), food, insect venom and drugs. The service was awarded accreditation following stringent assessment of its facilities, staff and working practices, to evidence its commitment to the delivery of high-quality patient care. </span></span>The accreditation makes the Trust’s allergy service one of just several services in the country to receive the accolade.</span></span></span></p> <p><span><span><span>The IQAS scheme aims to<span><span> improve the quality and outcomes of clinical services through the achievement of best practice standards.</span></span> <span><span>The inspection team, led by RCP IQAS clinical lead </span></span>Professor Thirumala Krishna, <span><span>spent a day at the Trust to review the service.</span></span></span></span></span></p> <p><span><span><span><span><span>Their report said</span></span>: “The allergy department at Royal Brompton is an excellent, comprehensive, multi-professional and cohesive service delivering  high quality, evidence-based care for their patients. The staff are highly skilled, knowledgeable, motivated and committed to provision of a safe and patient-centred care. The service has an excellent clinical leadership and are well supported by their senior management.”</span></span></span></p> <p><span><span><span><span><span>The inspectors also noted the 100 per cent positive feedback provided by patients. One patient commented: “The whole service was professional and well-delivered. I was very well looked-after.”</span></span></span></span></span></p> <p><span><span><span>Consultant allergy dietitian, Dr Isabel Skypala, who led the accreditation process for the allergy team, said:<span><span> “Applying for accreditation was a good way for us to look at our service and audit the quality of work we are doing. There were 44 standards that needed to be met and I am delighted that we managed to achieve all of them and have been officially recognised as providing a high-class allergy service.”</span></span></span></span></span></p> <p><span><span><span><span>Other key areas that the inspectors said stood out were: </span></span></span></span></p> <ul><li><span><span><span><span>The Food Allergy service, led by Dr Skypala, consultant dietitian, who has international recognition for her work in Food Allergy;</span></span></span></span></li> <li><span><span><span><span>The combined medical-surgical rhinology (nose) clinic was described as a world class service and role model for UK. Jointly delivered with ENT surgeons, it is ‘one stop’ with patients having ENT procedures and kin tests and other diagnostic services including CT scanning as needed during a single appointment;</span></span></span></span></li> <li><span><span><span><span>The allergy service protocols for core areas of specialist care and its weekly MDT meetings to discuss complex clinical cases; </span></span></span></span></li> <li><span><span><span><span>The ground-breaking research carried out in the field of rhinitis, and allergen-specific immunotherapy over the last three decades. The group has led landmark clinical trials in grass pollen immunotherapy for hay fever and unravelled key immune mechanisms that have led the way for novel treatment approaches, including sublingual tablet immunotherapy.</span></span></span></span></li> </ul></div> Mon, 24 Aug 2020 09:21:25 +0000 S.Anand 2745 at https://www.rbht.nhs.uk