News en How does a hospital continue life-saving treatment in the middle of a global pandemic? Christina Lamb, from the Sunday Times, investigates <span>How does a hospital continue life-saving treatment in the middle of a global pandemic? Christina Lamb, from the Sunday Times, investigates </span> <span><span>S.Anand</span></span> <span>Mon, 25/01/2021 - 15:41</span> <div class="field field--name-field-date field--type-datetime field--label-hidden field--item"><time datetime="2021-01-25T12:00:00Z">25 January 2021</time></div> <div class="field field--name-body field--type-text-with-summary field--label-hidden field--item"><p><span><span><span><span>Last week, Christina Lamb from The Sunday Times visited Harefield Hospital to find out how the hospital’s clinical teams are continuing with life-saving surgery in the middle of the latest Covid-19 surge.</span></span></span></span></p> <p><span><span><span><span>Lamb met with clinicians from the hospital’s cardiac, transplant and intensive care teams to see how it is possible to continue with these vital services while looking after some of the sickest Covid-19 patients who need the highest level of critical care. Nick Hunt, the hospital’s director of service development, attributed this to clinical innovations and sheer staff dedication</span><span>: “Emergency situations often bring out the best in people and that’s certainly been the case at Harefield. Initiatives that we’d talked about for months, or even years, have materialised in weeks. </span></span></span></span></p> <p><span><span><span><span>“Even with the incredible demands on staff and capacity we have somehow managed to introduce digital outpatient clinics, home testing, webcam support in ICU, and new ways of collaborating remotely with other hospitals that effectively give patients access to expert opinion from multiple sources. We’re well-known for our innovation, but the speed at which these solutions were found was remarkable; we have literally transformed the clinical landscape.”</span></span></span></span></p> <p><span><span><span><span>The formation of the ‘Cardiac Hub’, established during the first wave of the pandemic last spring, has ensured that priority cardiac procedures can still go-ahead. Spearheaded by consultant cardiologist, Dr Shelley Rahman Haley and cardiac surgeon Mr Mario Petrou, the cardiac hub <span><span>ensures that patients who need cardiac surgery are promptly reviewed and treated. It is made up of an expert team of consultant cardiologists and surgeons from across London who review and discuss patient cases from Royal Brompton and Harefield Hospitals and other trusts across the South East – to decide if urgent surgical intervention is needed. Experts at Harefield Hospital have performed 100 cardiac procedures since Christmas. Commenting on the cardiac hub, Mr Petrou said: “Patients are not just getting a second opinion, but maybe 20-plus, which is incredible.”</span></span></span></span></span></span></p> <p><span><span><span><span><span><span>Surgeons at the hospital’s world-famous transplant unit have carried out three lung transplants in the last week alone. </span></span></span></span></span></span></p> <p><span><span><span><span><span><span>Like many other teams across the Trust, the lung transplant team has had to adapt how it delivers its services to patients, many of whom are shielding and have been able to benefit from having their appointments virtually. Speaking about the virtual clinics, patient Vanessa Tedbury said: “I prefer it. I used to have to write off the day.” </span></span></span></span></span></span></p> <p><span><span><span><span><span><span>Dr Reed and her colleagues also organise regular webinars for their transplant patients so they are kept informed on the latest Covid developments and how these might impact them. </span></span></span></span></span></span></p> <p><span><span><span><span><span><span>And all of this activity is taking place against a backdrop of critically-ill Covid-19 patients, who are under the hospital’s specialist care, and require advanced life support. </span></span></span></span></span></span></p> <p><span><span><span><span><span><span>“Increasing our intensive care capacity to support the sickest Covid patients has inevitably affected how we prioritise non-Covid cases”, said Dr Robert Smith, consultant cardiologist at Harefield Hospital’s heart attack centre. “But for patients who come in with urgent, life-threatening cases, we have not compromised on getting them the care they need, when they need it – which, to a large extent, means it is still business as usual at our heart attack centre.”</span></span></span></span></span></span></p></div> Mon, 25 Jan 2021 15:41:34 +0000 S.Anand 2821 at Latest information on procedures and appointments during Covid-19 <span>Latest information on procedures and appointments during Covid-19</span> <span><span>S.Anand</span></span> <span>Fri, 08/01/2021 - 12:33</span> <div class="field field--name-field-date field--type-datetime field--label-hidden field--item"><time datetime="2021-01-08T12:00:00Z">8 January 2021</time></div> <div class="field field--name-body field--type-text-with-summary field--label-hidden field--item"><p><span><span><span><span>In light of the significant increase of new Covid-19 (coronavirus) cases, we have put measures in place to ensure our patients and staff are safe in our hospitals. As part of these measures, we have reorganised the way care is delivered to patients, with non-urgent, planned procedures being reduced and priority given to urgent cases where patients’ health would be at risk if treatment was delayed. </span></span></span></span></p> <h3><span><span><span><span>Outpatient services</span></span></span></span></h3> <p><span><span><span><span>Most of our outpatient clinics at Royal Brompton and Harefield hospitals are continuing to run as normal via </span><a href=""><span>telephone or video</span></a><span>. Patients who have an existing appointment should attend as planned. If a decision is made to postpone an appointment, patients will be contacted by their clinical team. </span></span></span></span></p> <h3><span><span><span><span>Urgent and emergency care</span></span></span></span></h3> <p><span><span><span><span>Urgent and emergency care, including cancer surgery, will continue. We are working closely with our partners to ensure that patients receive the appropriate level of care and treatment that they need. </span></span></span></span></p> <h3><span><span><span><span>The Cardiac Hub </span></span></span></span></h3> <p><span><span><span><span>The Cardiac Hub has been set up to ensure that patients who need cardiac (heart) surgery are promptly reviewed and treated. The hub is made up of an expert team of consultant cardiologists, surgeons and other specialist staff across Royal Brompton and Harefield hospitals, who review and discuss patient cases and decide if urgent surgical intervention is needed. Each cardiac case is considered carefully by the clinical teams involved in the patient’s care, who decide on the need for surgery and the timing of it. </span></span></span></span></p> <h3><span><span><span><span>If a decision is made to go ahead with a procedure </span></span></span></span></h3> <p><span><span><span><span>If your clinical team believes that the risk to your health of not having treatment is very high, surgery will be advised. In this instance, it will have been agreed that your health would be at risk if treatment was delayed. Your clinical team will discuss with you the benefits and risks of the procedure and answer any questions you have, before going ahead with surgery. </span></span></span></span></p> <h3><span><span><span><span>If a decision is made to delay a procedure </span></span></span></span></h3> <p><span><span><span><span>If your clinical team believes that the risks of having surgery at the present time outweigh the benefits, your treatment will be delayed until a later date. Your clinical team will continue to monitor your condition. However, if your condition worsens, you should contact your clinical team without hesitation, to access the advice and support you need.      </span></span></span></span></p> <h3><span><span><span><span>Testing for the virus</span></span></span></span></h3> <p><span><span><span><span>If you are being admitted to one of our hospitals for a cardiac procedure, you will be asked to take a series of tests for Covid-19 before surgery goes ahead. This is to ensure that we keep you as safe as possible and reduce the chance of spreading the virus to other patients or staff. The tests will be explained to you fully by your clinical team. You can also find more information </span></span></span></span><a href="">here</a><span><span><span><span>. </span></span></span></span></p> <p><span><span><span><span>We are sorry for any disruption to your care during this difficult time. We are doing everything we can to provide the best care and treatment for you, and we will be reviewing how this is delivered on an ongoing basis. Thank you for your understanding.</span></span></span></span></p> <hr /><p><span><span><span>Useful links:</span></span></span></p> <ul><li><a href="">How your care and treatment may change during the Covid-19 pandemic</a></li> <li><span><span><span><a href=""><span>Information for patients visiting the hospital for a procedure</span></a></span></span></span></li> <li><a href="">Covid-19 and heart surgery</a></li> </ul></div> Fri, 08 Jan 2021 12:33:28 +0000 S.Anand 2819 at Our wards are still closed to visitors in response to Covid-19 <span> Our wards are still closed to visitors in response to Covid-19</span> <span><span>admin</span></span> <span>Wed, 23/12/2020 - 12:48</span> <div class="field field--name-field-date field--type-datetime field--label-hidden field--item"><time datetime="2020-12-23T12:00:00Z">23 December 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><span><span><span><span><span><span>We are sorry that we are not currently allowing visitors in our hospitals. This has been a difficult decision to make, but we feel it is necessary to help</span> <span>prevent the risk of spreading Covid-19.</span></span></span></span></span></span></span></span></span></span></span></span></p> <p><span><span><span><span><span><span><span><span><span><span><span><span>Visitors will only be considered in exceptional circumstances, including: </span></span></span></span></span></span></span></span></span></span></span></span></p> <ul type="disc"><li>For patients at the end of their lives </li> <li>One regular carer for a patient with additional needs, such as a patient with dementia</li> <li>One parent/guardian for a child. </li> </ul><p><span><span><span><span><span><span><span><span><span><span><span><span>Please speak to the nurse in charge of the ward or unit to consider any exceptional arrangements.</span></span></span></span></span></span></span></span></span></span></span></span></p> <p><span><span><span><span><span><span><span><span><span><span><span><span>Any visitors who are allowed must: </span></span></span></span></span></span></span></span></span></span></span></span></p> <ul type="disc"><li><strong>Not </strong>come to the hospital if you are feeling unwell, including cold or flu symptoms</li> <li>Wash or gel your hands as soon as you enter a ward or unit</li> <li>Follow the additional measures that will be requested by our staff if you are visiting a patient with an infection</li> <li><strong>Not</strong> belong to the <a href="" target="_blank"><span>high-risk group</span></a> identified by Public Health England as those who are at increased risk of severe illness from coronavirus</li> <li>Follow <a href="" target="_blank"><span>NHS guidance</span></a> related to how to avoid catching and spreading coronavirus.</li> </ul><p><span><span><span><span><span><span><span><span><span><span><span><span>We understand how important the support of family and friends can be for patients in their recovery while they are in hospital so while visiting restrictions are in place, patients are encouraged to use the RBHT Guest Wi-Fi facility to ensure contact with friends and family is maintained. </span></span></span></span></span></span></span></span></span></span></span></span></p> <p><span><span><span><span><span><span><span><span><span><span><span><span>We thank you for co-operating with us during this time.</span></span></span></span></span></span></span></span></span></span></span></span></p></div> Wed, 23 Dec 2020 12:48:08 +0000 admin 2810 at Merger to transform care for heart and lung patients gets go-ahead <span>Merger to transform care for heart and lung patients gets go-ahead</span> <span><span>S.Anand</span></span> <span>Tue, 15/12/2020 - 15:30</span> <div class="field field--name-field-date field--type-datetime field--label-hidden field--item"><time datetime="2020-12-15T12:00:00Z">15 December 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>A proposed merger between Royal Brompton & Harefield Foundation Trust (RB&HFT) and Guy’s and St Thomas’ NHS Foundation Trust (GSTT) will proceed on February 1<sup>st</sup> 2021 following final approval from both Trusts’ Boards and ratification by their Councils of Governors. The Council of Governors of Royal Brompton & Harefield ratified the merger plans at a meeting today signalling the final stage of the approvals process. The partnership will create </span></span><span><span>one of the largest and strongest academic healthcare organisations in Europe. </span></span></span></span></span></p> <p><span><span><span><span><span>Since 2017, Guy’s and St Thomas’ and Royal Brompton & Harefield NHS Foundation Trusts have been working together, along with colleagues across King’s Health Partners, on plans to revolutionise care for people with heart and lung disease and to provide sustainability and security for the world-renowned specialist services currently provided at Royal Brompton Hospital. </span></span></span></span></span></p> <p><span><span><span><span><span>Earlier this year, the boards of both Trusts decided that a full integration of services provided by both organisations – effectively a merger – was the best way of achieving these aims. </span></span></span></span></span></p> <p><span><span><span><span><span><span>The combined expertise of the Trusts’ clinical and academic teams created through the merger will be unparalleled. Together the teams will continue to deliver exceptional care to patients and drive research into new and better treatments. This ambitious venture will create, in time and with the necessary consultation processes, a new centre of excellence for heart and lung disease on the St Thomas’ site.</span></span></span></span></span></span></p> <p><span><span><span><span><span><span>The merged Trust will have academic partnerships with both Imperial College and King’s College London. It will also continue to have strong links with the NHS in north west London and other partners, including local government, given that it will be a significant provider of NHS services in the area for a long time to come.</span></span></span></span></span></span></p> <p><span><span><span><span><span>Baroness Morgan of Huyton, chair of Royal Brompton & Harefield NHS Foundation Trust, commented: “This is a genuine milestone for the NHS. Our merged organisation will put the UK’s heart and lung care and research at the forefront of global efforts to combat these two debilitating diseases, which still account for many millions of deaths each year. </span></span></span></span></span></p> <p><span><span><span>“I am delighted that after three years of close collaboration our two leading organisations will become one.”</span></span></span></p> <p><span><span><span><span><span>Dr Richard Grocott-Mason, acting chief executive of Royal Brompton & Harefield NHS Foundation Trust and managing director of RBH-KHP Partnership, said: “Healthcare will undergo radical transformation over the next ten years and healthcare providers need to respond. From our earliest discussions with Guy’s and St Thomas’ NHS Foundation Trust, we realised we had the chance to create something new and dynamic with colleagues who shared our values and our appetite for innovation and transformation, which is vital if we are to break new ground in heart and lung disease treatment and research and in-turn, transform patient care.</span></span></span></span></span></p> <p><span><span><span><span><span>“</span></span><span><span>Patients are at the core of this merger, which has been clinically led from the start. They will be part of a dynamic and innovative network giving direct access to a wide range of medical expertise, from primary care right through to specialist care for rare conditions. We will continue to work closely with them as we take forward our plans.”</span></span></span></span></span></p> <p><span><span><span>Professor Ian Abbs, chief executive at Guy’s and St Thomas’ NHS Foundation Trust, said: “This is a hugely significant moment in the history of both organisations, a once in a generation opportunity, working together and with colleagues across King’s Health Partners, to create a centre of national and international importance devoted to the treatment of heart and lung disease. These remain among the most serious and deadly diseases, as has been amplified by the current pandemic, so it is hugely exciting to bring together our clinical and research expertise at this time.  </span></span></span></p> <p><span><span><span>“Working together, we will also be able to deliver a sustainable future for the paediatric congenital heart disease services provided at Royal Brompton, supporting the decision of the NHS England Board earlier this year. </span></span></span></p> <p><span><span><span>“As with any merger, the real work is only just beginning, and we are hugely excited about the steps we can now begin to take to bring our organisations together and to realise the benefits that this will bring to our patients and staff for many years to come.”</span></span></span></p> <p><span><span><span><span><span>Royal Brompton and Harefield hospitals will continue to deliver world-class heart and lung care from their current sites for many years to come and patients will continue to see the clinical teams that they do now.</span></span></span></span></span></p> <p><span><span><span><span><span>A public consultation on the integration of paediatric services within the expanded Evelina London Children’s Hospital on the St Thomas’ site, is planned by NHS/I to begin in summer 2021.</span></span></span></span></span></p> <p><span><span><span><span><span>On February 1<sup>st </sup>2021, Royal Brompton & Harefield Foundation Trust will be dissolved and will become one of Guy’s and St Thomas’ NHS Foundation Trust’s new clinical groups, with its board reporting into the Guy’s and St Thomas’ NHS Foundation Trust board. </span></span></span></span></span></p> <p><span><span><span><span><span>For further info about the merger please visit <a href=""></a></span></span></span></span></span></p></div> Tue, 15 Dec 2020 15:30:14 +0000 S.Anand 2805 at Our plans to join Guy's and St Thomas' NHS Foundation Trust: frequently asked questions <span>Our plans to join Guy's and St Thomas' NHS Foundation Trust: frequently asked questions</span> <span><span>S.Anand</span></span> <span>Mon, 14/12/2020 - 11:21</span> <div class="field field--name-field-date field--type-datetime field--label-hidden field--item"><time datetime="2020-12-14T12:00:00Z">14 December 2020</time></div> <div class="field field--name-body field--type-text-with-summary field--label-hidden field--item"><p>We have put together a list of frequently asked questions about our plans to join Guy's and St.Thomas' NHS Foundation Trust. You can find them <a href="">here</a>. </p> <p> </p></div> Mon, 14 Dec 2020 11:21:35 +0000 S.Anand 2802 at The Woodland Trust donates over 400 trees to Harefield Hospital <span>The Woodland Trust donates over 400 trees to Harefield Hospital</span> <span><span>R.Dalton</span></span> <span>Tue, 01/12/2020 - 10:59</span> <div class="field field--name-field-date field--type-datetime field--label-hidden field--item"><time datetime="2020-12-01T12:00:00Z">1 December 2020</time></div> <div class="field field--name-body field--type-text-with-summary field--label-hidden field--item"><p><span><span><span>Staff and patients at Harefield Hospital are planting 420 trees in the hospital’s grounds, to help make the hospital a greener and more sustainable place, thanks to a generous donation from the Woodland Trust. </span></span></span></p> <p><span><span><span>The Woodland Trust is donating tree saplings to a range of community groups including schools and healthcare organisations across the country in a bid to get millions more trees in the ground. Harefield Hospital received six different types of tree to plant in the green spaces around the hospital – silver birch, rowan, dogwood, hawthorn, hazel and wild cherry. </span></span></span></p> <p><span><span><span>Planting trees is a key initiative to come out of the Trust’s Green Plan which encourages staff, patients and members of the local community to become ‘Green Champions' by reducing carbon footprints with nature-based solutions and  to help influence positive, sustainable change at the Trust. </span></span></span></p> <p><img alt="" data-entity-type="file" data-entity-uuid="acab3513-bb39-4772-8f4e-acf7e295a5d8" src="" class="align-right" /></p> <p><span><span><span>Nicholas Hunt, executive director for </span></span></span><span><span><span>Harefield Hospital, who was one of the first to plant a tree, said: “This is a brilliant project that has given staff and patients the opportunity to plant a tree and help the hospital become a greener, more sustainable place. Everyone at Harefield will be able to watch the trees grow, enjoy improved air quality and the chance to relax outside. Harefield Hospital has a long history of patients spending time outdoors for their rehabilitation, so these trees will add to that legacy.”</span></span></span></p> <p><span><span><span>Karen Janody, interim head of the Trust’s Arts Programme, who organised the tree-planting, added: “We hope to improve and enhance the biodiversity at Harefield, as well as give staff and patients spaces to enjoy outdoors. Gardens and nature have physical and mental health benefits, and we want to get as many people involved as possible.” </span></span></span></p> <p><span>Derval Russell, Harefield Hospital director, who planted a wild cherry tree, said: “We are lucky to have such beautiful grounds at Harefield and with the addition these trees, they are going to look even better. I would like to thank Karen and the team for organising this event and I hope staff enjoy planting the trees.”</span></p> <p><span><span><span>During the launch on 23 November, staff and patient volunteers enjoyed getting their hands dirty for a good cause. Ciara Collins, critical care matron, who planted a silver birch, said: “It’s really nice to be part of this wonderful project. We have a lot of inpatients at Harefield who are here for a long time and this is their second home and their garden. I think it’ll have a really positive impact to their physical and mental wellbeing.”</span></span></span></p> <p><span><span><span>Husband and wife, Peter and Celia (an outpatient at Harefield), who planted a trio of hawthorns, said: “We feel like royalty planting trees on hospital grounds, it’s very special. It’s an honour to be involved and we’ll be back to check on their progress.”</span></span></span></p> <p><span><span><span>Find out more about Arts projects <a href="">here</a>.  </span></span></span></p> <p><span><span><span>Find out more about Woodland Trust <a href="">here</a>. </span></span></span></p> <img alt="" data-entity-type="file" data-entity-uuid="33276a59-08b5-4db2-8eeb-70e2754aa64b" src="" class="align-center" /></div> Tue, 01 Dec 2020 10:59:05 +0000 R.Dalton 2783 at Collaboration brings clinical academic innovation to the fore <span>Collaboration brings clinical academic innovation to the fore </span> <span><span>S.Anand</span></span> <span>Fri, 06/11/2020 - 10:27</span> <div class="field field--name-field-date field--type-datetime field--label-hidden field--item"><time datetime="2020-11-06T12:00:00Z">6 November 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 number of patient-centred initiatives have been selected to receive funding to help transform heart and lung care for adults and children. </span></span></span></span></p> <p><span><span><span><span>Teams from Royal Brompton & Harefield NHS Foundation Trust, Guy’s and St. Thomas’ NHS Foundation Trust (GSTT), King’s College Hospital NHS Foundation Trust (KCH) and King’s College London (KCL) will come together across several clinical areas, including cardiovascular, respiratory and critical care, to develop pioneering projects focused on improving patient care and outcomes for adults and children. </span></span></span></span></p> <p><span><span><span><span>More than 300 staff contributed to 39 funding applications which were then peer-reviewed and shortlisted for consideration by a cross partnership panel. The panel, chaired by Professor Richard Trembath, executive director of </span><a href=""><span>King’s Health Partners</span></a><span>, included clinicians, academics, patients and non-executive directors who selected twelve projects that demonstrated clinical academic innovation (using clinical research to bring new solutions to healthcare), benefits for patients, and collaborative working between teams across organisations. </span></span></span></span></p> <p><span><span><span><span>Dr Richard Grocott-Mason, managing director of the Trust’s partnership with KHP, said: “The calibre of applicants for this important new scheme was exceptionally high and a real testament to the appetite teams across the partnership have for creating new models of care through innovation. </span></span></span></span></p> <p><span><span><span><span>“Since 2017, our ambition has been to leverage the opportunity for collaboration offered across partner organisations to enable us to transform and improve patient care. These initiatives are another step forward in helping us realise this goal.” </span></span></span></span></p> <p><span><span><span><span>Joy Godden, director of nursing and clinical governance at the Trust, and a member of the funding panel, added: “Teams at Royal Brompton and Harefield hospitals have been working closely with KHP for some time and the standard of these projects reflects the great benefits of harnessing the collective knowledge and expertise of our respective organisations.”  </span></span></span></span></p> <p><span><span><span><span>Some examples of the projects that will be funded:</span></span></span></span></p> <ul><li><span><span><span><strong><span>Predicting the risk of aortic coarctation in newborns:</span></strong><span> A study to determine how the risk of aortic coarctation, a congenital heart defect associated with a narrowing of the aorta, can be better predicted during the fetal stage. </span></span></span></span></li> <li><span><span><span><strong><span>Home monitoring of high risk cardiorespiratory paediatric patients: </span></strong><span>Development of an in-home monitoring system to enable clinical teams to observe blood oxygen levels (oxygen saturation) in high risk cardiac and respiratory patients remotely. </span></span></span></span></li> <li><span><span><span><strong><span>Establishing a national ‘Difficult Cystic Fibrosis Diagnosis’ (DCFD) service: </span></strong><span>Development of a Difficult Cystic Fibrosis Diagnosis service to improve clinical diagnosis.   </span></span></span></span></li> <li><span><span><span><strong><span>Enhancing patient recovery after cardiac surgery: </span></strong><span>Improved measures to promote recovery of patients undergoing cardiac surgery, with a focus on organ protection and acute kidney injury. </span></span></span></span></li> <li><span><span><span><strong><span>Developing a critical care competency and education package for allied health professionals (AHP): </span></strong><span>Appointment of an AHP partnership lead to work alongside existing AHP clinical leadership teams to focus on workforce development, education and training for allied health professionals.  <strong>   </strong></span></span></span></span></li> </ul><p> </p></div> Fri, 06 Nov 2020 10:27:56 +0000 S.Anand 2776 at ‘Simple’ innovation to ventilators could increase oxygen supplies at 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="" /><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=""><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 (FiO<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=""><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><span>2</span></span></span> <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="">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 What we are doing to 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=""></iframe> </div> </div> Fri, 23 Oct 2020 12:08:05 +0000 S.Anand 2770 at Trust consultant leads global trial into 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=""><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