On the spot when life begins too early

Foto: privat
Foto: privat

Around seven percent of children in Austria are born prematurely, i.e. before the 37th week of pregnancy. The earlier a child is born, the more immature its organ functions are and the higher the risk that it will fall ill or suffer permanent impairment. Extremely immature babies (born before the 28th week of pregnancy) are often a matter of life and death and require optimum medical and pharmaceutical treatment around the clock. This demanding task is carried out at University Hospital Vienna by an interdisciplinary team of doctors, nurses and pharmacists who contribute their expertise.

The neonatal intensive care units at University Hospital Vienna and MedUni Vienna treat children who were born so prematurely that some of them weigh less than 500 grams and are barely the size of an adult’s hand. Just a few years ago, many of these patients would have had no chance of survival. Thanks to modern therapeutic approaches and interdisciplinary cooperation, the survival threshold for extremely premature babies has now been reduced to 22 to 23 weeks’ gestation. In Vienna, well over 80% of all extremely premature babies now survive in the intensive care units for premature babies run by Angelika Berger at MedUni Vienna and University Hospital Vienna, and well over 80% also show favorable neurological development over the course of their lives. "Such successes are only possible thanks to excellent professional collaboration and the great personal commitment of doctors, hospital pharmacists and nursing staff," says Angelika Berger.

Daily individual infusion sets for each premature baby from the hospital pharmacy The effort required to provide the best possible care for the little patients is huge - and not just in the intensive care units, where around three specialists are needed for each premature baby at any time of day or night. In the hospital pharmacy at Vienna General Hospital, headed by Martina Anditsch, pharmacists and pharmaceutical business assistants prepare all plannable infusions for the next 24 hours every day by hand and with the help of automated pump systems - individually for each patient. A "set" of infusions includes up to 15 perfusors (syringes for infusion pumps) or more per premature infant, as well as a large number of tubes ("lines"), bars and connectors.

Parenteral nutrition is an important component of these individually adapted "sets". The premature baby’s still underdeveloped body is supplied with amino acids, fat, glucose and important vitamins, minerals and trace elements through infusions via the vascular system. This procedure is intended to compensate as far as possible for the natural supply of nutrients in the womb. Depending on the laboratory values, the composition is continuously adjusted by the doctors (e.g. adding more sodium if the values are low) and additionally checked by the pharmacists. The "kits" also contain infusions that can be used to administer medication continuously over 24 hours ("bypasses") and short infusions for administering certain medications over shorter periods of time (e.g. antibiotics or painkillers).

Last year, the staff in the intravenous service department of the pharmacy at Vienna General Hospital prepared and assembled over 6,000 of these "sets" for young patients. In addition to the two neonatal intensive care units, the i.v. service also supplies the neonatal intermediate care unit as well as newborns and children on other selected wards of the Department of Pediatrics and Adolescent Medicine at MedUni Vienna and University Hospital Vienna with individual infusions. The

Pharmacy at University Hospital Vienna soon to be the largest hospital pharmacy in Europe

The i.v. service department currently comprises six pharmacists and ten pharmaceutical-commercial assistants (PKAs). In total, over 200 people are employed in the hospital pharmacy at Vienna General Hospital. Together, they ensure that the thousands of patients on the various wards are reliably supplied with the right medicines, diagnostics, medical products and special nutritional products at all times and that drug therapy safety is guaranteed at all times.

Every day, the pharmacy staff distribute around 15,000 medicine packs to the wards of University Hospital Vienna. The hospital pharmacy is currently being expanded during ongoing operations and will become the largest hospital pharmacy in the whole of Europe. In future, around 200,000 drug packages will be stored on site for patients.

YouTube link: Patient-centered advanced medicine at the CCP of MedUni Vienna & Vienna General Hospital-Case of premature twins