Extracorporeal membrane oxygenation (ECMO) is a procedure that uses a machine to take over the work of the lungs and sometimes the heart. Extracorporeal means that the blood circulates outside of the body with the help of a machine. Membrane oxygenation, referred to as the “artificial lungs,” is a special part of the machine that puts oxygen into the blood and takes out carbon dioxide just like the lungs do normally. Although similar to a heart-lung machine that is used during open-heart surgery, ECMO therapy is intended for patients whose heart and lungs cannot normally function on their own. ECMO is used to provide intensive care for babies, children and adults. The two most common modes of ECMO are veno-venous (VV) where access is via a vein for patients who have suffered loss of the lungs exclusively and veno-arterial (VA) with dual access by a vein and the carotid artery for patients with both lung and heart impairment.
According to a new report published by Ariadne Labs and MASS Design Group, the physical design of a hospital’s birthing unit may affect its Cesarean section rate. Based on previous research, the team knew C-section rates can vary from 7 percent to 70 percent simply depending on the facility. As many as half of these C-sections are unnecessary and add surgical complications and increase costs. To begin to determine how much the physical layout of a hospital may impact C-section rates, the team chose 12 diverse childbirth locations — three birth centers and nine hospitals. They conducted site visits and phone interviews to develop facility profiles and compare the childbirth locations as quantitatively as possible.
The capacity of a labor and delivery suite will vary depending on whether the hospital is deploying the single-room maternity care concept exclusively — using combined labor, delivery, recovery, and postpartum rooms (LDRP rooms) — or if the mother and infant are moved to a separate postpartum unit after delivery. The labor and delivery area will also typically include one to three delivery/operating rooms for C-sections and a normal newborn nursery or infant holding area. A designated admission/triage area is often provided for higher-volume services.
Virtual medicine allows patients to receive specialized care even when they are in remote locations far from medical experts and care specialists. It may eliminate the need to transfer a highly fragile infant from one hospital to another and allow high-quality care to be made available to infants in rural or remote locations — particularly given the national shortage of neonatologists. Children’s Hospital of Los Angeles and the Center of Fetal and Neonatal Medicine are developing and implementing a virtual neonatal intensive care unit (vNICU) structure to initially link two hospital sites. The long-term goal is to create a network of hospital NICUs across Southern California connected via telemedicine.