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SHIPS (Screening to Improve Health in Very Preterm Infants in Europe) meeting in Antwerp

At the beginning of June 2018 all members of the SHIPS project – Screening to Improve Health in Very Preterm Infants in Europe (SHIPS) – met in Antwerp, Belgium, for the second last two-day meeting. SHIPS has almost finished data collection and the results are about to accede, first analyses of data are already ongoing. A strategic action plan for analysis and reporting as well as priority research themes for the coming year has been developed.
Furthermore, concrete steps how and where to disseminate results and derived recommendations were defined. Stimulating visions from elsewhere were provided by two invited researchers from Japan and Australia introducing their work on longer-term neurodevelopment of very preterm infants. Our special thanks go to all partners for their valuable input and contributions.

To learn more about SHIPS, please visit our project website and the official SHIPS website.

 

Please note: This project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No 633724

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Lighthouse project in NICU design: the new Parents, Baby and Family Centre at the Children’s Hospital Dritter Orden Passau, Germany

Lighthouse graphicAfter five years of intensive planning and construction work, last year the Dritter Orden Clinic in Passau, South Germany,  celebrated the opening of its new Parents-Baby-and Family centre. Realising this lighthouse project in the field of NICU design was a task that brought varied specialists from many different subjects like medical engineers, architects and interior designers as well as medical staff, together in order to make this intensive care unit a place that meets the needs of both the small patients and their parents. A big challenge was to combine highest medical standards with a homey atmosphere. We had the opportunity to bring together three different perspectives and interviewed Professor Matthias Keller, head physician and clinical manager of the Children’s Hospital Dritter Orden Passau, architect Roland Schuster from g|s architects in Büchlberg, Germany, as well as Sigrid Stjerneby who was responsible for the interior architecture of this unique unit. We spoke about the particularities, but also challenges in this project, and much more.  To read the full interviews, please click on the links below. 

 

Professor Matthias Keller, head physician and clinical manager of the Children’s Hospital Dritter Orden Passau: “The core concept and intention are obvious: This is a matter of optimally supporting the development of preterm and ill born babies, to improve their life chances. Our aspiration is care and medicine on a peak level, so that ill and preterm born babies develop in a proper manner, grow and get healthy quickly.  This requires a developmentally supportive environment as well as the presence and support of the parents. Therefore, during a process of several years, a new type of intensive care unit concept was developed and implemented in Passau, which merges various fields of expertise like medical technology, architecture, interior design and a team of doctors and nurses. As a result, intensive care has been reconciled with cosiness, processes have been oriented towards children and parents, and the prerequisites have been created, so that parents can always be with their children, forming a bond with their child from the very beginning – and of course that the family really can be a family in a physical sense. Because: Ill children need their parents!” 
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Roland Schuster, g|s architects in Büchlberg, Germany: “The Parents, Baby, and Family Centre (Eltern-, Baby- und Familienzentrum, abbreviated as EBZ) in the Children’s Hospital Dritter Orden Passau was destined to be a very special project from the very beginning. Making it happen required assembling a planning team, which would be willing to embark on this adventure. With the starting point being the defined processes and procedures, we began planning the floor plan and room concept. During this preliminary design phase, it became clear to us, that in addition to the usual specialist planners like HLS (heating, ventilation, sanitation), electronic, medicine technology, building physics and static, we needed to bring an interior designer on board. The well-being of the patients or parents, respectively, should be first priority.” 
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Sigrid Stjerneby, interior planner, Germany: “The particular challenge in designing a neonatology unit probably basically lies in the complexity by the various specialist planners who particularly focus on technical or hygienic aspects. This can lead to limitations when it comes to imaginative design. The governmental and legal requirements might cause further restrictions. In the project in Passau, we jumped on the bandwagon. The floorplan had already been defined and the construction team had already widely been formed. The vision of Professor Keller, who had „infected“ us with the idea of a family-centred unit, had a huge impact on everything. We often had to go to the limits of the possible to come within reach of this vision, that is for example, to bring together the technical requirements and the ideas regarding design while at the same time everything had to remain within the given budget.” 
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Images Children’s Hospital Dritter Orden Passau: Marcel Peda, pedagrafie

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An interior planner‘s view on the new Parents, Baby, and Family Centre in the Children’s Hospital Dritter Orden Passau

An interview with interior planner Sigrid Stjerneby

As an interior architect, which special requirements did you face in this project?

I would like to point out that I am not an interior architect in a classical sense. I have a background in free arts, I am a painter and sculptor and 25 years ago I founded a planning office together with my husband because we do not understand art within architecture (so called „Kunst am Bau“) as some kind of decoration, but consider the whole space/building itself as a work of art. The needs of the users provide the basis from which the design develops. 

The particular challenge in designing a neonatology unit probably basically lies in the complexity by the various specialist planners who particularly focus on technical or hygienic aspects. This can lead to limitations when it comes to imaginative design. The governmental and legal requirements might cause further restrictions.

In the project in Passau, we jumped on the bandwagon. The floorplan had already been defined and the construction team had already widely been formed. The vision of Professor Keller, who had „infected“ us with the idea of a family-centred unit, had a huge impact on everything. We often had to go to the limits of the possible to come within reach of this vision, that is for example, to bring together the technical requirements and the ideas regarding design while at the same time everything had to remain within the given budget. Especially with regard to the furniture for the parents and child rooms, we often reached our limits. Chosing the right colours is a tricky issue, as people often are quite sensitive about this subject. But this is not primarily determined by personal taste, but more about the effects of colours, light, and forms. The ambient design should gently and quietly accomodate the child and reaffirm the staff on the unit in their approach. It has also been an enormous effort to reconstruct the unit while it continued in operation. I have great respect for the architect, the specialist planner, the craftsmen involved and the staff at the unit, who at the same time had to run their normal day-to-day operations!


Could you please elaborate on the spatial concept of the new EBZ, focusing on the interior design aspects?

The parent-child-retreat is in the foreground and forms the centre of all functional spaces of the unit and that allow for short communication channels and distances for the staff. Through seating areas and colour and light designs, an inviting reception area, and an open base, we created a rhythmic structure of the long corridors. Our “Room of Tranquility” is one of the centrepieces of the building. We intensively discussed the design of this room together with the team. It should be luminous, provide strength, interconfessional, and not closed. A place that can potentially also serve as a place of retreat for staff members. Overall, I would have wished the unit to be provided with more space.


Given the challenges of combing the highest medical equipment for an intensive care unit and of at the same time creating a homely atmosphere, how did you manage to find an appropriate design solution?

I think the key lies in giving up on a fixed idea of what a neonatal intensive care unit should look like. In the beginning, I always chose a design based on a theme which covers the vision the house stands for. You can consider this as ist corporate identity.

In Passau, the monastic house and its patron saint, were my point of reference. The patron saint of this house is St Francis of Assisi. It was immediately clear for everyone that the basic atmosphere of the unit could be based on the Canticle of Brother Sun by St Francis. I carefully listed to the atmosphere in a workshop of different staff members, to get an idea of what the „sound of the unit“ could be like and from this, I composed a melody. It is a subtle interaction between colour, form, and light design.

In general, chosing the right colour is of vital importance. This concerns the colour composition, but also the application of paint. In the corridor areas, we used the glazing technique. The complete colour wheel extends through the unit with its discreet motifs taken from flora, fauna, and astronomy. The light design and all surfaces, like the floor, tiles, furniture, for example, up to the door labels all refer to one special sound. We designed special panel curtains that create a pleasant warm atmosphere. In Passau, special attention was given to integrating the medical equipment into the furniture. This was a particular challenge which could only be accomplished with the support of experts and furniture makers from the hotel and boat building industry and the architect, while involving the staff members of the unit.

Could you give us an insight into the collaboration with the architects during the reconstruction process?

For architects and specialist planners, a holistic design approach, which we aspire, is not common.  That means that everyone needs to show willingness to carefully listen to the construction meetings. For an artist, this likewise is a good exercise to get a better understanding of the thoughts and language of the specialist engineers. I shall not hide the fact that we sometimes had to overcome difficulties, but ultimately, however, we have always found a good solution.

Which challenges did you face during the interior design process?

It is a balancing act between DIN standards, hygiene standards, costs, and the „simple“ wish to create a temporary home for parents and children, as well as to build an optimal work space for the staff. When one thinks about home, often feelings, memories of odours, sounds, colours, come up because this emotionally touches us. This is exactly what we wanted to achieve at the new unit, expressing by creative means: here, you are welcome and safe. At the same time, we also wanted to provide future visitors an element of personal freedom; therefore the furniture leaves room for personal things, also in the sanitary facilities. I was personally committed to leaving marks which express: this space was created by people for people. This is why we painted over 50 panels with different motifs and, this way, gave every room a personal touch. A photo exhibition in sub-areas of the corridors also bears witness to the personalities of our little patients.

Which experience did you gain in this project that you would like to share with other builders and users of similar projects?

Certainly, neonatology units are comparable in many respects, but ultimately, (re-)building such a unit is a very individual task which is strongly influenced by the concept or corporate culture that is lived there. Whether you deal with a new or an existing building, also is crucially important. Last, but not least, the region is decisive and can also be a source of inspiration. I recommend to allow time for a so called planning stage 0, in which the task can be determined from different perspectives. Include, even if only partially, all staff members and leave space for creativity. In a project that extends over a period of 2 or 3 years, new developments and experiences have to be considered.

In my view, the given government-funded financial scope often does not cover the real demand. Some areas are configured too small. This complicates work processes and also has an effect on the well-being of people. If, for example, handovers have to take place in a comparatively small room, you often have the feeling of „thick air“ despite the ventilation system. Man, after all, is a sentient being. From the outside, it is often difficult for me to have understanding for the given regulations when experiencing the everyday conditions at the unit. There I would wish for more exchange between payers, users, and planners. We rely upon teamwork. When everyone gives their best, you achieve a smooth result.

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An architect‘s view on the new Parents, Baby, and Family Centre in the Children’s Hospital Dritter Orden Passau

An interview with Roland Schuster from g|s architects in Büchlberg, Germany


Which special challenges did you meet as the architect of this project?

The Parents, Baby, and Family Centre (Eltern-, Baby- und Familienzentrum, abbreviated as EBZ) in the Children’s Hospital Dritter Orden Passau was destined to be a very special project from the very beginning. Making it happen required assembling a planning team, which would be willing to embark on this adventure. With the starting point being the defined processes and procedures, we began planning the floor plan and room concept. During this preliminary design phase, it became clear to us, that in addition to the usual specialist planners like HLS (heating, ventilation, sanitation), electronic, medicine technology, building physics and static, we needed to bring an interior designer on board. The well-being of the patients or parents, respectively, should be first priority.

Could you tell us more about the architectural aspects of this project?

At this point I would like to focus on some constructional aspects, which were very important to us. Particular attention was given to airflow or more precisely, draughts, in the rooms. There shouldn’t occur any uncomfortable appearances of draught while bonding. In most cases, the openings for fresh air were unconventionally installed into the walls, rather than, as usual, into the ceiling.

Waste- and laundry chutes with electric opining mechanisms were integrated into the built-in furniture, to avoid unnecessary noise. All drawers and cabinet doors were equipped with “soft close”. Here again special attention was given to noise reduction. Every door that leads from the corridor into a patient room was constructed highly sound insulating. Particularly high attention was given to the implementation of the footfall sound insulation. The screed and floor covering from the corridor to patient rooms are sound isolated from each other. The partition walls between the patient rooms, too, were realised with even higher requirements as DIN 4109 (noise protection in structural engineering).

All patient rooms are equipped with specially designed built-in furniture. As far as possible, the medical technology was hidden in the furniture. After all, the design complies with the requirements for a five-star hotel room. To avoid noise in the corridors, all disinfectant dispensers are automatic. While designing the corridors, we laid particular value on recesses and corners, to ensure lounge quality.

Which challenges did you meet during the reconstruction of the unit?

The biggest challenge was organising the reconstruction during ongoing operation. We are all very proud of our project, even with the challenges to integrate the station in an already existing building, to cleverly take advantage of the existing geometry.

Which valuable experience from this project would you like to pass on to other colleagues?

My advice for colleague: Carefully listen to the users and builders.

Text: Roland Schuster
Translation: Manuel Kreitmair

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A chief physician’s view on the new Parent, Baby, and Family Centre in the Children’s Hospital Dritter Orden Passau

A guest article by Professor Matthias Keller, head physician and clinical manager of the children’s hospital Dritter Orden Passau

The idea: Arranging intensive care and cosiness, so that families can authentically be families!

The core concept and intention are obvious: This is a matter of optimally supporting the development of preterm and ill born babies, to improve their life chances. “Our aspiration is care and medicine on a peak level, so that ill and preterm born babies develop in a proper manner, grow and get healthy quickly.  This requires a developmentally supportive environment as well as the presence and support of the parents”, says chief physician Prof. Dr. Matthias Keller. Therefore, during a process of several years, a new type of intensive care unit concept was developed and implemented in Passau, which merges various fields of expertise like medical technology, architecture, interior design and a team of doctors and nurses. As a result, intensive care has been reconciled with cosiness, processes have been oriented towards children and parents, and the prerequisites have been created, so that parents can always be with their children, forming a bond with their child from the very beginning – and of course that the family really can be a family in a physical sense. Because: Ill children need their parents!

Implementation and planning – Neonatology newly defined!

The research cooperation between the Charité in Berlin and GRAFT-architects, which conducted an analysis on the impact of different ambient aspects like room atmosphere, lighting and acoustics on the healing process of intensive care patients, gave relevant momentum and input in this context. “Based on the model of this modern concept, we’ve taken approaches out of adult intensive care, and projected them onto neonatal intensive care.”, says Keller. The interactive online-portal neo(t)räume, which deals with the constructional requirements of a modern NICU and is  hosted by the federal association “Das frühgeborene Kind e.V.”, also had a big  influence on the designers. The actors involved in the project development, besides the usual hospitals planners, were, initially Thomas Willemeit (founding partner of the architecture firm GRAFT) from Berlin, the gs-Architekten-Büro from the Lower Bavarian town Büchlberg, Sigrid Stjerneby from the Planning Office Stjerneby located in Göttingen, as well as the APPIA Contract GmbH from the Lower Bavarian Dietersburg, a field specialist in high grade hotel interiors and in customised furniture manufacturing. “This was necessary, because such a sophisticated unit surpasses the usual NICUs with regards to hospital construction”, explains chief physician Keller. In close coordination with the medical engineering company Dräger, a detailed analysis on essential intensive care processes was carried out, as well as the appropriate optimisation of determined medical technology. “Only through the consistent realisation of our concepts and with comprehensive support through teams of doctors and nurses, but above all through their parents, the tiny ones can master their hurdled start in life at the best”, says Keller.

Being close helps development and healing process

The new Parents, Baby, and Family Centre (Eltern-, Baby- und Familienzentrum, abbreviated as EBZ) in the Children’s Hospital in Passau is divided in three sectors: The NICU for preterm born as well as critically ill children, the general neonatology and the Ronald McDonald House from the McDonald’s foundation for child support. Another special feature is the worldwide first direct integration of the Ronald McDonald House into the intensive care unit.
“With the new building we broke new ground, to combine intensive care with warmth and cosiness and to create a developmentally supportive environment and room for the whole family.” This treatment approach is reflected by the interior design: Parents have access to a special lounge area, with a particularly high appreciation for cosiness – the rooms are equipped with a wardrobe, reading lamp, table, a mirror and WIFI-access. There is a common kitchen for the parents, chat rooms, rooms dedicated to breastfeeding and even a lounge with refreshing beverages – everything directly integrated into the station. Every little aspect, no matter how small, was taken into account, considering all sensory perceptions for the best possible solution: “The comfort factor is one of the key elements! For example: We have installed a special ventilation system and cooling ceilings in the patient rooms, to reduce the children’s and parents body temperature drop off during kangarooing, and soundproof doors as well as insulated partition walls, so that parents aren’t disturbed by other external activities in the station”, Keller explains.

The family in the limelight!

“Always being together, took away some of my anxiety”, says Mother Dagmar from Passau, who remembers her time in the paediatric clinic with her twins Vroni and Toni. Close to two months the three, in the beginning even the four with dad Florian, had to stay in the clinic – Vroni was born with only 790 grams and needed respiratory assistance. Difficult times for caring and treating preterm born babies correctly, in which the clinic’s team utilises family-integrated approaches – in addition to the best medical treatment. The lighthouse project in Passau is complemented through the set-up of Bavaria’s second human milk bank and a simulation centre for preterm infants, in order to train teams of doctors and nurses in the course of needs-oriented care, the optimal handling approach, as well as resuscitation procedures for preterm babies. It is amazing to experience and observe every single day, what has changed throughout the last years. We’ve finally created the best conditions for the optimal care for the tiny ones and we’ve grown much closer together as a team”, confirms the head of station of the new EBZ, Luise Resch-Veit.

A huge fundraising campaign makes the construction possible

Actually realising this comfort for ill children and their families, demanded additional funding apart from existing financial resources. With the fundraising campaign “Wir bauen fürs Leben” (We are building for life) close to three million euros were collected. “We’ve barely missed our targeted funding goal and can be proud of the massive backing and trust from the general public. No matter if associations, organisations, entrepreneurs or individuals – everyone helped”, the chief physician expresses his gratitude, on behalf of the whole paediatric team, towards their sponsors, donors, partners, supporters and prominent messengers, who made the construction of the Parents, Baby, and Family Centre possible.

Selected quotes from our patient families:

  • “We owe you, that our son could develop such a deep, confident sense of basic trust from the beginning. Thank you, that […] I was able to be around my little sunshine 24/7. Thank you, that I could follow my own path, spend hour for hour at my child’s crib, could undertake treatment and was supported during breastfeeding… All that and much more made our terrific well-being today possible and made us feel like a real mom and dad from the very beginning.” (From a letter from a parent)
  • “We’ve been treated and cared for incredibly well here – we feel like we’re in good hands here.” (From an interview with a preemie-parent)
  • “As a mother, to get to see your child directly after its born, even it being laid on your belly, is an indescribable and important experience.” (From a letter from a parent)
  • “My son, my husband and I would like to thank you dearly and are hardly able to deservedly phrase what we were allowed to experience here. We’ve rarely come across people, who are so passionate about what they’re doing and give so much human closeness, friendliness, attention and professional, loving care to all of their patients.” (From a letter from a parent)

Text: Prof. Matthias Keller
Translation: Manuel Kreitmair

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Pregnancy and Pre-eclampsia – an interview with high-risk patient Cathleen Simnick

Question: Have you ever come across the term Pre-eclampsia before or in the beginning of your pregnancy?

Cathleen Simnick: Frankly speaking, I have never heard of pre-eclampsia before I got pregnant. I did know the term ‘toxemia of pregnancy’ but I had no idea what this was actually all about.

 Did you notice any of the “typical” symptoms of pre-eclampsia? If so, when and in which form did they appear?

During my pregnancy I had a subtle form of placental insufficiency. However, very luckily, this did not affect my baby’s growth. But besides that, I felt well and enjoyed my pregnancy. A week before I was diagnosed with HELLP I had the typical symptoms such as elevated blood pressure and severe water retention.

What was the screening test like?

I really appreciated that my physician recommended these measures. It was very easy and for me it felt like a normal prenatal appointment.

 When and how did your physician diagnose your pregnancy as an at-risk pregnancy?

I got the diagnosis when I was 13 weeks pregnant.

Did you feel well informed concerning risks and possible treatment?

My doctor told me about the consequences of pre-eclampsia and how to identify the different symptoms. We then decided I should take ASS100[1] during my further pregnancy to reduce the risk of developing pre-eclampsia. Moreover, I was monitored more frequently. Consequently to my diagnosis, my gynaecologists gave me a sick note and from pregnancy week 27 on I was officially prohibited from working.

 How was your state of health throughout your further pregnancy?

I must say that I actually really enjoyed my pregnancy. I felt fine and never noticed any particular problems. Between Christmas and New Year’s Eve when I was around 30 weeks pregnant, I attended another appointment at my perinatal centre and the doctors detected a rapid deterioration of my results. In a follow-up appointment one week later the results have gotten even worse. Hence I was advised to consult a clinical unit and to consider lung maturity injections. It was very clear by then that I would not be able to carry my baby to full term. Later I visited the Hospital Lueneburg where I was supposed to stay for two days for 24-hour blood pressure monitoring and urine collection. However, all of a sudden, my blood pressure sky-rocketed also the second measurements showed a result above 100. The doctors then tried to medicate me accordingly and I got steady magnesium infusions to prevent seizures. They also took daily blood samples. By then I had increasing water retention in my legs and feet. To play it safe, in pregnancy week 33+6, I received the mentioned lung maturity injections. After one week at the hospital I noticed subtle but increasing epigastralgia. This pain grew stronger and eventually reached my back. I found myself in a situation where I didn’t know how to handle the pain any longer. After another blood test they found out that my liver function reading had deteriorated and that my pregnancy had to be terminated immediately. So on 19 January 2017, I became Mum to my little baby girl Martha Elisabeth. She was delivered at 34 weeks by C-section.

You were not only at risk to develop pre-eclampsia but did in deed develop HELLP. Has this experience influence on your feelings regarding a possible future pregnancy?

I must admit that these events do influence me a bit regarding a future pregnancy. I will definitely opt for exhaustive prenatal check-ups. Looking back, I am glad that my complications had been detected at an early stage and that the doctors did everything to counteract these developments. I think all these steps enabled me to continue my pregnancy for as longs as possible and to take a healthy daughter home, only 13 days after she had been born. 

With hindsight to your own pre-eclampsia experience, is there anything you would recommend other affected women?

I would definitely recommend other women to go with their gut. Everything, even if it may feel irrelevant, should be taken seriously in case of a diagnosed pre-eclampsia. The situation can change at a moment’s notice and one can end up feeling really bad. This can be in deed life threatening for both mother and baby. I am indeed glad I was already in hospital when things started to get worse.  

Thank you very much for your time and your frank and insightful answers.

 

[1] An acetylsalicylic acidic blood-thinning medication, only available on prescription

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EFCNI at the Annual Meeting of ESPGHAN

The 51st Annual Meeting of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) took place in Geneva, Switzerland, from 9 to 12 May 2018. At the EFCNI booth, our colleagues Johanna and Philine represented the foundation and informed participants about our general work and current projects.

Johanna Walz, Professor Berthold Koletzko and Philine Jaeger introducing the EFCNI factsheet on Parenteral Nutrition

Johanna Walz, Professor Berthold Koletzko, Philine Jaeger

In addition, we used this congress to launch several new publications:

• The position paper and toolkit for promoting human milk banks are now available in English. Both publications were developed by an interdisciplinary project Scientific Advisory Board with the aim to support clinical centres in the setup and operation of human milk banks. After positive feedback from other countries, the position paper and toolkit were translated into English, but still need adaption to country-specific conditions

• Our new factsheet “Why the first 1,000 days of life matters” deals with the period between conception and a child’s 2nd birthday. The four-page factsheet highlights the enormous impact of this time period on the health and wellbeing of unborn babies, infants, and young children, as well as on pregnant and lactating women.

• The EFCNI factsheet “Parenteral nutrition in preterm and ill babies” describes the feeding therapy that provides nutrition through the veins to babies who cannot (yet) be adequately fed by mouth or through a feeding tube.

As we want to ensure widely accessible information for all stakeholders in the field of maternal and newborn care, EFCNI provides all publications free of charge ant www.efcni.org/downloads.

We warmly thank all experts and partners who made these publications possible.

 

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Lighthouse Project: NICU Design at Lurie Children’s Hospital of Chicago

A guest article by Vita Lerman, Ann & Robert H. Lurie Children’s Hospital of Chicago, USA

Ann & Robert H. Lurie Children’s Hospital of Chicago is a state-of-the-art, 22-floor facility that opened in 2012 on the campus of the hospital’s academic partner Northwestern University Feinberg School of Medicine. It was built to replace the previous facility (called Children’s Memorial Hospital), providing expanded capacity and innovative, child-friendly design that promotes healing. During every stage of the planning process, project leaders met with the hospital’s Kids and Family Advisory Boards to ensure that design decisions incorporated their needs.

One of the innovations at Lurie Children’s is the design of its neonatal intensive care unit (NICU), which has all private rooms, like the rest of the hospital. While there is sufficient evidence that NICUs with all private rooms benefit newborns and their families, the primary concern with this model expressed by caregivers is not being able to visually monitor babies as easily as in the traditional NICU ward model that has beds arranged in a large open room. The layout of the 44-bed NICU on the 14th floor of Lurie Children’s, with its four transparent nursing stations, each surrounded by a grouping of patient rooms with glass doors, combines the best of both models. It provides privacy and quiet for families and sufficient visibility of infants for caregivers.

NICU inpatient room (c) Lurie Children’s Hospital Chicago

The remaining 16 NICU beds are part of the Regenstein Cardiac Care Unit, where patients with heart conditions are treated from admission to discharge. The patient rooms in this unique unit are designed to meet the technological requirements of an intensive care room, while providing the family amenities and atmosphere of an acute care patient room. This acuity-adaptable model helps improve patient safety and comfort by reducing transfers within the hospital.

The NICU at Lurie Children’s also includes transitional care rooms that are equipped to ensure that new parents receive necessary instruction and hands-on practice in caring for their baby in a simulated home setting. These rooms are designed to build family members’ competence and confidence, which helps reduce re-admissions.

Crown Sky Garden (above), CMH int Level 12 fire truck (below left), main lobby (below right) (c) Lurie Children’s Hospital Chicago

To help reduce the stress of hospitalization and provide families with an inspiring respite space, Lurie Children’s features a striking Crown Sky Garden on the 11th floor. Designed by world-renown landscape architect Mikyong Kim, the garden combines light, sound, water and wood elements to create an oasis for parents and play areas for kids.

Another unique feature at Lurie Children’s is its creative, child-focused interiors that were designed in partnership with over 20 of Chicago’s premier cultural and civic institutions. In the hospital’s main lobby, families are greeted by near life-size models of a mother humpback whale and her calf that were donated by the Shedd Aquarium, while on the 12th floor, kids can play in a customized fire truck cab donated by Pierce Manufacturing to recognize the hospital’s longstanding partnership with the Chicago Fire Department. Each floor of the hospital has its own creative theme and exhibit. In the NICU lobby, for example, the Adler Planetarium developed an interactive exhibit that invites families to press a button with their baby’s birthday to light up the corresponding astronomical constellation.

  

Now Lurie Children’s is in the process of expanding its inpatient capacity from 288 beds to 360 by November 2019. Twenty beds will be added to the NICU, which will expand to the floor above.

View more (website Ann & Robert H. Lurie Children’s Hospital of Chicago)

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Relaunch of EFCNI website and newsletter

Screenshot new EFCNI websiteOn the occasion of the 10th anniversary of EFCNI in 2018, the EFCNI website came up in a fresh, modern design. The aim was to give users an easy access to their desired information. In addition, the newsletter design was updated as well. For easy readability, a special colour concept guides you through the news: from updates about EFCNI activities (grey section), to events and projects by our collaboration partners (purple section), up to scientific news (gold section). 

Go to www.efcni.org and enjoy!

 

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Lung function in children born extremely preterm

Some babies born too early show signs and symptoms later in life that may be long-term consequences of preterm birth. To look at this in more detail, follow-up studies are of great importance. Their results provide a scientific basis for follow-up and continuing care. A study from Sweden recently analysed lung function in 6½-year-old children born at less than 27 weeks. These extremely preterm born children had suffered from immature lungs after birth, and almost all of them had developed Bronchopulmonary dysplasia (BPD), a chronic neonatal lung disease.

Graphic of a baby with highlighted lungsIn total, 178 children from the Swedish national cohort study EXPRESS (Extremely Preterm Infants in Sweden Study) agreed to participate in the follow-up study on lung function (71% inclusion rate). Each of these children was matched to a healthy control born at term, based on date of birth, hospital of birth, sex, and mother’s country of birth. The idea behind such a matched case-control follow-up study design is to compare a specific condition (here: lung function) in two groups that differ in one characteristic (here: preterm birth versus full-term birth) but are otherwise as similar as possible.

All children from both the extremely preterm and the full-term groups were invited to do clinical and lung function assessments. Six controls were unable to reach or declined, resulting in a control group of 172 children.

Among the children born extremely preterm, 40% reported respiratory wheeze or the use of asthma medication in the last 12 months. In the control group, this percentage was significantly lower with only 15%. The results of the lung function tests showed that the children born extremely preterm had reduced lung function compared to the controls. Functional deficits included reduced maximal expiratory flows, lower lung volumes, and altered airway mechanisms. Furthermore, children born at 22-24 weeks of gestation had a 5-10 times increased risk to have a lung function below the lower limit of normal compared to the control group.

A comparison of lung function of preterm born children with BPD and without BPD was not possible to perform. As 90% of the children born extremely preterm suffered from moderate or severe BPD in the neonatal period, the group of children without BPD in the neonatal period would have been too small and the group sizes too unequal for statistical analyses.

The findings of the study suggest that preterm birth and the level of preterm birth have an effect on lung function in childhood. They also provide indications that follow-up and continuing care is necessary not only during but also beyond childhood, to detect and track further long-term outcomes.

Read the original study (Pediatric Pulmonology)

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