More than 70% of all premature babies born in the 23rd week of pregnancy (currently regarded as the earliest limit for survival) survived in the neonatal unit in Vienna General Hospital. The average survival rate throughout the world is 35%, so that twice this percentage of tiny newborns survived in our care,” says Angelika Berger, Head of the Clinical Department of Neonatology, Paediatric Intensive Care and Neuropaediatrics.
At the same time, there was a further improvement in the outcome for so-called Very-Low-BirthWeight-Infants (VLBWI), that is newborns with a birthweight of less than 1,500 g: 161 out of the 171 premature babies born with a birthweight of less than 1.5 kg survived at MedUni Vienna/Vienna General Hospital. That represents a survival rate of 94.2%. Internationally, the average survival rate for neonatal units belonging to the Fairmont-Oxford-Neonatal-Network, a network of more than 900 leading neonatal units, is 85%.
“What is particularly pleasing is that the survival of these fragile little patients was not associated with increased morbidity,” explains Berger. “Despite improved survival, the prevalence of chronic lung disease or brain haemorrhage was significantly lower than in the international network.”
This success is due to the healthcare concept practised in the neonatal unit at Vienna General Hospital, whereby optimum care starts well before birth. “We are only able to achieve these excellent results with the close collaboration of our colleagues in obstetrics,” stresses Berger. An important factor in the success of this healthcare concept, which was introduced in 2009, is an innovative method of treatment in the primary care of extremely premature babies, which was originally developed in Cologne and has been scientifically refined at MedUni Vienna. This involves administering the vital substance “surfactant” to spontaneously breathing children, without the need for artificial ventilation. It is only after approximately the 28th week of pregnancy that babies can produce enough of their own surfactant and, in most cases, sufficient surfactant is produced from week 34 onwards. Surfactant is an emulsifying, surface-active substance, which helps to keep the alveoli open in the lungs. In this method the surfactant is administered to the spontaneously breathing infant via a thin probe.
The whole new healthcare concept works. Berger: “We can clearly identify that the survival rate of extremely premature babies started to increase significantly from 2009 onwards.” And this was achieved, even though the general conditions were not always ideal: “At present we are looking after these infants on five wards at five different locations within Vienna General Hospital, some of them a long way from each other.” It is hoped to make a further improvements in the care of these high-risk patients and their families by combining all the obstetric and neonatal units in the planned perinatal center as part of the joint project being implemented by MedUni Vienna and Vienna General Hospital, “University Medicine Vienna 2020”.
MedUni Vienna/Vienna General Hospital.