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The Ramsay Way - 2015 04

The Ramsay Way 2015 | 04 11 HOSPITALS Bold medicine, brave hearts at Strathfield Private It was a daring three hour dash over the Coral Sea, through-the-night surgery and a masterful surgeon’s hands that saved the life of Henri Contri this month. This 69-year-old Noumean man’s extraordinary journey was captured by France NC1ER, France’s national broadcaster — as part of a documentary on cardiac patients being flown from Noumea to Strathfield Private Hospital for life-saving heart surgery. Cardiothoracic surgeon Dr Michael Byrom performed the aortic dissection repair after Mr Contri’s aorta tore, creating a life-threatening cardiac emergency. “Even for a patient who lived in the next suburb, the chances of dying on the way to the hospital with this condition are significant and about one in four don't survive the first day without an operation,” says Strathfield surgeon Dr Byrom. “The fact that our transport teams and our doctors in Noumea and in Australia could galvanize into action so quickly and get him here in three hours; the fact that even a few minutes later and we probably would have lost him and the fact that he is recovering so well is quite remarkable and testament to the fantastic team I work with. “Of all patients who have cardiac surgery at Strathfield Private — and this includes people in their 80s and 90s who have serious and complex cardiac conditions – the hospital has a 97.5 per cent survival, well above the expected survival for this group. For aortic dissection, the mortality rate internationally is 25 per cent and Strathfield’s rate is well below at 15 to 17 per cent.” Strathfield Private CEO Paul Darcy said Strathfield area residents were lucky to have access to medical talent like Dr Byrom — the same doctor who brought back to life rapper Jelal Edmonds in 2012, after the X-Factor star was stabbed in the heart in a Darlinghurst nightclub. Without a pulse or a heartbeat, Dr Byrom used his finger to plug a hole in Jelal’s heart until he could reestablish his circulation and surgery could be performed. For Henri Contri’s wife Chantal, filmed by the French television crew tearfully thanking the surgeon, words will never be enough. “I cannot say in words how much I thank you,” she told Dr Byrom in French. “You have given me back my husband.”  Patient Henri Contri recovering after his life-saving surgery with Cardiothoracic Surgeon Dr Michael Byrom. Sleep hormone could save lives and money Article courtesy of Antony Perry, APHA Ramsay Health Care’s Joondalup Health Campus is likely to be a trial site for a new hormone supplement that could save the Western Australian Government millions of dollars each year — not to mention save lives. A new study is seeking to prove that giving intensive care patients pills containing the sleep hormone melatonin could reduce the delirium that up to 80 per cent of patients suffer. The randomised, ‘blinded’, placebo-controlled trial on 840 patient volunteers will occur over the next 12-18 months. Joondalup has been earmarked as a potential trial site, while Sir Charles Gairdner Hospital, Royal Perth Hospital, Fiona Stanley Hospital and John Hunter Hospital in New South Wales will also be used. Sir Charles Gairdner Hospital intensivist Bradley Wibrow is the principal researcher of the study. He said previous studies showed that up to 80 per cent of patients in Western Australia’s intensive care units (ICU) suffered from delirium, which is linked to higher mortality rates as well as increased length of stay in the ICU. It is generally accepted that a delirious patient will spend at least half a day longer in ICU. When it costs $5,534 per day to keep a patient in intensive care, shortening stays could save significant amounts of money. Dr Wibrow said the ICU environment, dark in the daytime and full of noise and bright lights at night, made delirium worse. “The factors associated are decreased quality and duration of sleep,” he told Fairfax Media. “It’s a really big problem and there has been more and more focus on it for the past five to 10 years in intensive care literature.” Light fading at the end of the day normally triggers the brain to produce the sleep-inducing hormone melatonin. But Dr Wibrow said previous studies on ICU patients had showed they had melatonin deficiency. Melatonin supplements have been used in limited studies before and in wards for treatment purposes, but never as a preventive measure and never in ICUs. Dr Wibrow said it is different to sleeping pills because it isn’t addictive and patients aren’t able to build up a tolerance against it. “It’s not that difficult to actually create and you can generally buy it easily. It’s still manufactured, but it’s the same hormone that’s produced by the body,” he said. “If it does work it would be good because there are not many medical treatments to prevent delirium. Antipsychotics have significant side effects so giving any drug to a patient already experiencing side effects is not ideal.” Melatonin is cheap, with a patient’s daily dose estimated at costing about 85 cents. Giving it to ICU patients in Western Australia for the length of their stay would cost less than $15,800 per year. “This is by far the biggest study ever done on melatonin and this will hopefully give us the definitive answer,” Dr Wibrow said.  Joondalup Health Campus


The Ramsay Way - 2015 04
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