Division of Neonatology, Intensive Care Medicine and Neuropediatrics

Fields

Neonatology
At the neonatology wards, high-risk and premature babies are cared for after birth and in the aftercare clinic up to the age of six. A total of two neonatal intensive care units (E9 C directly next to the delivery room in the green bed tower and E10 NICU in the area of ​​the university children's hospital) and two neonatological intermediate care stations (E12 IMC in the area of ​​the university children's hospital and E15B IMC in the area of ​​the obstetric level in the green bed tower) are available. Up to 200 premature babies with a birth weight <1,500 g are cared for annually in 20 intensive care beds (IC) and 24 intermediate care (IMC) beds, including up to 100 premature babies with a birth weight <1,000 g. This makes our institution the largest perinatal center in Austria, but also one of the largest perinatal centers in all of Europe.

The focus of clinical care in neonatology is on extremely immature premature babies, although in recent years there has been great progress in the outcome of the children, especially at the limit of survival. With a survival rate of 90% even for the very smallest premature babies aged 24–26 weeks, unprecedented positive results have been achieved, which is an extremely encouraging development, especially given the fact that morbidity has not increased.

For years, a focus of care in neonatology has been the development-promoting care of premature babies (WEFIB = Vienna Development-Promoting, Family-Centered, Individual Care). The focus of this care concept is on promoting the brain development of immature premature babies, with factors such as light, noise and stress reduction as well as early and intensive integration of the parents into everyday ward life playing a central role. This also includes an open visitation policy with parents present without restrictions for 24 hours. Furthermore, breastfeeding and lactation advice for mothers of premature babies was intensified and improved. What is particularly pleasing is the establishment of a parent group of former premature babies in our department, which represents a valuable addition to the support offer for affected parents. You can find information about this on the website "A Hand Full of Life" (in German).

Quality assurance is achieved through participation in external registries, including the Vermont Oxford Neonatal Network, which provides outcome data for premature infants <1,500 g birth weight from over 850 neonatal intensive care units worldwide.

Last but not least, attention should be paid to the education and training of employees and teams in the pediatric simulation center. The interdisciplinary team uses highly complex patient simulators to train rare emergency situations in newborns in a realistic environment, which leads to better performance in emotionally stressful situations and, in this context, to a significant increase in patient safety.

Pediatric intensive care medicine
The pediatric intensive care unit (PICU) is responsible for the clinical care of pediatric intensive care patients, with eight intensive care beds and a resuscitation unit available. The focus of the activity is on the intensive care treatment of life-threatening organ failure in children as well as the care of children after neurosurgical and cardiac surgery procedures. All diagnostic and therapeutic procedures in pediatric intensive care are available. A particular clinical and scientific focus is extracorporeal membrane oxygenation (ECMO) for temporary heart and lung replacement. The mechanical heart support system “Berlin Heart” has been in use for children since 2011. This pulsatile heart support system enables long-term support and the bridging until heart transplantation. Quality assurance is achieved through participation in international medical organizations such as ELSO (Extracorporeal Life Support Organization).

Neuro-oncology
The clinical specialty area of ​​neuro-oncology at the Medical University of Vienna is one of the largest centers for the treatment of childhood brain tumors. Every year, around 50 patients with new tumors of the central nervous system are treated in our center. The area consists of an inpatient bed unit (level 9 with ten IMC beds), the oncological day clinic (level 5 with 4 beds) and the neuro-oncological outpatient clinic.

Epileptology – full member ERN EpiCare
The Department of Pediatrics and Adolescent Medicine of the Vienna Medical University has been home to the only level 4 pediatric epilepsy center in Austria since 2004. It offers 24 hours/7 days advanced (differential) diagnostics (including non-invasive and invasive pre-surgical evaluation) for difficult-to-treat and/or drug-resistant pediatric epilepsy patients (age 0-18 years) from all over Austria and neighboring EU countries (including genetic and metabolic testing). There is an epilepsy outpatient clinic certified by the International League Against Epilepsy (ILAE) and the Austrian Society for Epileptology (ÖGfE) including extended (pre-surgical) epilepsy diagnostics, an EEG laboratory certified by the Society for Neurophysiology (ÖGKN) and inpatient care four IMC beds and four beds for continuous video-EEG monitoring (Epilepsy Monitoring Unit – EMU) operated at level E09. Diagnosis and treatment are carried out according to the ILAE guidelines and the diagnostic and management criteria of the TSC Alliance.

Special tasks are:

• the evaluation of patients who are difficult to treat with medication or who are refractory to treatment with regard to the possible implementation of an epilepsy surgery procedure,
• the postoperative management of drug-resistant children,
• the use of new “off-label” anticonvulsants,
• and the provision of alternative therapy options such as ketogenic diet and vagus nerve stimulation.

The pediatric epilepsy center also offers a special outpatient clinic for rare and complex, difficult-to-treat pediatric epilepsy syndromes (ages 0–18 years), a pediatric center for tuberous sclerosis, which also treats other neurocutaneous syndromes (e.g. PIL3CA, SWS, …), and a Transition clinic.

The pre-surgical evaluation and the epilepsy surgery procedures are carried out in close collaboration with the university clinics for neurosurgery, radiology, nuclear medicine and neurology.