We are the combination of four hospitals: the General Hospital, the Children’s Hospital, the Women’s Hospital and the Traumatology, Rehabilitation and Burns Hospital. We are part of the Vall d’Hebron Barcelona Hospital Campus: a world-leading health park where healthcare plays a crucial role.
Patients are the centre and the core of our system. We are professionals committed to quality care and our organizational structure breaks down the traditional boundaries between departments and professional groups, with an exclusive model of knowledge areas.
Would you like to know what your stay at Vall d'Hebron will be like? Here you will find all the information.
The commitment of Vall d'Hebron University Hospital to innovation allows us to be at the forefront of medicine, providing first class care adapted to the changing needs of each patient.
ECMO is a technique used in critical patients suffering from extremely serious respiratory and/or cardiovascular diseases where conventional life support is insufficient. The machine temporarily replaces lung or heart function, enabling the organs to rest while the underlying illness is treated.
The machine removes blood through a thick tube inserted into a major vein and transfers it to a centrifugal pump. The pump pushes it through an oxygenator, where oxygen is added and carbon dioxide removed. Subsequently, it is reintroduced into the patient’s body. If this is done through another vein, it is known as veno-venous (VV) ECMO and provides respiratory support. Where it is done via an artery, this is known as veno-arterial (VA) ECMO and provides support for both the heart and lungs.
ECMO is not a treatment per se but rather a support mechanism. It optimises organ recovery but does not resolve the underlying problem. In fact, one of the reasons to use the procedure is its reversibility for patients. The system is highly effective in replacing vital organ function. However, it is currently a last option for a specific patient group given its complex nature and associated risks, such as bleeding, thrombosis and infection.
Regardless of the support strategy chosen, this is a highly complex technique associated with a high risk of serious complications. That is why, in order to ensure excellent care, a well-organised programme is required, with optimal material and sufficient numbers of properly trained staff. Cases need to be clustered at leading centres and units with the necessary resources and material to ensure effectiveness, as well as a highly trained multidisciplinary team.
The Extracorporeal Life Support Organization (ELSO) is the benchmark international scientific association for ECMO. It establishes care and organisational guidelines, coordinates teaching activities and promotes research in the field. The organisation has a multi-centre database with information on over 200,000 patients. Although patients receive optimal care through ECMO with excellent survival rates, they often have later side effects due to the seriousness of their illness and the intense nature of their care, both during ECMO and with prior treatment.
Vall d’Hebron is home to two ECMO programmes. One is for adult patients and led by Dr Jordi Riera, and the other is for children and new-born patients, led by Dr Joan Balcells.
Our programmes follow ELSO guidelines at all levels, from lifelong, multidisciplinary and skill-based training for ECMO teams to filling in records for continuous assessment, as well as optimised protocols that align with our context and setting.
Our programmes take a long-term outlook, focused on getting patients back to their daily lives with maximum functional recovery. In this sense, we prioritise minimal deep sedation and safe early physical rehabilitation, even where recovery of the failed organ is still ongoing. ECMO support makes this possible by substituting heart and lung functions. Moreover, patients are able to directly interact with professionals and family members.
Veno-Arterial (VA) and Veno-Venous (VV):
The VA option provides heart and lung support by taking over organ functions. It is used when there is a cardiorespiratory problem, such as a heart attack or myocarditis (inflammation). The VV option is used to provide respiratory support and takes over lung function. It is used where there is a breathing issue, such as pneumonia or an acute blockage in the airways.
Peripheral or central line:
Patients are normally connected to an ECMO machine through cannulae (thick tubes) in the neck or groin. This is known as a peripheral line. At times, the machine needs to be directly connected to a patient’s heart or very close to the heart through the chest. This is known as a central line.
Special scenarios:
ECMO is an effective system but can pose major risks for patients. In terms of frequency and potential seriousness, these risks include bleeding and infection.
Bleeding is due to the fact that patients are often treated with blood thinners. Infection is due to receiving highly invasive therapy and the severity of the illness.
In order to minimise these risks, it is essential to have a properly trained multidisciplinary ECMO team, cluster ECMO cases and resources, and ensure robust records comparable to other consolidated external records.
The Cardiovascular Critical Care Unit is a part of the Cardiology Department at Vall d’Hebron. It treats people with acute and serious cardiovascular disease. It mainly looks after cases of complex ischaemic heart disease, such as acute myocardial infarctions or chest angina.
The Cardiovascular Critical Care Unit (initially known as the Coronary Care Unit) was created in 1971 to admit patients with acute myocardial infarction, or other acute cardiovascular diseases. It also dealt with cardiac surgery post-operative care. In 1989 the unit was divided into two. The current Cardiovascular Critical Care Unit became responsible for the patients and became a part of the Cardiology Department.
In addition to providing multidisciplinary care for patients of all ages who suffer this condition, the objectives of Vall d’Hebron Hospital’s Hereditary Angioedema Unit include teaching and research in this field.
The Hereditary Angioedema Unit (UAEH) of Vall d’Hebron University Hospital’s Allergology Department has been treating patients with this disorder for more than 25 years.
UAEH outpatients are treated by allergology specialists in a multidisciplinary manner in the Outpatient Clinic in the Old Nursing School and in the Children’s and Women’s Hospital, ensuring transference and continuity of care from childhood through to adulthood for this genetic, lifelong condition.
Oculoplastic and orbital surgery is a sub-specialism that treats the pathology related to the eye attachments, with four main fields of interest: orbital pathology, tear duct anomalies, anophthalmic cavity pathology and eyelid disorders.
The main characteristic of this field is its multi-disciplinary nature, due to the diversity of systemic diseases that may be involved. It is also an area that touches on other specialisms, including maxillofacial surgery, ear, nose and throat, plastic surgery and neurosurgery.
Treatment in this field often involves inter-relation with other medical specialisms, including endocrinology, internal medicine, radiology and oncology. We also provide medical and surgical care for oculoplastic pathology at the Children’s and Women’s Hospital.
This Section treats conditions affecting the optic nerve and Strabismus, a loss of ocular alignment.
This Section treats conditions affecting the optic nerve, whether secondary to intracranial hypertension, inflammatory/demyelinating, ischemic, infiltration-related (such as sarcoidosis), compressive, autoimmune, due to nutritional/toxic deficits, paraneoplastic or genetic, those affecting the visual field due to involvement of the visual pathway, whether cranial tumours, stroke, traffic accidents, infections (meningitis, encephalitis…) and those affecting pupil shape, size or reactivity.
Uveitis is an inflammation of the middle layer of the eye, the uvea, and can affect only the ocular and periocular region or it may be associated with systemic diseases. The aetiology of this clinical picture is very varied and includes trauma, infection, previous eye surgery, systemic inflammatory disease and others.
In this Section, we have access to all the testing required to diagnose and manage these conditions, from exclusively ocular tests, such as wide-field retinography, autofluorescence, optical coherence tomography, campimetry, etc., to extraocular testing in close relation with other specialties across the hospital.
The retina sub-specialism is a branch of ophthalmology concerned with studying, diagnosing and treating retina, uvea and vitreous conditions.
Among the pathologies tackled by this sub-specialism are pathologies of the retina that require medical treatment, including: diabetic retinopathy, retinal vascular disorder, such as venous thrombosis or arterial occlusions, age-associated macular degeneration or severe myopia.
The Department has the most advanced technology for the surgical treatment of various retina conditions:
Integrated monitoring of patients with glaucoma, from diagnosis at the GP surgery/hospital to surgical treatment, where required.
Our Section deals with the diagnosis and treatment of all pathologies affecting the ocular surface, whether inflammatory, infectious, dystrophic, traumatic, tumour-related or degenerative.
Within the Department, we have the most up-to-date complementary tests for diagnosing ocular surface pathologies: specular microscopy, pachymetry, state-of-the-art topography (Pentacam, Cassini), high-resolution anterior segment OCT, etc.
Aortic diseases are relatively common, affecting 5% of the population over the age of 65. Abdominal affectation is much more common in the elderly, while affectation of the thoracic aorta is more likely to occur among younger people.
The main problem is that due to the lack of symptoms it can go unnoticed and is often diagnosed through a study using imaging techniques such as echocardiography or CT. The aorta is almost always prone to dilation and aneurysm before rupture, which is why it is very important to diagnose the problem early and to try to slow it down.
Classically this condition has been treated by surgeons. In recent years it has been proven that the only way to improve diagnosis and treatment is to treat the subject in a multidisciplinary manner. Certainly, when the aorta is broken it is vital to offer prompt, careful surgical treatment, but the medical goal is to try not to break it, or to indicate the surgery before the risk is too high. There are two reasons behind aortic disease developing.
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