CRITICAL CARE UNIT
1. HEMODIALYSIS UNIT IN THE MEDICAL INTENSIVE CARE UNIT
Acute and Chronic Renal Failure needing Renal Replacement Therapy (RRT) often accompanies and may occur because of and in conjunction with pulmonary and other medical conditions. In the past, In-patients of the Lung Center of the Philippines requiring RRT had to be conducted to NKTI or other institutions to avail of this procedure. In order to serve its patients better, the Lung Center of the Philippines has allocated two (2) beds in the Medical Intensive Care Unit (MICU) to serve our In-patient clientele needing renal replacement therapy.
These beds are reserved for use by Inpatients presently confined in the Lung Center of the Philippines (Intensive Care Unit or General Ward) needing Renal Replacement Therapy (RRT).
The Hemodialysis Unit was inaugurated last January 21, 2019 and is at present fully functional. The unit is Headed by a duly accredited Nephrologist and 2 Certified Renal Nurses (CRN). The unit is open from 8AM to 8PM.
2. EXTRACORPOREAL MEMBRANE OXYGENATION IN THE LCP
Extracorporeal Life Support (ECLS) is the use of Extracorporeal Membrane Oxygenation to temporarily (days to months) support heart or lung function (partially or totally) during cardiopulmonary failure, leading to organ recovery or replacement. Although ECLS may be performed in both cardio and respiratory failure, LCP – ECMO will mainly involve patients who are in respiratory failure.
Lung Center of the Philippines is the premier institution for lung and other chest diseases, providing quality healthcare through highly competent and compassionate staff for the improvement of the Filipino people’s quality of life.
The Lung Center of the Philippines has recently acquired 3 units of ECMO to addressed the growing demands of more advanced pulmonary cases in the country to serve both Surgical and Medical need.
The LCP – ECMO Team is fully functioning and its Headed by Critical Care Specialist, with Cardio – Thoracic Surgeons, Anesthesiologist and Perfusionist in the team and in recent time, they have already done few cases.
3. AMBULATORY MEDICAL ONCOLOGY UNIT (AMOU)
The Ambulatory Medical Oncology Unit (AMOU) of the Lung Center of the Philippines is an out-patient facility that aims to offer quality medical and nursing cancer care treatment among stable adult patients with cancer. It was established by the Section on Oncology of the Department of Pulmonary Medicine.
The old facility was housed next to the Emergency Department and consisted of only two beds and two ‘lazy boy’ chairs providing care for both the service and pay patients. However, with the increasing number of cancer patients, the waiting period for such a small unit would be an average of one hour. Expansion of that area was limited so it was decided that the creation of two separate and larger units would greatly improve service delivery and patient convenience. The Oncology Service head, Dr. Guia Ladrera, along with top administrative management convened the Medical Oncology consultants to get feedback and suggestions on the proposed establishment of a new unit. It was then that a decision was made to house the units in the wards manned by its own nursing staff. The present AMOU, which formally opened on August 15, 2014, offers a set-up whereby patients can receive out-patient chemotherapy in a restful, relaxed, comfortable, yet controlled environment and where they can be assured of quality oncologic care. Attending physicians, on the other hand, are then confident that their patients would receive chemotherapy from hospital staff who have been properly trained and gained sufficient skills in administering treatment and fully capable of addressing the special needs of cancer patients.
One AMOU is located at room 3103 on W3A (for service patients) and the other one is located at room 2101 on W2A for pay patients. Operating hours are from 7:00 AM to 6:00 PM from Mondays through Saturdays (except holidays and other non-working days).
Adult Ambulatory Oncology Unit (AMOU)
The Adult AMOU transferred to its new home located at the T-block section of the hospital last July 2019. It has an adjoining waiting area for relatives. It now has 13 lazy boys chemotherapy chairs to cater to cancer patients on OPD chemotherapy at a given time.
Compounding of the chemotherapy drugs regarded as hazardous substance is carried out though the newly acquired isolator. The AMOU complex has its own emergency crash cart equipped with defibrillator, emergency medicines. The unit has its own 12L ECG machine. The AMOU also acquired an ultrasound machine for point of care ultrasound and for ultrasound guided IV insertion for difficult IV cannulation.
The AMOU personnel are trained Philippine Oncology Nurses Association (PONA) members with training in basic life support. They are looking forward to further training in ultrasound guided IV cannulation and point of care ultrasound.
The AMOU is in the process of forming a cancer support group for patients and caregivers. It will be composite of trained facilitators that shall include but shall not be limited to the following: Nurses, social workers, pastoral personnel, radiation and medical oncologist, pain management and nutritionist.
Enlisted are the current services offered by the Adult AMOU:
a) Compounding of OPD and in-patient chemotherapy drugs
b) OPD infusion of chemotherapy drugs
c) OPD blood transfusion
d) OPD bone marrow biopsy
e) Flushing of IVAD
f) Subcutaneous/intramuscular injection of anti-hormonal therapy, ancillary
g) Intravesical administration of cytotoxic drugs
h) Intrathecal administration of cytotoxic drugs
i) Lay fora for patients and caregivers
4. HYPERBARIC MEDICINE AND WOUND CARE CENTER
The HYPERBARIC CHAMBER SYSTEM (HCS), owned by the Philippine Commission on Sports Scuba Diving (PCSSD), an agency under the Department of Tourism, is currently housed at the Lung Center Hyperbaric Medicine Facility and Wound Center located in a separate building within the Lung Center compound. Its use, operation, and maintenance is based on a memorandum of agreement between the Lung Center and PCSSD.
Hyperbaric oxygen therapy (HBO) is defined as breathing 100% oxygen while in an enclosed system pressurised to greater than one atmosphere (sea level). Breathing 100% oxygen at atmospheric pressure or applying topical oxygen without enclosing the entire patient in a pressurised chamber does not produce the same effects and is not recognized as hyperbaric oxygen therapy.
Hyperbaric oxygen therapy delivers oxygen quickly, and in high concentrations, to injured areas systemically. The increased pressure changes the normal cellular respiration process and causes oxygen to dissolve in the plasma. This results in a substantial increase in tissue oxygenation.
The Mechanisms associated with the action of hyperbaric oxygen
The elevated pressure (1.5 to 3.0 atmospheres) increases the amount of oxygen present in the bloodstream and available to tissues, 10 to 13 times over normal conditions. Hyperbaric oxygen provides immediate support to compromised tissue areas with marginal blood flow. Elevated levels of oxygen can also purge toxins, including carbon monoxide, from the body.
- Direct Pressure.
Hyperbaric oxygen shrinks the size of gas bubbles so that they may be reabsorbed. Hyperbaric oxygen is important in the treatment of arterial gas embolism and decompression sickness.
Elevated levels of oxygen cause vasoconstriction that leads to a reduced blood flow without significantly affecting tissue oxygenation. Hyperbaric oxygen is used to control compartment pressures in crush injuries and to treat thermal burns.
Super oxygen saturation of tissue stops the spread of certain toxins and enhances the killing of bacteria. This is important in the treatment of gas gangrene and necrotizing tissue infection.
- Angiogensis and Neovascularization.
Hyperbaric oxygen promotes the growth of new blood vessels by enriching the area with oxygen-carrying blood. Although decreased oxygen tensions stimulate angiogensis; for it to be effective, there must be an underlying scaffolding of collagen to support it. Overall, therefore, hyperoxygenation stimulates useful angiogensis.
Only the following indications are the approved uses of hyperbaric oxygen therapy (as defined by the Hyperbaric Oxygen Therapy Committee of the Undersea and Hyperbaric Medicine Society or UHMS) in this facility:
1. Air or Gas Embolism
2. Carbon Monoxide Poisoning with or without cyanide poisoning
3. Clostridial Myositis and Myonecrosis (Gas Gangrene)
4. Crush Injury, Compartment Syndrome and Other Acute Traumatic
5. Decompression Sickness
6. Arterial Insufficiencies : Central retinal artery occlusion;
Enhancement of healing in selected problem wounds
7. Severe Anemia (when transfusions are not an option)
8. Intracranial Abscess
9. Necrotizing Soft Tissue Infections
10. Osteomyelitis (Refractory)
11. Delayed Radiation Injury (Soft Tissue and Bony Necrosis)
12. Compromised Grafts and Flaps
13. Acute Thermal Burn Injury
14. Idiopathic Sudden Sensorineural Hearing Loss
Patients who undergo hyperbaric oxygen (HBO2) therapy or treatment in the facility shall do so following duly approved Policies and Procedures
For inquiries, contact Lung Center of the Philippines Tel no. 8924-6101 local 1952, 1953 or the Philippine Commission on Sports Scuba Diving Telephone nos. 524-2242 or 523-8411 local 218.
5. SAINT THERESE UNIT
As early as 2004, the Center has put up its Saint Therese Unit (STU) which was specially made to house the highly contaminating patients. The construction of the St. Therese Unit was rushed to meet the SARS problem. The same unit came in handy with the admission of an alleged meningococemia patient.