Cooper Leads Region in Management of Critically Ill Pulmonary Patients

Advanced Therapies, Clinical Excellence, Rapid Transport

In the management of critically ill pulmonary patients, superior outcomes are often dependent on access to a crucial combination of care: experts at the bedside, advanced medical, minimally invasive and surgical therapeutic modalities, and rapid transfer. Advanced centers like Cooper University Hospital, provide access to these services through centers of excellence in critical care, pulmonary medicine, and thoracic surgery – without leaving South Jersey.

“There is nothing available in critical care management today that is not available at Cooper University Hospital,” says R. Phillip Dellinger, MD, Head of the Division of Critical Care Medicine and Vice Chief of Medicine at Cooper. “The advanced care provided by Cooper for the management of critically ill patients with complex airway disease is unmatched in the Delaware Valley.”

Internationally renowned for sepsis, shock, and post-cardiac arrest hypothermia treatment, Cooper’s Critical Care Medicine Program also provides the most cutting-edge care in the region for complex patients requiring respiratory life support.

“We believe strongly that we have the most advanced resources in the region for the care of Acute Respiratory
Distress Syndrome (ARDS) patients with refractory hypoxemia, or patients with high oxygen needs,” says Sergio L. Zanotti, MD, Cooper Critical Care Medicine attending physician and Director of the Cooper Critical Care Medicine Fellowship Program. “Our therapeutic arsenal can address the most critical patients.”

In Cooper’s state-of-the-art, 30-bed Intensive Care Unit, Critical Care and Pulmonary Medicine provides:

  • Rescue therapies including inhaled vasodilators and prone positioning.
  • Alternative modes of mechanical ventilation including High Frequency Oscillatory Ventilation (HFOV) and Airway Pressure Release Ventilation (APRV) for patients who have failed conventional ventilation.
  • Multidisciplinary team of experts – In addition to critical care and pulmonary physicians, respiratory therapists, nurses, and nutritionists, an Infectious Disease attending physician and Pharm D are assigned to the ICU care teams.
  • Round-the-clock critical-care trained physicians at the bedside.
  • Cooper Transfer Center – 24/7 air and land transfer capabilities.

As the acuity and number of patients with complex airway disease has increased, the Cooper Division of Pulmonary Critical Care has added diagnostic and therapeutic options, as well as faculty. Wissam Abouzgheib, MD, joins pulmonary interventionalist Ziad C. Boujaoude, MD, in providing advanced services under the direction of Division Head Melvin R. Pratter, MD.

In addition to offering a comprehensive array of outpatient and consultative services, Drs. Abouzgheib and Boujaoude provide minimally invasive diagnostic and therapeutic interventions for critically ill patients including:

  • Endobronchial ultrasound (EBUS) for diagnosis of intrathoracic tumor
  • Rigid bronchoscopy for resection of endobronchial lesions
  • Laser therapy, transtracheal catheter placement
  • Stricture dilatation
  • Foreign body retrieval
  • Stenting

“We have a robust interventional program that has demonstrated superior outcomes in difficult-to-treat patients,” says Dr. Boujaoude. “We work closely with Critical Care and Thoracic Surgery to provide a multidisciplinary approach to care management.”

Cooper University Hospital is the first hospital in southern New Jersey to offer the new FDA approved Intra Bronchial Valve (IBV) System to control prolonged air leaks of the lung, or significant air leaks that are likely to become prolonged following lobectomy, segmentectomy, or lung volume reduction surgery (LVRS). Once in place, the IBV Valve prevents air from flowing distally to the injured tissue while still allowing mucus to exit through normal ciliary transport. This reduction in the flow of air to injured lung tissue may promote healing and accelerate resolution of an air leak.

“At present the IBV Valve System is approved for humanitarian use only in patients with prolonged leaks. It is also being studied for bronchoscopic lung volume reduction surgery in patients with emphysema,” says Dr. Abouzgheib. “It is yet another example of the therapies available at Cooper for complex pulmonary patients.”

Under the direction of cardiothoracic surgeon Frank W. Bowen, MD, the Cooper Thoracic Surgery Program is an integral part of the care team. “Critically ill pulmonary patients require a wide range of procedures, from decortication and pleural evacuations, to resections and diaphragmatic repairs,” says Dr. Bowen. “We perform 90 percent of our cases minimally invasively, utilizing video-assisted thoracic surgery (VATS). Being able to offer a minimal access procedure to a critically-ill patient can significantly improve outcomes.”

The Thoracic Surgery Program performs more than 170 major procedures annually. Plans are also underway to expand the robotic surgery program which will benefit a diverse patient population, as well as the growing Cooper Lung Cancer Program.

Swift transfer of critically ill patients in need of advanced pulmonary support is an essential part of the tertiary care services provided at Cooper University Hospital. The Cooper Transfer Center provides rapid, round-the-clock air or land transfer coordination and enhanced access to specialized acute care. More than 3,100 patients have been transferred from 20 hospitals in southern New Jersey in the past year.

For more information about transferring a critically ill patient to Cooper Critical Care, Pulmonary Critical Care, or Thoracic Surgery, please call: 1.855.284.9337.

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