NUHKIDS (Children's Health)

The Children's Medical Institute (CMI) at NUH has a track record for innovation, excellence and leadership in patient care:

We built many "first in South East Asia and/or Singapore" programmes for children. For example liver transplant, kidney transplant, bone marrow transplant, kidney dialysis, liver dialysis services, sleep study unit.
We are the national centre and the only centre for children liver transplant, kidney transplant, liver dialysis and chronic kidney dialysis.
We are the first satellite centre for the internationally renowned academic centre, St Jude Research Hospital (USA), the world leader in treatment of childhood cancers.
Our doctors hold key leadership and membership positions in specialist bodies, international and national expert committees e.g. College of Paediatrics and Child Health, Singapore Paediatric Society, Royal College of Paediatrics and Childhealth (UK), International Pediatric Nephrology Society, MOH committees.
A significant volume of our patients see us because we are able to help them deal with complex medical problems.

Our clinical outcome data reflects our commitment to keeping at the forefront of medicine and giving our patients the latest in patient care. Some of our progress in excellent clinical outcomes are:

Each year, our centre sees many cases of paediatric cancer cases of which half are patients with leukaemia.

Our 5-year survival rate for acute lymphoblastic leukemia (good, intermediate and high risk) is almost identical to the world's best, St Jude's Hospital, USA.
Our 5-year survival rate for rhabdomyosarcoma is 84.5%
Our 3-year survival rate for osteosarcoma is currently 100%

Our blood and bone marrow transplantation (BMT) programme started in 1983. Today, we do bone marrow transplants, peripheral blood transplants and cord blood transplants. In addition, we perform complicated transplants including mismatched adult donors and mismatched dual cord blood donors. These types of transplants allow patients who previously did not have a matched donor a chance of cure. Together with St Jude investigators, we are also using cellular therapeutics to treat highly aggressive cancers.

To reduce BMT-related complications, we design patient-tailored BMT protocols as well as reduced intensity regimens.

Our BMT survival rates are comparable to the best centers in the world.

Since the Liver transplant programme was established in 1990, we have performed 46 liver transplants in 43 children. Our 1-year survival rate is 85.7% and the 5-year survival rate is 81.8%. These rates are comparable to North American rates.

We have performed many living related and cadaveric kidney transplants.
The 5-year survival rate of the patient is 90%
The 5-year survival of the transplanted kidney in a living related transplant is 87%. This is similar to the North American rates of 85.1% for 1996-2005.

We are the only centre in Singapore doing chronic haemodialysis and peritoneal dialysis in children. Our rate of peritonitis (infection) is one of lowest in the world at 1:40 patient-months

We see many patients with epilepsy and have a comprehensive medical, nursing and education programme to enhance control of seizures. Part of our education programme includes teaching parents how to administer first aid medication (rectal diazepam) in the event of a fit. As a result of this education programme, 72% of patients who had seizures could be managed at home, with only 27% requiring further treatment in the emergency room and/or required admission to the hospital.

We see many asthmatic patients, as asthma becomes an increasingly common problem in Singapore among children. We launched the first holistic asthma management programme in Singapore - The Children's Asthma & Allergy Network , in 2001 to help children with asthma and allergies. Our " I CAN ! " asthma programme resulted in dramatic decrease in school absenteeism and parental loss of days at work.

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The Department of Neonatology continually strives to improve quality of care for our newborn babies by using evidence-based treatment methods, and by conducting regular audits of patient health outcomes.

Among newborn babies, those born too early are especially vulnerable to complications related to prematurity.

We are happy to have achieved good health outcomes for very premature babies (birth weight <1.5 kg), with morbidity rates lower than the Vermont-Oxford Network (VON)* average.

Complications	National University Hospital, 2005-2006, mean	Vermont -Oxford Network, 2005, mean (inter-quartile range)
Retinopathy of prematurity, stages III & IV	2.8 % **	10 % (3-12%)
Chronic lung disease	6.4 % **	25 % (14-34%)
Intraventricular hemorrhage, grades III & IV	6.8 %	9 % (3-13%)
Late-onset sepsis	14.8 %	21 % (12-26%)

* Vermont-Oxford Network database comprises more than 600 neonatal ICUs worldwide, with data available for about 50,000 very low birth weight infants

** Within the VON Best quartile, p<0.05