Simulation-based training supports the care of premature orangutan in Taiwan
When Stanford Medicine’s Center for Advanced Pediatric and Perinatal Education (CAPE) invited Taiwanese neonatologist Anne Yen, MD, to spend 16 months training with their team, they never imagined that training would result in saving the life of an orangutan.
Dr. Yen came to CAPE at Stanford to learn from experts at the world’s first simulation-based training and research center dedicated to fetal, neonatal, pediatric, and obstetric sciences. Shortly after her return home to Taiwan, she received a call from the Taipei Zoo asking for her help to prepare for a rare event—the delivery of premature twin orangutans.
Dr. Yen, along with her Neonatal Intensive Care Unit staff and other multidisciplinary teams from the National Taiwan University Children’s Hospital, worked closely with the Taipei Zoo veterinary team during the week preceding the scheduled C-section. They used simulation techniques and strategies Dr. Yen learned at CAPE to run multiple simulations before the scheduled delivery and to prepare to care for the newborns. “CAPE has been conducting simulation-based training and research for over 20 years, and multidisciplinary, simulation-based training is used to prepare our neonatal resuscitation teams for any situation in the delivery rooms at Lucile Packard Children’s Hospital Stanford,” explains Nicole K. Yamada, MD, MS, a neonatologist at Stanford Children’s and CAPE’s associate director. According to the zoo’s staff, it is rare for orangutans to have twin pregnancies. Additionally, this orangutan mother had already experienced two prior pregnancy losses, so the zoo decided to schedule an early delivery to increase the chances of the babies’ and mother’s survival.
Stanford Medicine Children Health’s nationally ranked neonatology team provides the highest-quality care for newborns with critical, surgical, or special medical needs. Their world-leading research is focused on early response and prevention and includes the most advanced simulation training—a critical component of their clinical expertise.
“Seeing Dr. Yen and her colleagues collaborate with veterinary colleagues to use simulation to help save an endangered species is a remarkable extension of CAPE’s expertise. It has been inspiring for CAPE and our neonatology team to learn how impactful and far-reaching this sharing of knowledge has been,” says Dr. Yamada. Orangutans are a critically endangered species, and experts estimate that orangutans could be extinct in the wild in less than 50 years. Saving just one orangutan life is incredibly meaningful, and the Taipei Zoo credits the neonatologists’ expertise in respiratory care, nutrition, gastrointestinal tolerance, and assessment of premature newborns as invaluable in their care for this rare and complex premature case.
Much like human babies, premature orangutan newborns are at high risk for complications from respiratory illness, feeding difficulties, temperature instability, and overall acute multi-organ immaturity that can cause significant challenges at birth and in the long-term development of the baby. Dr. Yen implemented strategies used for human neonatal resuscitation and neonatal intensive care to treat the twins. The orangutan twins were born at approximately 30 weeks’ gestation, weighing 1.7 pounds and 2.2 pounds—smaller than the typically expected birth weight range of 3.3–4.5 pounds in orangutan babies.
Sadly, one of the twins died shortly after birth due to respiratory distress syndrome. However, the surviving twin is receiving around-the-clock care and has progressed nicely, from needing intensive life support over the summer to developing the ability to breathe and suck independently; has gained weight; and has become much more active.
While the focus of CAPE—and the neonatology team—remains on caring for human babies, seeing their expertise translated to saving a baby orangutan has been heartwarming, and the team will continue to check in periodically with Dr. Yen to track the baby orangutan’s progress.
Learn more about National Taiwan University Children’s Hospital, the Taipei Zoo, or orangutan conservation efforts at orangutan.com.
