XIAOQIAN | A LIFE STORY
ANNUAL REPORt 2016
What do we stand for?
We protect and improve people’s health worldwide: From people’s
personal lives to providers settings such as hospitals, medical
practices and care institutions.
What characterizes us?
Innovation, efficiency and sustainability. These values are our
compass – in everything that we do.
What is important to us?
Listening, empathy and collaboration. It is through intensive communication with users and partners that we develop effective solutions and
Every single life is precious. That is why a life story is again our
focus for the Annual Report this year. Accompany us as we follow
the day-to-day life of Xiaoqian in Shanghai and discover where
B. Braun makes a difference.
XIAOQIAN + B. BRAUN
For the sake of simplicity, the masculine form will be used exclusively to refer to employees
and customers in this annual report. Of course, both genders are intended.
How to use this E-Book
Imprint und Financial Report
From left to right
Caroll H. Neubauer LL.M.
Otto Philipp Braun
Dr. Annette Beller
Dr. Meinrad Lugan
Prof. Dr. Heinz-Walter Große
Anna Maria Braun LL.M.
Prof. Dr. Hanns-Peter Knaebel
Region North America
Out Patient Market (OPM) Division and Region Iberian Peninsula and Latin America
B. Braun Avitum Division
Finance, Taxes and Central Services
Hospital Care Division
Chairman of the Management Board, Human Resources, Legal Affairs and Director of Labor Relations
2016 was an exciting year that brought new ideas and changes. For the B. Braun Group, it was also the first full year of implementation of our 2020 corporate strategy.
We have defined the course of our future with this strategy: As a “system partner for health care,” we want to better understand the problems of our customers and partners to develop compatible approaches to solutions in collaboration with them. The goal is to achieve the best results through the interactions of people, products and processes. We are already seeing the first results in the market and consider this to be confirmation that we are on the right path with our initiatives.
Our more than 58,000 employees around the world form the foundation of our achievements and future success of the company. The drive to develop solutions that protect and improve lives of people around the entire world unites us all.
Many examples show us how this can be done, and numerous awards acknowledge our commitment. For example, B. Braun
SYSTEM PARTNER For HEALTH CARE
received the “Best Employer” award in China and Hungary and the “Top Workplace” title in Pennsylvania, USA. In 2016, we celebrated the opening of our office in Kenya and grew in South Africa through the acquisition of two production facilities. In China, we gave the go-ahead for the Aesculap Academy training center in Suzhou, and at our corporate location in Melsungen, Germany, we built a comprehensive school incorporating concepts for creative learning.
Furthermore, employees, the Workers’ Council and corporate management supported the local integration of refugees with the “B. Braun for Refugees” initiative and provided help to more than 200 social and cultural projects worldwide. These initiatives stand for responsible collaboration and lay the foundation for continued success in the future.
The Management Board of B. Braun Melsungen AG is pleased to look back at a successful 2016 fiscal year. We recorded sales of € 6.5 billion and a sales increase of 5.6 percent. With a strong growth in earnings, we exceeded our goals for the year. This success is based
on a targeted strategy and strong team performance. Therefore, I would like to sincerely thank all of our employees for their dedication, ideas and trust.
I am convinced that we will continue on our present course in the coming year. Proximity to customers remains our defining maxim. Collaboration and innovation will also help us to solve the tasks that lie ahead of us. Investments in research and development and the expansion of production capacity in Japan, Indonesia, and the USA are further important components of the implementation of our strategy.
The process of “digitalization” is an integral component of all projects, and something we consider to be part of our continual advancement and a guarantor of long-term competitiveness. More than ten years ago, we commissioned a fully IT-supported production process. For many years, we have also relied on automation and intelligent networking in logistics. By further harmonizing global processes, we aim to utilize synergies and to develop new potential.
Our goals are to achieve an annual growth rate of five to seven percent and annual sales of about € 8 billion by 2020. On the basis of our strong corporate culture, we will all contribute to achieving these goals.
The central character of this year’s annual report takes us on a journey through her everyday life. We accompany Xiaoqian from Shanghai and gain insight into her life and a changing China. Xiaoqian represents the diversity and opportunities that life offers us and that we strive for every day at B. Braun. I wish you an interesting and exciting read.
With best regards
Prof. Dr. Heinz-Walter Große
Chairman of the Management Board of B. Braun Melsungen AG
FACTS AND FIGURES
Sources: 1Atsom, Y., Magni, M., Li, L., & Liao, W. (2012): Meet the 2020 Chinese customer. McKinsey China 2Le Deu, F., Parekh, R., Zhang, F., & Zhou, G. (2012): Healthcare in China: Entering ‘uncharted waters‘. McKinsey China 3United Nations (2015): World population prospects. Department of Economic and Social Affairs, Population Division
My goal in life?
To follow my own heart.
In the end, that
is all that matters.
Even in my mother’s generation, this was not a given. I am lucky to have grown up in modern China.
Shanghai, the city where I was born, is a cosmopolitan
metropolis these days. It offers plenty of opportunities for anyone with ambition and ideas.
First name: Xiaoqian | Age: 30
Marital status: Single | Profession: Human Resources Manager | Place of residence: Shanghai
Hobbies: Piano, fitness | Personality: Cheerful
I am Xiaoqian
I AM Xiaoqian
I am Xiaoqian (Video)
I have seen how China has
since my childhood.
I grew up in a traditional
neighborhood behind the Bund, the splendid promenade along the Huangpu River. As
a child, from the balcony of
our home I watched the ferries chug by. There were rice paddies on the other side of the river. Today, the tallest skyscrapers in Asia stand there.
My mother worked as a sales assistant in a supermarket; my father was a construction worker and chauffeur. I am the first one in our family to go to college. I now work as a human resources manager for an international corporation. I am thirty years old and single. I’m in no rush to start a family. In other parts of the country, some people would say that I’ve been “left on the shelf.” However in Shanghai, women like me are fairly typical.
“I don’t have a lot of friends,” Xiaoqian says, “but the ones I have are very close. Even though our calendars are usually full, we get together regularly – and not just to goof around.”
My Shanghai (Video)
Some karaoke bars in Shanghai are not only packed on weekends, but are also frequented during the week for after-work fun with coworkers.
It’s no surprise to Xiaoqian: “I really enjoy singing, dancing and having fun.”
Life is too short, and you have to enjoy yourself. I am happy with my work situation.
I work with nice, young colleagues in an international environment. We sometimes
go out together for a glass of wine in the evening. My working hours are flexible.
Sometimes, I leave work early to work out or go to my piano lessons. Then I work some more from home in the evening, writing emails or calling our headquarters in America.
What’s the most important thing in life? Health, I think. I want to be healthy in order to be able to explore the world and learn something new every day. I want to finish things I have started. Everything else, I just take as it comes. When will I have the chance to enjoy my life, if not now?
I love having time for myself. I box, play the piano, and go to exhibitions and to the movies. I don’t mind going alone. I recently saw “Doctor Strange” and also “Inferno,” the latest movie in the Dan Brown series. I love being out and about. My boyfriend, an American, moved back to Cincinnati after working in Shanghai for many years. For the past year and a half, we have maintained a long-distance relationship over 12,000 kilometers. Many people ask me whether that’s too complicated. I think that in our globalized world, love should be able to survive something like this.
My career is important to me, but it’s
not the only thing in my life.
Often, I have seen people working
just for the money. For me, other values
are more important.
No family can put a sign on their home saying: We have no problems here.
Living in the moment
I live with my father in the district of Baoshan. Baoshan is in the north of Shanghai, 15 kilometers away from downtown. My father and I live in a three-room apartment in a large apartment complex. We share our apartment with Nannan, a Border Collie, and Milo, a Samoyed – a Siberian sled and herding dog. The two of them keep us pretty busy. Now that my father is retired, he often cooks for us. Sometimes my grandmother comes over and we spend a nice evening together.
Living in the moment
“Old Shanghai is like an elegant lady – the modern part of the city
is as exciting and stunning as New York. I love this contrast,”
“I not only learned how to knit from my mother, but also to enjoy life and to do what really makes me happy. My memory of her is very vivid. When I miss her, I look at old photographs. But her love is not gone – she is with me, and I know that I can share her love with other people, too.”
In 2007, I went to the hospital with
my mother for a routine check-up.
“You have a lump,” the doctor said. “It’s large. It doesn’t look good.” I felt like someone had pulled the rug out from under my feet. The diagnosis: ovarian cancer. Cancer runs in our family. My aunt also died from ovarian cancer.
My mother was diagnosed with stage II
cancer. We didn’t know how much time we would still have with each other.
She was a strong woman. She held on for seven years, until the summer of 2014. For the first few years, I was really
scared. How could we carry on without her? I tried to reassure myself that everything would be okay. At some point, however, I had to face the facts.
But instead of endlessly worrying about what would happen after she was gone, I learned to appreciate the time we had left. I had just finished my English degree and moved back home. I hardly ever went out, spending every free moment with her. We had never been as close as we were during those years. We watched films and comedy shows together, played mahjong and went on trips to the countryside. Our favorite activity together was knitting. Every few months, we would decide which sweaters we wanted to knit next and with which colors we wanted to experiment. This meant that my mother always had a goal she could work towards.
She had two operations in 2007 and 2009, but the cancer couldn’t be stopped.
Every three weeks, I went with her to the hospital for chemotherapy. Later, I gave her daily injections of white blood cells at home. In early 2014, her condition
worsened. For my sake, my mother wanted to hold on for as long as she could.
“You are still so young,” she said. She would have liked to see me get married and
to have had grandchildren.
For years, I had prepared myself for the day when her body would give up the fight. When the day came, I was collected and calm inside. Her illness has made me very aware of how important our health is. At the same time, it also taught me to enjoy life for as long as possible.
Through my mother, I have learned to follow my heart, to take care of myself, and to do what makes me happy. I think that is all that matters, in the end.
After my mother’s death, I felt as if I’d lost my bearings. Over time, it became clear to me that I could also offer the love I’d given her to other people. A Swiss musician I met through friends put me in touch with the Non-Governmental Organization (NGO) “Heart to Heart,” which supports children with heart defects whose parents
Xiaoqian spielt gern Mahjong. Die Spielsteine wurden früher aus Elfenbein hergestellt und kunstvoll verziert.
cannot afford operations. Here in Shanghai, we work together with two state hospitals, where we have furnished playrooms for the children. I visit the children there on weekends, bring them things they need, and play with them.
It makes me happy to be with the children before and after their operations, to spend time with them, to pay attention to them, and to watch them get healthy. Children handle a serious illness in a way that is completely different from the way adults deal with it. They don’t ask, “Why me?” They don’t feel self-pity or despair. Their bodies simply hurt, that’s all. But no matter how much it hurts, their innocent enjoyment of life remains. I think that we, as adults, can learn a lot from them.
A family in harmony will be a happy family.
“My grandmother is unbelievable. She’s still in such good shape at 93.”
“When we cook together, we love to make dumplings – everyone likes them. Even my father, our master chef.”
Incredible but true: An adult human body consists of up to
100 trillion cells. Every second, 50 million cells die in the body and are replaced by just as many new ones – a miracle that occurs every day in each human being. However, what if gene changes turn into cell division? Many such small mutations cause cells to change abnormally. Usually, the body is able to repair these mutations. Only when impacted cells divide in an uncontrolled manner so that nodules and growths are formed, do we speak of cancer.
Higher age – Higher prevalence of cancer
In 2012, 14 million people worldwide were diagnosed and fell ill to cancer. By 2025, the annual number of new cases could rise to 20 million.1 This is mainly due to higher life expectancy. Elderly people are usually more affected by cancer than younger people. Data also shows that cancer rates are rising sharply in countries like Africa, Asia and Latin America. This is being attributed to lifestyle changes. People eat more unhealthy foods such as red meats and prepared foods, and they move less. Smoking is also very common in many of these countries and air pollution is a growing problem. Combustion gases, i.e., polycyclic aromatic hydrocarbons, are highly carcinogenic. In China, for example, around 12,000 people are diagnosed with cancer every day.2 Ovarian cancer is ranked ninth in
frequency.3 It is particularly dangerous because it is often recognized in the later stages of development.
In recent years, medicine has made tremendous progress in the fight against cancer. For example, more than two-thirds of all patients diagnosed with cancer died in Germany in 1980. Today, more than half of all cancer patients can hope for lasting remission.4 Therapy usually follows a similar pattern. The first step is the operation: Doctors remove the diseased tissue. The second step is radiation therapy. Radiation damages the cells’ genetic make-up and the tumors become smaller or disappear. As a third step, chemotherapy is then used to treat the patient’s entire body. Drugs distributed in the organs destroy scattered tumor cells. Often, a combination of surgery, radiation therapy and chemotherapy is recommended.
The active substances of chemotherapy, called the cytostatics, are extremely aggressive, must be accurately dosed and must not come into contact with the skin or the respiratory tract of the hospital staff. B. Braun offers an extensive infusion therapy system to administer medications in a controlled manner and as comfortable as possible for the patient. It is painful for the patient when the doctor punctures the vein for each medication administration – at the
Infusion therapy against cancer
WHEN CELLS BECOME DISEASED
Sources: 1 International Agency for Research on Cancer (2012): http://globocan.iarc.fr/Pages/fact_sheets_cancer.aspx (viewed on 1 March 2017) 2 American Cancer Society (2016): http://pressroom.cancer.org/China2015 (viewed on 1 March 2017) 3 Chinese Journal of Cancer Research (2015): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4329183/ (viewed on 1 March 2017) 4 Robert-Koch-Institut (2012): http://www.rki.de/DE/Content/Service/Presse/Pressemitteilungen/2012/01_2012.html (viewed on 1 March 2017)
How tumor cells are created
same time the risk of infection increases. This is why the physician often places an implantable port below the patient’s clavicle. This is a small chamber with a catheter, that flows into a vein near the heart. Doctors now administer cytostatics via the port with a special needle. Celsite® port catheter systems from B. Braun have a compact flat design and have a minimal impact on the patient’s freedom of movement. Many other features, such as the X-ray visible CT marking, help facilitate treatment. The connection between the infusion container and the port is made secure by our Cyto-Set® Infusomat® Space tube system, which is made of a special crack-resistant material and can be easily vented. The Infusomat® Space pump reduces programming errors, because it can be operated intuitively. The pump also has a large drug database, which helps hospital staff determine the right dosage.
Oral nutrition or feeding tube
Swallowing difficulties, nausea and vomiting are often a result of chemotherapy. Antiemetics from B. Braun, i.e., medicines
for nausea and vomiting, alleviate these symptoms. If patients have difficulty chewing and swallowing food, enteral nutrition is recommended. With Nutricomp®, B. Braun offers a range of high-calorie enteral nutrition products that vary in their nutrient composition and suit patients’ individual needs. If the patient cannot be sufficiently fed in this way, nutrients must be supplied via a feeding tube. B. Braun has developed a comprehensive offering, including a wide selection of feeding tubes and enteral nutrition products.
Many cancer patients prefer to receive care at home. B. Braun not only develops suitable products for home care and therapy, but also offers comprehensive services at the interface between clinic and home care. Case managers from B. Braun analyze the patient’s needs, then manage the necessary measures in close coordination with the patients, relatives, attending physicians and nursing staff, in an effort to ensure complete care. Whether at home or in the clinic, B. Braun is committed to the best patient care possible.
B. Braun + Infusion Therapy
Handling cytostatics and other toxic substances in infusion therapy is now part of everyday clinical practice. These drugs are used for treating tumor-based diseases and are defined as carcinogenic and mutagenic substances. Therefore, health risks for clinicians and patients during the preparation and
application of these medicinal products require special care.
The most frequent symptoms of ovarian cancer1
Increased urge to urinate
Loss of appetite
A therapy in line with the guidelines
significantly improves patients’ survival after three years.2
Sources: 1 Ovarian Cancer Action (2017): http://ovarian.org.uk/about-ovarian-cancer/what-are-the-symptoms-of-ovarian-cancer (viewed on 1 March 2017) 2 Burges, A., & Schmalfeldt, B. (2011): Ovarian cancer: Diagnosis and treatment. Deutsches Ärzteblatt International 108 (38): 635–641. The “Diagnostics and Therapy of Malignant Ovarian Tumors” guidelines were published by the Ovarian Commission of the Research Group on Gynaecological Oncology (AGO).
women suffer from
ovarian cancer during
1 out of 77
Aggressive chemotherapy drugs
are often administered centrally, preferably via one of the different B. Braun port catheter systems.
In this way, medications are transported directly into the blood stream, and possible damage to body tissue is greatly reduced.
Port catheter system
Closed infusion systems reduce
the risk of contamination with
Tubing system Cyto-Set®
If a normal diet is not possible
during the cancer treatment,
nutrients must be administered via
a feeding tube – B. Braun has developed a wide range of
enteral feeding tubes
Nutritional solution NuTRIflex
Sources: 1ISR Report (2015): Pharmaceutical Market Research. Infographic: Ovarian Cancer
I noticed that diabetes
is widespread among
In 2014, my uncle Bing was diagnosed with type 2 diabetes. The news shocked me. We are very close. When I was a child, we often visited him and my aunt on weekends, and I played with my little cousin. Later, I also was their babysitter. I have memories of outings and trips to the movies together. Even now, Bing often comes to visit us. He is a quiet, educated man, a real family man who helps his wife a lot with domestic chores. The diagnosis was a complete surprise. My uncle is in his late forties and had never been seriously ill before. Sure, he liked to eat and was somewhat stout, but he wasn’t obese. He smoked and occasionally had a drink, but nothing in excess. When I asked around, I discovered that diabetes is widespread among my acquaintances. Almost everyone knows someone in their family or circle of friends who suffers from it.
We were therefore even more relieved to learn that the
diabetes was at an early stage and that his sugar levels were only slightly higher than normal. Bing had to make a few changes to his daily routines, but none of them restrict him
in any way. He takes a pill each morning before breakfast now. He no longer drinks alcohol and eats less, avoiding sweets. Other than that, he just continues to lead a normal life. We are optimistic that my uncle will stay healthy for many more years to come. He has to go to the hospital every three months for a check-up. His health insurance pays for the treatment. Ever since he felt sick at the office one day, he has carried some grape sugar (dextrose) in his pocket for emergencies. And there is always sweetened yogurt in the refrigerator at home.
We are optimistic that my uncle
will stay healthy for many
more years to come.
Because the doctors didn’t give my uncle very much information material about diabetes, we researched a lot together online. Colleagues who have experience with diabetes also give him advice. I think it’s great that Bing is more active now and that he often walks instead of taking the subway or a taxi. He has also quit
smoking. I hope my father will follow his example.
A breath of fresh air: Songnan Park
is a green oasis in the mega-metropolis. Xiaoqian and her uncle Bing enjoy the
Whatever we do: whether it’s running or laughing, breathing or thinking – the highly efficient metabolism of our body provides us with necessary energy in every situation. Among other things, this is obtained from carbohydrates in our food, which are first broken down completely into glucose. Glucose enters body cells using the hormone insulin and is converted into energy there. But what if this control mechanism no longer works and the glucose accumulates in the blood? Then we are faced with dealing with diabetes.
A national disease – not just in industrialized countries
While around 415 million people were already living with diabetes worldwide in 2015, it is estimated there will be 642 million in 2040. Many would think that Europe and the US have the highest number of diabetics, however, China, with 109.6 million people affected, is the country with the most diabetics, and India follows with 69.2 million. The numbers also are growing rapidly in Africa and Latin America. In addition, one out of two patients does not know about his/her diabetes and remains untreated.1
The reason is that symptoms such as fatigue, thirst, or weight loss are often overlooked or considered harmless, and are therefore not associated with diabetes. There also are different forms of the
disease: In the case of type 1 diabetes, the body cannot produce insulin. The trigger is usually an autoimmune reaction which leads to the destruction of insulin-producing cells.2 Those affected need to regularly supply the missing insulin – which is directly impacted by food intake, physical activity and various other influencing factors – from the outside. This is the only way to keep the blood glucose level within the normal range.
In the case of the significantly more frequent type 2 diabetes, there is a more or less pronounced insulin resistance of the cells. In this case, the insulin has a reduced effect. In contrast to type 1, type 2 is a classic lifestyle disease, which is primarily caused by obesity, a lack of exercise and a carbohydrate-rich diet. The good news: By means of a healthy lifestyle with a balanced diet and exercise, patients can significantly delay the progress of the disease.1 If required, a medication is typically in pill form or by insulin injection.
Whoever has diabetes, should regularly measure
However, whether type 1 or 2: In both cases, regular monitoring of blood glucose levels is the basis for daily therapy and life management using precise measuring devices. The consequences of too
The global phenomenon of diabetes can lead to serious secondary diseases
BLOOD GLUCOSE: OUT OF CONTROL
high or low blood glucose levels equally affect both patient groups. If blood glucose is too low, there is a risk of unconsciousness. If blood glucose is too high, the patient may fall into a coma – which can be fatal. In addition, permanently elevated blood glucose levels lead to severe consequences such as cardiovascular disease, impaired renal function, ocular diseases, nerve damage or diabetic foot syndrome.1,2
Equally important as the monitoring is documenting the glucose levels as well as all other important influencing factors. In addition to the amount of insulin administered and the type and portion of the meals consumed, excessive physical stress also influence blood glucose levels. The more precisely these factors are documented, the better the causes of blood glucose fluctuations in everyday life can be detected and intercepted by appropriate adaptations of insulin therapy – the best conditions for a good therapy process and the reduction of the risk of possible long-term effects.
B. Braun has been committed to the field of diabetes for many years with its high-quality products and services. Our goal is to help patients with diabetes lead a normal, self-determined life despite their illness. They can use the Omnitest® measurement system to
precisely determine their blood glucose levels within seconds. And thanks to the Omnican® Lance device, the necessary needle penetration is less painful. The Omnican® fine pen needle for insulin pens as well as various insulin syringes make injections comfortable for insulin-dependent patients. For easy-to-use and secure data management, we offer patients with diabetes the diabetes diary Omnitest® Center for smartphones, tablets or computers.
Quellenangaben: 1International Diabetes Federation (2015). IDF diabetes atlas: Seventh edition 2World Health Organization (2016). Global report on diabetes
B. Braun + Diabetes
A good therapy program is crucial in order for patients with diabetes to lead a normal, self-determined life. To achieve this goal,
we offer high-quality products and services in the areas of blood glucose measurement, capillary blood collection,
insulin injection and data management.
Sources: 1International Diabetes Federation (2015). IDF diabetes atlas: Seventh edition 2World Health
Organization (2016): http://www.who.int/mediacentre/factsheets/fs360/en/ (viewed on 1 March 2017) 3World Health Organization (2016): http://www.who.int/mediacentre/factsheets/fs104/en/ (viewed on 1 March 2017) 4World Health Organization (2016): http://www.who.int/mediacentre/factsheets/fs094/en/ (viewed on 1 March 2017)
Top 10 countries: Millions of adults with diabetes (2015)1
Deaths in 2015
5. Russia (12,1)
6. Mexico (11,5)
7. Indonesia (10,0)
8. Egypt (7,8)
9. Japan (7,2)
10. Bangladesh (7,1)
3. USA (29,3)
4. Brazil (14,3)
2. India (69,2)
1. China (109,6)
adults worldwide has
Blood glucose measurement and blood collection
Blood glucose measurement device Omnitest 5
Lancing device Omnican Lance with lancet Omnican Lance soft
Diabetes diary Omnitest Center and Omnitest App
Pen needle Omnican fine
and insulin syringe Omnican
Sources: 1International Diabetes Federation (2015). IDF diabetes atlas: Seventh edition
Products in the diabetes therapy field at a glance:
1 out of 11
Large, illuminated display
High measurement accuracy according to ISO 15197:2013
Only 5 seconds measuring time
Easy to use
Compatible with fresh capillary and venous whole blood samples
7 finely graduated
Gentle puncture and good blood flow
– Silicon tip
– 3-facet grinding
– Special silicone
Pen cannulas with 3-facet
grinding are compatible with all major pen manufacturers on the market
Improved insulin flow thanks to thin-wall or extra-thin-wall technology according to ISO 9626: 2016
Simple data management
Better understanding of the data
including different views such as
tables, graphs, average day,
Data can be exported, for
example for the next doctor’s appointment
Diabetes can lead to kidney damage
However, even with the best possible therapy, diabetes may still attack the kidneys. In a healthy state, the kidneys filter waste products from approximately 1,500 liters of blood each day and secrete it via the urine.1 In addition, they regulate body fluid composition and produce hormones. However, worldwide diseases such as hypertension or diabetes can lead to chronic renal failure. The fact that 30 to 40 percent of all diabetics eventually suffer from renal disease shows how strongly both diseases are linked.2
If, however, permanently elevated blood glucose damages the kidneys, they can gradually no longer fulfill their functions. The fact is the earlier the damage is detected, the more effectively the process can be slowed. In the first stages, nutritional therapies and medications help slow the loss of kidney function. Whether it leads to renal failure is, however, not fully controllable. In all stages of chronic renal failure, however, there are still opportunities to continue to live an active and self-determined life despite this illness – mainly thanks to modern methods such as hemodialysis.
In this case, instead of the kidneys, a special filter – the dialyzer – cleans the blood. The patient is connected to a dialysis machine via a specially placed vascular access, and the blood flows through
the filter by means of a tubing system. In addition to dialysis, many doctors prescribe medication to their patients. Adjustment of nutrition also may be necessary, for example in the form of altered protein and restricted potassium intake.
Much more than dialysis centers and machines
B. Braun has been for many decades helping renal patients. In this health care space, we are one of the largest suppliers worldwide. In more than 350 renal and dialysis centers in more than 30 countries in Africa, Asia, Europe and Latin America we provide patients with holistic medical care – from initial education, prevention and early diagnosis to dialysis. For us, patients and clinicians are always our top priority: By taking care of organizational and logistical tasks in the centers – such as billing or personnel search – we help doctors and nurses concentrate on their patients. In order for our employees to continue to provide optimal service to patients and keep their expertise up-to-date, they regularly attend training courses.
Sources: 1Kuhlmann, U., et al. (2015). Die Nephrologie. Georg Thieme Verlag, 6. Auflage 2International Diabetes Federation (2013): IDF diabetes atlas: Sixth edition
We not only operate kidney and dialysis centers, but also manufacture equipment and consumables – for hemo- and acute-dialysis as well as for special blood purification procedures, for example for the therapy of fat metabolism disorders. It is important to us to offer an integrated system with coordinated components. In addition to dialysis machines, these include therapy options, software solutions, water treatment systems, technical service as well as process consulting, planning, documentation, installation, and further education.
Sharing expertise is B. Braun’s philosophy
Even though technological possibilities are groundbreaking, they do not replace the exchange between people. This applies to doctors and their patients, as well as to us: By maintaining direct dialog with them, we recognize their needs to continue developing innovative solutions in diabetes management and dialysis.
SYSTEM PARTNER IN DIALYSIS
B. Braun + Hemodialysis
Confidence in man and machine is of particular importance in extra-corporeal blood treatment. Different disease patterns can be treated
with this therapy form. The therapies are vital because they replace many renal functions in the case of dialysis.
Our goal is to provide reliable medical care and high-quality products to help improve our patients’ quality of life.
The kidneys have important functions for metabolism: They remove waste products from the body, regulate body fluid composition, and produce hormones. If the kidneys only work in a restricted way, treatment should begin at an early stage to prevent or delay complete renal failure.
B. Braun operates more than
in more than 30 countries.
Each day, about
of blood flow through both kidneys.1
Cross-section of a dialysis fiber ratio 100 : 1
of diabetics also develop kidney disease.4
Sources: 1Kuhlmann, U., et al. (2015). Die Nephrologie. Georg Thieme Verlag, 6. Auflage 2Hecking, E., et al. (2004). Haemodialysis prescription, adherence and nutritional indicators in five European countries: Results from the Dialysis Outcomes and Practice Patterns Study (DOPPS). Nephrol Dial Transplant 19: 100–107 3Boschetti-de-Fierro, A., et al. (2015). MCO membranes: Enhanced selectivity in high-flux class. Sci Rep 5, 18448 4 International Diabetes Federation (2013): IDF diabetes atlas: Sixth edition
3–5 times thicker than a human hair
A dialyzer has 10,000–20,000 fibers
Blood flow rate: 200–500 milliliters per minute2
Pore size: 1–8 nanometers3
Fresh from the market: “Grandmother and I pick out the vegetables and chop them up, but my father does most of the cooking. He just makes the food taste better.” In fact, in many households in Shanghai, it’s the men who do the cooking.
Enjoying good health
My day begins with a look at my smartphone smog app. The air quality in Shanghai is often very poor. That is the negative side of rapid economic growth. Some people stay at home when there is smog, but I don’t want to let it affect my everyday life. All the more reason to make sure I live a healthy lifestyle.
For me, nutrition is everything, and we Chinese learn that at a very early age. My breakfast has to be nutritious: rice porridge with dumplings or fried eggs. That gives me energy. For lunch, I go out to eat with my co-workers, or I take a lunch pack with me from home to the office, since we
sometimes have leftovers from the evening before. When my father cooks, he uses seasonal and fresh ingredients. We eat a lot of vegetables and fish, and not very much pork. For several years now, I have given up eating dinner altogether. That might seem unusual, but I feel much healthier when I do this. I would never smoke. However, I do have one weakness: cake.
means everything to me. My breakfast has to be
Enjoying good health
Xiaoqian knows many people who prefer to relax at home in front of the television. “That’s not the right thing for me, though,” she says. “I need challenging physical exercise.”
I go to the gym twice a week after work: one hour of strength training, one hour
of boxing with a trainer. I take private lessons. I treat myself to this luxury. When
I started boxing, I primarily wanted to get my body in shape. Now, I can’t live
without it. Whether I’m having a stressful time at work or have other things on
my mind – after my boxing session, I always feel liberated, like a new person.
When I travel, I try to discover new sports. Last summer, in Malaysia, I took a diving course. In the winter, I visited a friend in Geneva and took a five-day ski course in the Alps. On the first day, I fell over all the time. I was exhausted physically and was really frustrated. On the second day, I was about to give up and pretended to have a headache so I wouldn’t have to go. But I was determined to not give up and went back to the slope on the third day. I was confident that I could master this.
On the fourth and fifth day, I was able to race down the whole slope on my skis.
I felt a great sense of achievement. Next on my to-do list: rock climbing, sky
diving, and surfing.
He who has lots of
money is wealthy. He who is healthy is happy.
I feel like
a new person.
In addition to my sessions at the gym and my activities on vacation, I integrate as much exercise as possible into my daily routine. On days when I don’t go to the gym, I get out of the subway one station earlier after work and walk the rest of the way home, which takes about 40 minutes. On the weekend, I take our dogs for walks in the morning and evening. When I am old, I want to be as fit as my grandmother. She is 93 years old and looks like she’s in her early seventies. She still does all her own laundry every day, chops and cooks vegetables, and sweeps the floor. I want to age like her.
In Shanghai, tai chi was long seen as something only old people did. Young people are now rediscovering it for themselves. Xiaoquan also enjoys shadow boxing.
A path is made
I integrate as
much exercise as
possible into my
A walk after work: “Shanghai offers plenty of opportunities for anyone with ambition and ideas. I am enjoying this stage of my life, and I look forward to what the future holds,” says Xiaoqian. So does her friend Lan.
The heart is a miracle of endurance. During 80 years of life, it beats around three billion times, pumping about 185 million liters of blood through the vessels. It provides the body with oxygen, nutrients, minerals, vitamins, hormones and other important substances. It must never rest, because even a small interruption can be life-threatening. But as tireless and resilient as the heart is: according to the World Health Organization (WHO), cardiovascular disease is the leading cause of death in adults.1 The reasons for heart disease are diverse: little exercise, fatty food, alcohol and nicotine, medication, mental stress – but also simply because people are getting older.2
Heart vessels and valves are susceptible
One of the most common heart diseases is the calcification of the coronary arteries.3 The heart doesn’t work well when the heart muscle is not supplied adequately. In the case of sudden vascular occlusion, a heart attack may occur. The heart valves are also vulnerable. These valves ensure that the blood flows in the right
direction. Heart valve defects are either congenital or form during the course of life. If heart disease is present, the blood is no longer transported efficiently through the body.
Fortunately, the treatment of hereditary diseases has made great progress in recent years. For a long time, the only option was opening the chest (thorax) in cardiac-thoracic surgery. In the meantime, interventions are less and less invasive. This is now also possible with operations on the heart valves. The surgeon tries to retain the heart valve if possible. If it cannot be reconstructed, he inserts a mechanical or biological heart valve. B. Braun innovations support the repair and maintenance of heart valves in various ways, including our Aesculap® EinsteinVision® 3D Full HD camera system, which offers great advantages for the surgeon as well as the patient. For certain indications, the surgeon does not have to open the chest – but still has the operating field in view. For this purpose, he places small surgical accesses between the ribs and uses special instruments, including an endoscope camera. Using the
Modern therapy for the heart and vessels
SMALL MUSCLE, LOTS OF MOVEMENT
differentiated 3D imaging, the surgeon can now see the treatment location clearly and with depth, which allows the valve to be repaired or replaced in a confined space.
In intensive and continuous interactions with surgeons and medical personnel, B. Braun has developed additional equipment that significantly simplify an operation and reduce the risk of possible secondary damage. For example, there are the XS instruments for minimally invasive heart valve surgery or Valve XS Atrium retractor system, which allows the surgeon free access and a clear view of the operating field. These minimally invasive procedures are typically much more gentle for patients than the classic open procedure.
Sources: 1World Health Organization (2016): http://www.who.int/mediacentre/factsheets/fs317/en (viewed on 1 March 2017) 2Deutsche Herzstiftung (2017): http://www.herzstiftung.de (viewed on 1 March 2017) 3Bundesministerium für Forschung und Bildung (2017): http://www.gesundheitsforschung-bmbf.de/de/herz-kreislauf-erkrankungen.php (viewed on 1 March 2017)
B. Braun + Cardio-Thoracic Surgery
For surgical heart procedures, it is not always necessary to completely open the chest. Today, minimally invasive therapies are possible in cardio-thoracic
surgery. B. Braun supports this with high-precision instruments and advanced technologies for 3D visualization.
Sources: 1Perier, P., et al. (2016): 3D video-assistance: A giant leap for totally endoscopic minimally invasive mitral valve repair. Meeting presentation, EACTS, Barcelona 2Deutsche Gesellschaft für Thorax-, Herz- und Gefäßchirurgie (2017): http://www.dgthg.de/de/node/310 (viewed on 1 March 2017), DocCheck Flexion (2017): http://flexikon.doccheck.com/de/Herz (viewed on 1 March 2017)
is as big as a
is a hollow
Source: 1Massberg, S., et al. (2011): Polymer-free Sirolimus- and Probucol-eluting versus new generation Zotarolimus-eluting stents in coronary artery disease. Circulation. 124:624–632
Minimally invasive procedures instead of major operations
Methods of interventional cardiology are also developing. Until recently, surgeons have had to apply one or more bypass bridges in narrowed or blocked vessels, today there are procedures that in many cases can be used to avoid a major operation. For example, the doctor introduces a balloon catheter into the narrowed vessel and can thus expand the diseased areas deliberately. Stents are often implanted. These are wire meshes, which serve to splint the vessel from inside and keep it open.
B. Braun has been involved in interventional cardiology for many years. It is our greatest desire to respond to the needs of physicians and patients alike in order to develop pioneering solutions such as innovative stents and balloon catheters. Despite technical progress, conventional methods and instruments prevent the formation of excessive scar tissue after vessel surgery which in turn limits blood flow. Therefore, we developed the Coroflex® ISAR stent system in cooperation with the German Heart Center Munich. It continuously releases a drug which prevents these undesirable reactions and as is often the case does not use polymer carriers, so no plastic remains in the patient’s body.1 Similarly, the drug-coated balloon catheter SeQuent® Please releases a growth-inhibiting agent and
reduces scarring. As is the case with catheter treatments, this procedure is also performed under local anesthesia. The patient can leave the hospital after a short time. No matter where our diverse innovations are applied, one thing is always the same: B. Braun is committed to reducing risks, suffering and pain.
B. Braun + Interventional Vascular Diagnostics and Therapy
An aging society poses a challenge to medical care. Vascular disorders, particularly acute and chronic circulatory disorders, are increasing.
This situation is our driving force for further developing and improving innovative system solutions in interventional vascular diagnostics
B. Braun AT A GLANCE
Through its subsidiaries and holdings,
B. Braun operates in
B. Braun at a Glance
B. Braun Melsungen AG
FOR FURTHER INFORMATION CONTACT
Tel. +49 (0 56 61) 71-0
Dr. Bernadette Tillmanns-Estorf
Senior Vice President
and Corporate Human Resources
Tel. +49 (0 56 61) 71-16 30
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