Critical Care Medicine
Who we are
Critical Care Medicine at Boston Children’s Hospital promotes the health and safety of children who are critically ill or injured or who suffer acute or chronic pain. Our team offers a broad range of treatments, ranging from nutrition therapies in our pediatric intensive care units to caring for children with chronic respiratory conditions.
Our 30-bed Medical-Surgical Intensive Care Unit (MSICU) and 12-bed Medicine Intensive Care Units (MICU) are run by a multi-discipline team of physicians who provide critical care services in Medicine, General Surgery, Transplantation, Neurosurgery, Trauma, Orthopedics, Otolaryngology (the study of head and neck disorders) and Craniofacial Reconstruction.
- We have one of the highest levels of expertise and largest pediatric intensive care units in the United States.
- We see more than 2,000 patients annually; the survival rate is 98 percent.
- Boston Children's has one of the largest pediatric Extracorporeal Membrane Oxygenation programs in the world. Functioning as a replacement for a critically ill child’s heart and lungs, ECMO technology serves between 50 and 60 children with severe respiratory or cardiac problems each year.
A Collaboration of Intensive Care Units
The Division of Critical Care Medicine and the Medicine Critical Care Program work together to ensure that those Boston Children’s patients with intensive care needs receive the best care possible. Between the two units, our specially trained physicians care for children with all types of childhood illnesses, with the exception of burns and cardiac diseases.
The accomplishments of the Division of Critical Care Medicine are of the highest excellence across the three core missions: clinical care, research and teaching.
The MSICU at Children's has consistently had excellent outcomes, with more than 2,000 admissions per year and a survival rate of 98 percent, providing care for a broad class of critically ill children. The MSICU, which spans all medical disciplines, includes one of the largest pediatric ECMO programs in the United States.
The September 2003 introduction of the "closed-unit" intensivist-attending model concept, and the November 2004 implementation of in-house attending coverage, have strengthened the faculty's ability to meet the dual challenges of increasingly complex patient care and the supervision of trainees -- the next generation of critical care medicine experts.
The Medicine Intensive Care Unit (MICU) is a lead site for a national clinical trial of glucose control in pediatric critical care patients. The purpose of the study is to determine whether or not keeping a child’s blood sugar in the normal range during their stay in the ICU will help to decrease infections and speed up the recovery process.
The division is academically productive, with its faculty presently including one professor, five associate professors, one clinical associate professor, four assistant professors and eight instructors.
National Institutes of Health grant activity among the faculty includes two RO1 awards, a K-O8 award, one R21 award, one K-23 award, and one K-12 award.
Excellence in teaching is an especially strong feature of Critical Care Medicine. In the past four years alone, two faculty were awarded the Department of Medicine's Janeway Award, and one the Anesthesia Department's Teacher of the Year Award.
The critical care medicine fellows have won the Department of Medicine's Fellow Teaching Award for the past two years. In addition, the Fellowship has consistently matched its top prospects for each of the seven years that the MATCH has been in existence, while the housestaff have consistently ranked the MSICU as the best, or among the best, educational rotations in the entire Boston Combined Residency Program.
The division's faculty hold important leadership positions in national and international organizations.
Adrienne Randolph, MD, MSc, is chair and founder of Pediatric Acute Lung Injury and Sepsis Investigators (PALISI), the largest collaborative of pediatric intensive care units in North America, which is united to perform clinical trials in pediatric critical care.
Jeffrey Burns, MD, MPH is the vice chair of IPOKRaTES International, the largest European-American pediatric teaching consortium.
Monica Kleinman, MD, is the chair of the American Heart Association's Emergency Cardiovascular Care Committee, as well as past chair of the Pediatric Subcommittee. She previously served as co-chair of the Pediatric Task Force for the International Liaison Committee on Resuscitation (ILCOR) and will be the co-chair for the 2015 Conference for Consensus on Science and Treatment Recommendations.
Robert D. Truog, MD, is Professor of Medical Ethics, Anaesthesia and Pediatrics at Harvard Medical School. He also serves as Director of Clinical Ethics at Harvard Medical School and Executive Director of the Institute for Professionalism and Ethical Practice at Boston Children’s Hospital.
Discoveries in Pain Management
Researchers at Boston Children's Hospital developed a slow-release anesthetic drug-delivery system that could potentially revolutionize treatment of pain during and after surgery, and may also have a large impact on chronic pain management. Children’s Daniel Kohane, MD, PhD, explains, "It would be useful for conditions like chronic pain where, rather than use narcotics, which are systemic and pose a risk of addiction, you could just put that piece of the body to sleep."
To learn more, visit the Pain Management website.
Critical Care Medicine’s leadership responsibilities at Boston Children's Hospital are extensive, and include a broad range of programs vital to the functioning of the institution, including:
- Medical Surgical ICU
- Medical Critical Care Program
- Transport Program
- Simulator Program
- Respiratory Care & ECMO Program
- Code Team & CPR Committee
- PALS (Pediatric Advanced Life Support) Program
- Program for Patient Safety & Quality
- Institute for Professionalism & Ethical Practice (IPEP)
- Program to Enhance Relational & Communication Skills (PERCS)
- Ethics Committee
- Critical Care, Anesthesia, Perioperative Extension (CAPE) and Home Ventilation Program
- Critical Care Fellowship Program
- Nosocomial Infection Oversight Committee
- Nutrition in the ICU
- BMC PICU
Conditions & Treatments
- Airway obstruction
- Bites and scratches
- Carbon monoxide poisoning
- Chemical burns
- Congenital high airway obstruction (CHAOS)
- Critical Care Transport Program
- Electrical and thermal burns
- Extracorporeal Membrane Oxygenation (ECMO)
- Facial cuts and wounds
- Lacerations with stitches
- Lead poisoning
- Medical/Surgical Intensive Care Unit
- Puncture wounds
- Respiratory System
- Blood donations and blood banking
- Central venous line insertion
- Congenital cystic adenomatoid malformation (CCAM)
- Congenital limb defects
- Cystic lung disease
- Esophageal atresia
- Eye injuries
- Facial fractures
- Foreign bodies in the eye
- Intravenous line and tubes
- Lacerations without stitches
- Lung transplantation
- Respiratory Distress
- Respiratory syncytial virus (RSV)