Critical Care Medicine

CCM’s primary clinical practice is the Medical-Surgical Intensive Care Unit (MSICU), the highest volume pediatric intensive care unit in Northeast, with plans for expansion to 54 beds in 2022-23. The MSICU provides care for critically ill infants and children across the full range of medical and surgical conditions, including one of the nation’s first and highest volume Extracorporeal Membrane Oxygenation (ECMO) programs. The MSICU has specific programmatic expertise in the care of patients with neurologic and oncologic diseases (including stem cell transplant recipients), complex surgical conditions such as congenital diaphragmatic hernia and esophageal atresia, and solid organ transplant.

Innovation: CCM has a unique collaboration with the Department of Surgery: a combined Surgical Critical Care service that fuses all clinical and educational domains within one critical care program. This includes three surgeons, trained in surgical critical care, who provide attending coverage in the MSICU over 26 weeks of the year.

Other hospital programs that are led by members of the division's critical care faculty include:

• Neurocritical Care Program
• Resuscitation Program
• Respiratory Care & ECMO Program
• Critical Care Transport Program
• Pediatric Critical Care Nutrition Program
• Global Health Program
• Critical Care, Anesthesia, Perioperative, Extension (CAPE) and Home Ventilation Program — providing care in the home for more than 300 technology-dependent children

With more than 75 trainees completing rotations in the MSICU each year, including Harvard Medical School students, Boston Children’s pediatric residents, and fellows in critical care, surgical critical care, pediatric emergency medicine, and pediatric anesthesia, CCM maintains an active postgraduate medical education program. The division’s fellowship program in pediatric critical care is one of the nation’s first and most highly sought-after, with 18 fellows. Fellows in the program are offered focused experiences in procedural sedation, ultrasound training, transport medicine, neurocritical care, and ECMO, in addition to a comprehensive curriculum on critical illness and injury.

Innovation: Faculty from the Division of Critical Care Medicine created and lead Boston Children’s hospital-wide Immersive Design Systems, devoted to inter-professional training, systems testing, healthcare networking, and three-dimensional engineering to develop the most advanced simulation activities. Faculty from the division also created and lead the OPENPediatrics program, an online medical education website currently in use in more than 145 countries across the world. It delivers high quality, peer-reviewed multidisciplinary education content on the care of critical illness in children. It’s based on a research collaboration with experts on adult learning from the Harvard Graduate School of Education and experts on the latest in adult learning technologies from the Massachusetts Institute of Technology.

CCM faculty have active research programs across the domains of basic, translational, clinical, outcomes, medical education, and medical ethics. Eight current faculty are National Institutes of Health-funded; one is funded by the Department of Defense.

Innovation: CCM faculty have internationally recognized research programs including the largest CDC-sponsored pediatric COVID-19 research network, the biomaterials and drug delivery laboratory, a laboratory focusing on bacterial pathogens and vaccine development, a translation program in the immunobiology of critical illness in children, the perioperative and critical care outcome center, and leadership of the program in medical ethics at Harvard Medical School. A CCM faculty member founded the Pediatric Acute Lung Injury and Sepsis Investigators Network in 2002. It is the largest pediatric clinical-translational research consortium. It now includes 80 pediatric intensive care units across the U.S. and Canada.