Critical Care Medicine | Fellowship Program | PICU/CICU
The Pediatric Intensive Care Unit at St. Louis Children's Hospital is equipped to provide the highest level of care to critically ill children. The unit has capacity for up to 30 patients. It averages approximately 2,000 admissions per year, and its team provides care for infants and children with the complete spectrum of critical pediatric medical illness and traumatic injury. The PICU is staffed with experienced health professionals, including pharmacists, respiratory and physical therapists, dieticians, and social workers. A total of four pediatric and emergency medicine residents are assigned to the unit during the day, and two residents are on at night. Critical care medicine fellows and faculty lead the team to provide children optimal management of complex life-threatening disease. PCCM fellows and faculty assist with all pediatric critical care transports, including ECMO transport. Additionally, St. Louis Children's Hospital has a robust Neurocritical Care program and is an American College of Surgeons Level 1 verified Trauma Center.
The 16-bed Cardiac Intensive Care Unit (CICU) in St. Louis Children’s Hospital is specifically geared toward the care of children with congenital and acquired heart disease and had approximately 420 encounters in 2015. This includes patients with heart failure requiring medical or device management. All post-operative lung transplant patients are also cared for in the CICU. The unit has dedicated nursing and physician teams that offer state-of-the-art care for pre- and post-operative cardiac surgery patients and for critically ill cardiology patients, including those with end-stage heart failure. Care is provided by a joint team comprised of attendings and trainees from Critical Care Medicine, Cardiology, and Cardiothoracic Surgery. PCCM fellows rotate in the CICU throughout their three years of fellowship and are actively involved in all aspects of ICU care, including care of patients on ECMO, ventilator management, sedation, use of vasoactive and anti-arrhythmic drugs, and performance of bedside procedures. We have one of the most active pediatric heart failure and transplant programs in the country (~20-25 transplant/year). A number of our patients are supported prior to transplant with ventricular assist devices, including the Berlin Heart, Heartmate II and HeartWare. Finally, we offer an additional year of specialized cardiac critical care fellowship training.