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Critical Care Medicine

Delivering around the clock care to infants, children, and adolescents with life-threatening illnesses and injuries.


The Division of Pediatric Critical Care Medicine strives for excellence in patient care, research, and fellowship training. Our division provides comprehensive services for a wide variety of critically ill medical and surgical patients with acute, life-threatening disease and injury. Our division includes the 16-bed Pediatric Intensive Care Unit (PICU), and the 13-bed Pediatric Cardiac Intensive Care Unit (PCICU), which are state-of-the-art critical care units designed to meet the needs of our patients and families. Care is also provided in a nine-bed Pediatric Progressive Care Unit.

Medical and surgical subspecialists from all disciplines are immediately available in the PICU and PCICU. Areas of subspecialty expertise include congenital heart disease, cardiovascular surgery, respiratory failure, neurosurgery, stem cell transplantation, immunodeficiencies, hematologic and oncologic emergencies, sepsis, and multiorgan system dysfunction. Available advanced treatment modalities include Extracorporeal Life Support (neonatal, pediatric, and cardiac ECMO), high frequency ventilation, nitric oxide therapy, non-invasive ventilation, and hyperbaric oxygen therapy. Twenty-four-hour-a-day critical care consultation is available.



Patient Story: Sophie McGehee - Duke and WakeMed teamed up to save the life of this baby girl who was weakened by the Enterovirus D68. A life-saving technique using Extracorporeal Membrane Oxygenation (ECMO), at Duke, made the difference.


Treatments

The Pediatric Intensive Care Unit (PICU) and Pediatric Cardiac Instensive Care Unit (PCICU) at Duke Children's Hospital provides comprehensive services for a wide variety of critically ill medical and surgical pediatric patients with acute, life-threatening disease and injury. Duke is a Level I Trauma Center and a regional, national, and international referral facility. Areas of subspecialty expertise include congenital heart disease, cardiovascular surgery, respiratory failure, neurosurgery, stem cell transplantation, immunodeficiencies, hematologic and oncologic emergencies, sepsis, and multiorgan system dysfunction. Available advanced treatment modalities include Extracorporeal Life Support (neonatal, pediatric, and cardiac ECMO), high frequency ventilation, nitric oxide therapy, non-invasive ventilation, ventricular assist devices (VADs), and hyperbaric oxygen therapy.  

The 16-bed PICU and 13-bed PCICU are state-of-the-art critical care units designed to meet the needs of our patients, families, and staff team members. Care is also provided in a nine-bed Pediatric Progressive Care Unit. The Pediatric Critical Care Medicine Division and the Pediatric Intensive Care Unit are actively growing to better serve the needs of our patients and our community. 

Additional inpatient services at Duke Children's Hospital include 55 intermediate care beds, a 16-bed stem cell transplant unit, and a 48-bed Neonatal Intensive Care Unit and Transitional Care Nursery. The Pediatric Radiology Division offers the highest quality imagery techniques including magnetic resonance imaging, positron emission tomography, ultrasound, and nuclear medicine. The Emergency Department, a Level I Trauma Center, includes a specialized pediatric emergency center staffed by board-certified Emergency Medicine physicians. A new Pediatric Emergency Department facility was completed in 2007. The Duke Hyperbaric Center is a well-established facility involved in both patient care and research which is used for PICU and PCICU patients primarily for the management of carbon monoxide poisoning or air embolism.

The PICU and PCICU attendings coordinate the transport of critically ill infants, children, and adolescents to Duke through the Life Flight / Life Care program which provides air and ground transport by highly-trained pediatric transport nurses. Fellows participate in the coordination of transports during their second and third years of training.  

Problems commonly managed in the PICU and PCICU include:

  • Medical and surgical management of neonatal and pediatric congenital heart disease
  • Acute respiratory failure from multiple causes including status asthmaticus, pneumonia, bronchiolitis, and airway obstruction
  • Septic shock
  • Pre- and post-operative management for all surgical subspecialties (neurosurgery, cardiothoracic surgery, general pediatric surgery, orthopedics, otolaryngology, ophthalmology, and plastic surgery)
  • Diabetic ketoacidosis and other severe endocrine disorders
  • Status epilepticus
  • Brain tumors (pre- and post-operative management)
  • Trauma including closed head injury
  • Stem cell and solid organ transplantation
  • Poisonings including ingestions and carbon monoxide inhalation
  • Primary immunodeficiencies including DiGeorge Syndrome and Severe Common Immunodeficiency Syndrome (SCIDS)

Specialized services in the PICU and PCICU include:

  • Advanced respiratory support including conventional mechanical ventilation, high frequency oscillatory ventilation, high frequency jet ventilation, and inhaled nitric oxide
  • Extracorporeal membrane oxygenation (ECMO) for neonatal and pediatric patients with refractory respiratory and/or cardiac failure
  • Continuous veno-venous hemofiltration, hemodialysis, and peritoneal dialysis
  • Non-invasive and invasive state-of-the-art cardiovascular and neurological monitoring
  • Continuous bedside monitoring of respiratory mechanics and capnography
  • Advance diagnostic imaging support

The PICU and PCICU team is comprised of a broad range of healthcare professionals including board certified / eligible pediatric intensivists and cardiac intensivists, pediatric critical care fellows, highly skilled and specially trained critical care nurses and respiratory care practitioners, residents, medical students, social workers, physical and occupational therapists, chaplains, discharge planners, clinical nutritionists, and clinical pharmacists. All medical and surgical subspecialties are readily available to provide consultation as needed. The PICU and PCICU care delivery model supports this entire team's commitment to utilizing their specialized skills to meet our patients' needs in a family-centered care environment.


Physicians and Staff

Physicians

Name Areas of Special Interest
Jon N. Meliones, MD, MS Pediatric cardiac critical care, pediatric critical care performance improvement, ECMO, high-frequency ventilation, technology
George Ofori-Amanfo, MB ChB Postoperative management of the critically ill neonate after open-heart surgery; outcomes of neonatal cardiac surgery; cardiac critical-care education and simulation
Caroline P. Ozment, MD ECMO, alternate modes of mechanical ventilation (high frequency, JET), transfusion medicine
Kyle J. Rehder, MD Care of critically ill infants and children, including the use of mechanical ventilation and ECMO; patient safety; quality improvement
Jennifer L. Turi, MD Pediatric critical care medicine, acute lung injury
David A. Turner, MD Pediatric critical care medicine, medical simulation, education, extracorporeal membrane oxygenation (ECMO)
Kevin M. Watt, MD Pediatric critical care medicine, mechanical ventilation, extracorporeal life support
Ira M. Cheifetz, MD Pediatric critical care medicine, acute lung injury, high-frequency ventilation, cardiopulmonary interactions, cardiopulmonary resuscitation, ECMO, congenital heart disease, mechanical ventilation
Christoph P. Hornik, MD, MPH Pediatric cardiac critical care

Staff

NameAreas of Special Interest
Michael A. Gentile, RRT, RCP, FAARC Research Associate
Samantha Wrenn Clinical Research Coordinator
Lisa Mamo Research Analyst
Austin B. Cutler, PharmD Clinical Pharmacist
Travis Heath, PharmD Clinical Pharmacist
Susan Strasser, RN, BSN, MBA Clinical Operations Director, Neonatal & Pediatric Critical Care
Karla Abela, RN Nurse Manager of Operations, Pediatric Intensive Care Unit
Kelly Ellington, RN Nurse Manager of Operations, Pediatric Cardiac Intensive Care Unit (Interim)
Tammy L. Uhl, RN, MSN, CCRN, CCNS Clinical Nurse Specialist, PICU/PCICU
Valorie Smith Division Administrator
Veronica Mills Staff Assistant

Pediatric Critical Care Nurse Practitioners

NameAreas of Special Interest
Rachel Bushman, RN, MSN, CPNP-AC Pediatric Critical Care Nurse Practitioner
Debbie Guentensberger, RN, MSN, PNP Pediatric Critical Care Nurse Practitioner
Lauren Heinz, RN, MSN, CPNP-AC Pediatric Critical Care Nurse Practitioner
Leigh-Ann Hill, RN, MSN, CPNP-AC Pediatric Critical Care Nurse Practitioner
Remi Hueckel, RN, MSN, FNP, CPNP-AC, DNP Pediatric Critical Care Nurse Practitioner
Jeannie Koo, RN, MSN, CPNP-AC Pediatric Critical Care Nurse Practitioner
Kelly Swain, RN, MSN, PNP Pediatric Critical Care Nurse Practitioner
Sarah Tallent, RN, MSN, CPNP-AC Pediatric Critical Care Nurse Practitioner


Clinic Hours and Locations

Duke Children's Hospital & Health Center
2301 Erwin Road
Durham, NC 27710
Tel: 919-668-4000


Contact Information

Pediatric Intensive Care Unit (PICU):
919-681-5541

PICU Attending Pager:
919-970-1904

Pediatric Cardiology Intensive Care Unit (PCICU):
919-613-5400

PCICU Attending Pager:
919-970-1504

Patient Transfer Center:
800-524-LIFE(5433)

Life Flight/Life Care:
800-326-LIFE(5433)