New Year Brings New Home for Tiniest Heart Patients

Duke Children’s Hospital & Health Center opened the state’s first pediatric intensive care unit (PCICU) tailored to the special needs of young cardiac patients on January 7, 2009. The development of the new PCICU is a direct response to marked increases in younger patients and the number of echocardiograms, cardiac catheterizations, electrophysiology procedures, and cardiothoracic surgeries performed in recent years.

“Until now, a lack of ICU space has forced us to cancel surgeries almost every week. We believe this expansion will help us reduce those numbers and will allow us to more effectively serve all the families who wish to bring their children to Duke for care,” said Joseph St. Geme, MD, Chair of the Department of Pediatrics.

The new 13-bed pediatric cardiac intensive care unit will be located adjacent to the multi-disciplinary pediatric intensive care unit on the fifth floor of Duke University Hospital. The highly specialized staff will consist of 23 dedicated physicians, 75 nurses, respiratory therapists, social workers, and therapists and nearly two dozen mid-level providers.

The pediatric cardiac intensive care unit will provide a heightened level of care focused on multidisciplinary planning and performance. The Duke PCICU team has already received national recognition for adopting “hand-off” protocols that ensure the highest level of post-surgical care and have resulted in a fifty percent reduction in mortality over the past five years.

“One of the most important periods in critical care is the ‘hand-off,’ when the patient leaves the operating room and enters the intensive care unit,” explained Jon Meliones, MD, Medical Director of the PCICU. “We designed an innovative communications system based on military and aviation models that calls for regular reporting procedures for every step of the way—and the protocol begins when the patient enters the operating room, not when he or she leaves.”

Hospital staff began moving patients to the unit during the week of January 5, and the first surgical patient was transferred directly to the new facility on January 7.

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The Duke Children’s Heart Program is the only pediatric heart program in the tri-state area ranked by U.S. News & World Report. Duke is also a founding member of the Pediatric Heart Network, an NIH-sponsored program dedicated to the performance of high-quality clinical trials.