Critical Care Physicians: Creating Solutions Out of Crisis
from Practice Update, Summer 2006
There are a variety of characteristics that separate the pediatric critical care physicians at The Children’s Hospital from other intensive care units and programs across the country. Their responsibilities include providing care for critically ill pediatric patients from across the region, directing cutting-edge research studies and training future intensivists.
Along with the wide range of responsibilities, many challenges present themselves. However, this group of physicians chooses not to focus on the challenges, but rather on the opportunities that present in treating critically ill pediatric patients. The pediatric intensivists at The Children’s Hospital are experts in their field who provide the utmost in caring for both the critically ill patient and their family.
Dr. Emily Dobyns, medical director, explains, “As pediatric critical care physicians, we directly apply our knowledge of complex physiology and pathophysiology to the care of each critically ill child. We use both common sense and high technology daily. Most importantly, each of us gets to know families intimately in an often brief and vulnerable time.”
The pediatric critical care physicians at The Children’s Hospital include, Todd C. Carpenter, Emily L. Dobyns, Eva N. Grayck, Peter M Mourani and Kurt R. Stenmark, all of whom are board-certified in pediatric critical care. In addition, all five physicians are funded by the National Institutes of Health (NIH) for their research efforts. As a result, they are able to offer critically ill pediatric patients access to new therapies that are not widely available. Their current research efforts cover a broad spectrum of innovative therapies in pediatric critical care.
Dr. Stenmark is nationally and internationally recognized for his research in pulmonary vascular remodeling and pulmonary hypertension and serves as head of the Developmental Lung Biology and Cardiovascular Pulmonary (CVP) Research Laboratories.
Dr. Carpenter is recognized for his research in altitude-related illness in children and the effects of viral infections on the pulmonary vasculature and lung fluid balance.
Dr. Dobyns’ research efforts are primaril directed toward clinical studies of novel therapies for pediatric acute respiratory failure.
Dr. Grayck’s research focuses on new mechanisms by which reactive oxidents and antioxidants regulate pulmonary vascular function in developing lungs.
Dr. Mourani’s research work is directed toward clinical studies identifying molecular mechanisms and genetic risk factors for the development of bronchopulmonary dysplasia and pulmonary hypertension.
In addition to each individual’s research, The Children’s Hospital critical care physicians are often asked to participate in multi-center clinical trials of cutting-edge therapies such as the use of activated protein C in severe sepsis.
Children’s critical care physicians blend bedside medicine in the PICU with bench research from the lab. These combined efforts provide each physician with an opportunity to contribute to the advancement of medical science that they would not necessarily be able to find outside of a setting like Children’s.
Dr. Stenmark explains, “Critical care medicine affords us the opportunity to perform research that hopefully leads to improvements in care for many children, not only at The Children’s Hospital in Denver , but throughout the world. Nearly 95 percent of the patients treated in the PICU at The Children’s Hospital improve and are transferred out of the unit. We are dedicated to helping every PICU patient overcome their problems and go on to live healthy and happy lives.”
In addition to providing family-centered care and cutting-edge research, the group provides training for future intensivists. The fellowship training program at The Children’s Hospital/University of Colorado was among the first accredited in the nation in 1989 and attracts trainees from all over the United States and the world. Currently, the six fellows include Amelia Hopkins, Joseph Albeitz, Claudia Kunrath, Livia Veress, Grant Burton and Roopa Thukaram. Past fellows from this program work in both private practice and academic settings, and most importantly are making a difference in the care of critically ill children across the nation. In addition to the fellowship training program, the faculty participates in the training of pediatric residents, child health associates, physician assistants, nursing students, nurse practitioners, pharmacy students and others.
While stabilizing and caring for critically ill patients is rewarding, it is also challenging. The Children’s Hospital PICU is fortunate to have a multidisciplinary team of specialists and state-of-the-art technology at hand. At a facility without these resources, it can be more than just challenging; it can be stressful or even overwhelming. Few facilities in the region have the resources available to treat critically ill pediatric patients and provide support for their families. When critically ill pediatric patients arrive at a facility, Flight for Life, The Children’s Hospital transport team, is often called. This team is able to bring additional expertise and resources not readily available in smaller communities throughout the Rocky Mountain region. They bring resources and expertise needed to respond to the special needs of critically ill children and safely transport them to the PICU at The Children’s Hospital. Throughout each transport, the Flight for Life team is in contact with the PICU attending physicians who are available 24/7 to talk through a critically ill patient’s care or give advice on management.
Once a patient arrives in Children’s PICU, a team collaborative approach is utilized to provide follow-up information to the referring provider and referring facility through phone calls and faxed reports.
