Research Story Tip: Johns Hopkins Children’s Center Opens Critical Care Unit for the Tiniest Heart Patients

10/13/2020

Caring for infants with heart disease is nothing new to Johns Hopkins Medicine. In November 1944, Johns Hopkins surgeons performed the first “blue baby” procedure on an 18-month-old girl with a heart defect that prevented blood from reaching her lungs to be replenished with oxygen for the rest of the body. Surgeon Alfred Blalock, with assistance from technician Vivien Thomas, implanted a shunt that he and pediatric cardiologist Helen Taussig had developed. With her blood flow restored, the baby turned pink and the modern era of pediatric cardiac surgery began.

Nearly 76 years later, the Blalock-Taussig-Thomas Pediatric and Congenital Heart Center at Johns Hopkins Children’s Center — named in honor of the three pioneers — has dedicated a new pediatric cardiac intensive care unit (PCICU) to provide state-of-the-art, specialized and highly focused care for tiny patients struggling with serious heart conditions from the moment of their first breath.

“Building this cardiac critical care program is an opportunity, when coupled with the already established systems, programs and — importantly — the people at Johns Hopkins Medicine, that will enable us to provide a level of medical care and a patient-family experience that is truly unique in this region and the country,” says Darren Klugman, M.D., director of pediatric cardiac critical care at Johns Hopkins.

Klugman says the PCICU will be staffed by board-certified, subspecialty-trained intensivists and cardiologists who will partner with surgeons to deliver high-quality care. The team also will include respiratory therapists, nurses and nurse practitioners trained in pediatric and cardiac critical care.

The high quality, comprehensive and multidisciplinary cardiac care services in the new PCICU include:

  • Coordinated care beginning at fetal diagnosis
  • A dedicated cardiac anesthesia team
  • Heart transplantation
  • Cardiac extracorporeal membrane oxygenation (ECMO), which uses a device that takes over the function of the heart and lungs, giving them time to rest
  • A cardiac imaging program, including computerized tomography (CT) and magnetic resonance imaging (MRI) capabilities
  • Temporary and permanent ventricular assist devices (VADs), mechanical devices that support or replace a weakened or faulty heart ventricle
  • An electrophysiology ablation and pacemaker program that treats irregular heartbeats known as arrhythmias
  • Preoperative and postoperative management

While one-year survival for infants with critical congenital heart defects has been improving over time, mortality rates remain high. Advanced surgical approaches enabling early intervention, Klugman explains, along with specialized cardiac critical care of these children, has translated into better treatment results. Research shows that PCICU care has many advantages over traditional ICU cardiac care, including shorter ventilator stays, improved continuity of care and more seamless coordinated multidisciplinary care, which is necessary to ensure high quality outcomes.

An internationally known researcher in congenital heart disease quality and outcomes, Klugman will lead efforts to advance outcomes in the PCICU and optimize practice through scientific inquiry and quality improvement.

“One of the things that attracted me to Johns Hopkins Medicine was the enormous research infrastructure and resources that exist within our system,” says Klugman. “All of the dedicated subspecialty care, research and education here will enable us to ask important questions, to understand the differences among our patients, and participate in research and clinical care advances to improve our outcomes. Without question, our singular goal is to continue to advance the care we provide through research, science and practice to improve outcomes beyond where they are today.”

For more information on the Johns Hopkins Children’s Center PCICU, go to www.hopkinsmedicine.org/heart_vascular_institute/specialty_areas/pediatric-and-congenital-heart-center/critical-care.html.