Critical care unit

ICU staff

PICU is manned by senior pediatric intensivist and fellows, round the clock, who are capable of providing world class health care facilities in practically ‘no time lag’. 2 fellows are available on floor round the clock. Experienced nurses and ICU technicians provide care to sick children in patient oriented manner.

Facilities available

Advanced hemodynamic and cardiac monitoring

• Central venous pressure
• Invasive and noninvasive blood pressure
• Continuous non invasive cardiac output
• Continuous SCVO2 monitoring

Advanced and difficult ventilation

• Invasive – conventional ventilation
• Non invasive ventilation
• High frequency oscillator
• Inhaled Nitric oxide therapy

Neurointensive care

• Bispectral index monitoring (BIS)
• Continuous bedside EEG monitoring
• Intracranial pressure monitoring

Nephrology

• Peritoneal dialysis
• Bedside hemodialysis and hemofiltration
• Plasmapheresis

Post op surgical case management

• Pediatric surgery
• Pediatric cardiac surgery – nursed in 8 bedded specialized pediatric cardiac ICU
• Neurosurgery
• Orthopedic
• Hepatobiliary
• Endocrine

Post transplant management

• Liver transplant
• Bone marrow transplant
• Kidney

Provision for parenteral nutrition

PICU procedures

• Airway (including difficult and advanced) management
• Thoracocentesis
• Core (esophageal and rectal) and peripheral temperature monitoring
• Defibrillation and cardioversion
• Central venous/ arterial line insertion
• Liver abscess drainage
• Bone marrow aspiration and biopsy
• Bedside interventional radiological procedures
• Bedside diagnostic and therapeutic bronchoscopies
• Abdominal pressure monitoring
• Tracheostomy insertion
• Percutaneous enterogastrostomy tube insertion

Recent addition

• Use of bedside ultrasonography for various procedures and therapy titration like

• Assessment of fluid responsiveness
• Cardiac function monitoring
• Titration of ionotropes
• Central venous line insertion
• Pleural fluid drainage
• Differentiating pneumonia from interstitial edema
• Optic nerve sheath monitoring for raised intracranial pressure

• Extra corporal membrane oxygenation (ECMO)
• Near infrared spectrometry (NIRS)

Each bed in PICU has the facility of real time continuous multi parameter monitors including EEG, Bispectral index and invasive cardiac monitoring. It is one of very few units in India where intracranial pressure monitoring facility is available for children suffering with serious neurological ailments.

PICU has got an excellent round the clock support from paramedical services like hematology, pathology, microbiology and biochemistry. In coherence with PICU team, they continue to take great strides in advancing the survival, recovery and quality of life critically ill patients.

After discharge

It is equally important to continue the quality care even after discharge from intensive care area. We have a wonderful provision of providing “step down” care, in our well equipped pediatric wards, by the same pediatric specialists, who were involved in critical care in PICU. There are special “follow up visit protocols” for high risk children on long term basis, even after discharge from hospital, with the same expert critical care team, in out-patient department.

Pediatric Intensive Care

PICU was started in 1993 as a four bedded unit with 2 nurses, basic monitoring equipment and only one ventilator. Now this is a multi disciplinary unit with 12 beds with 1:1 patient nurse ratio (for ventilated patients) and has state of the art equipments for the real time continuous monitoring of vital signs in the critically ill children. Each bed has the facility to monitor ECG, respiratory rate, temperature, non-invasive blood pressure, invasive intra-arterial pressure, central venous pressure, end-tidal carbon dioxide, oxygen saturation, EEG, Bispectral index and intracranial pressure.

Advanced airway management conventional invasive, non invasive, high frequency ventilation with patient friendly, modern machines are the highlighted achievements of this unit.

It is a busy unit with more than 1000 admissions per year and with survival rates comparable to the PICUs of developed western countries.

Most important and significant feature of this ICU is the in house availability of at least 2 trained intensivist at any given time.