Pediatric Intensive Care Unit (PICU)

Conditions We Treat

We care for children who are having a heart, liver, kidney, intestine or bone marrow transplant. We also care for children who need intensive care after surgery or who have a broad range of other conditions, such as these:

Acute kidney or liver failure

Kidney failure happens when your child’s kidneys cannot remove enough wastes from your child’s blood or control their salt levels. Sudden (acute) kidney failure may be caused by an injury or poisoning. Liver failure means your child’s liver cannot filter blood or support the needs of your child’s body. Acute liver failure may be caused by a sudden illness in someone who has never had liver problems.

Brain tumors

Brain tumors are abnormal growths of cells within the skull. There are many types of brain tumors in children. Some brain tumors are cancer, and others are not. All types can cause health problems and require treatment. Read more.

Breathing or lung problems

These are some of the breathing or lung problems that may need to be cared for in the PICU:

• Having a serious asthma flare-up
• Having an infection of the tiny airways that lead to the lungs (bronchiolitis)
• Not getting enough carbon dioxide out of the blood and enough oxygen into the blood through the lungs (acute respiratory failure)
• Choking on an object (foreign-body aspiration)

Cancer and blood disorders

When cancer or a blood disorder — or treatment for these conditions — has serious effects on your child’s body, your child may need to stay in the PICU. Read more.

Craniofacial conditions

Problems with the skull or face can be complex, and many need to be treated with surgery. Some children with craniofacial conditions may need to stay in the PICU — such as if they have breathing problems or while they recover after surgery. Read more.

Diabetes and other metabolic problems

Metabolic problems have to do with the way the body changes food into energy. These problems may cause toxins to build up in the body and keep children from getting the nutrients they need. In diabetes, the level of sugar (glucose) in the blood gets too high because the body doesn’t make enough insulin (type 1 diabetes [PDF]) or doesn’t respond well to insulin (type 2 diabetes). If it’s not controlled, diabetes can lead to a serious condition called ketoacidosis.

Epilepsy and other nervous system conditions

A seizure happens when brain cells called neurons send signals in a way that is not normal. This may make your child unconscious or make their arms and legs jerk (convulse). A child with epilepsy (PDF) has seizures again and again. Causes include head injuries, strokes, infections and tumors that injure the brain. Read more about nervous system conditions.

Genetic and chromosomal conditions

Your child’s genes carry instructions for how your child’s body forms and works. Health problems may happen if a gene changes, chromosomes have extra or missing pieces or a child has too few or too many chromosomes. Hundreds of health problems come at least partly from genes and chromosomes. Some are serious. In the PICU, we care for children with conditions such as Down syndrome (trisomy 21). Read more about genetic conditions.

Immune system and rheumatic conditions

If your child’s immune system isn’t working how it should or is missing needed parts, your child is more open to serious infections and illness. An infection that is minor in most children may cause more danger for your child. When your child’s immune system doesn’t protect them, they may need special care in the PICU. Read more about immune system conditions.

Problems with the immune system cause some rheumatic conditions. Rheumatic conditions have to do with swelling and pain, mainly in the joints and muscles. Lupus is one example. In lupus, the immune system attacks healthy cells, damaging joints, skin, blood vessels and organs. Read more about rheumatic conditions.

Infections, such as bacterial meningitis or sepsis

Infection and swelling in the membrane around the brain and spinal cord are called meningitis. The kind caused by bacteria (rather than a virus) tends to be more serious. It can cause brain damage and must be treated right away. Sepsis is another serious infection, often caused by bacteria. In sepsis, toxins from bacteria trigger your child’s immune system to attack your child’s body.

Intoxication or overdose

Children are at risk for serious health effects if they drink alcohol, take street drugs or take too much of any medicine (over-the-counter or prescription). The most serious effects include coma and death. Children who are intoxicated or have overdosed may need emergency care. Then they may be admitted to the hospital, sometimes the PICU. Read more about alcohol, drugs and medicine safety.

Near-drowning

In drowning, a child doesn’t get enough oxygen because their face is in water or some other liquid. The liquid gets into the child’s lungs, which keeps them from breathing in a normal way. Or the child’s airway closes to keep out the liquid, but this also keeps out air. Near-drowning means a child started to drown but survived. The effects can vary widely and may include brain damage.

Pulmonary hypertension

High blood pressure in the lungs is called pulmonary hypertension. It happens when blood vessels in the lungs cannot expand enough to receive blood coming from the heart. The main effect is that the right lower chamber (ventricle) in the heart must pump harder to get blood to the lungs. Because it’s working harder, the right ventricle gets bigger and thicker, and it could fail. Read more.

Sleep apnea and other sleep problems

Apnea refers to short pauses in breathing. Obstructive sleep apnea happens when your child’s airway closes partway or all the way during sleep, blocking air from getting in. Central sleep apnea occurs when the part of the brain that controls breathing doesn’t start or maintain breathing as it should. Sleep apnea can cause breathing to stop (respiratory arrest) and oxygen in the blood to get too low (hypoxemia). Read more about sleep problems.

Services We Offer

The PICU offers a complete range of services to care for critically ill or injured children. Our services include:

Extracorporeal membrane oxygenation (ECMO)

ECMO is a heart-lung pump that provides life support when your child’s lungs, heart or both are not working as they should or need time to heal. With ECMO, blood is pumped out of the body, pushed through a machine to add oxygen and then returned. While on ECMO, your child will be given medicine to keep them comfortable (sedated) and closely monitored by a nurse and an ECMO specialist.

High-frequency oscillatory ventilation

This is a form of help with breathing (mechanical ventilation) that sends small, quick puffs of air into your child’s lungs. It is gentler than conventional ventilation, which sometimes needs high pressure that can damage lungs that are fragile.

Continuous renal (kidney) replacement therapy (CRRT)

CRRT works like the kidneys, and it allows us to gently filter your child’s blood. This gives your child’s kidneys a chance to rest and get better. It is used to support patients with kidney failure (renal failure). CRRT is nonstop, short-term dialysis (hemodialysis or peritoneal dialysis). Read more about CRRT (PDF) and dialysis.