The PICU at UCLA Westwood continues to be a compelling and challenging environment for the respiratory therapy staff. Tertiary care, as a maximum, has been replaced by the ability to serve a quaternary level population. Our therapists can contribute to children with such high acuity illness in part because of a comprehensive training program and a commitment by the department administration to support them during the period post training when they are on there own with back up. The PICU incorporates 6 out of 24 beds for pediatric cardiothoracic surgery patients. Training is separate for these fragile patients, some of whom present with single ventricle physiology.
The pediatric cardiothoracic patients, whose under lying cardiac disease is so serious pre op, that they can be unstable post op, often require the use of nitric oxide. Those patients, who go on to develop pulmonary failure, are candidates for high frequency oscillatory ventilation (HFOV). Our therapists in addition are relied on to provide bedside support during ECMO cannulation, emergency surgical intervention and chest closure.
Mechanical ventilation is common in the PICU. We utilize heliox therapy to combat post extubation laryngeal edema, particularly in the infant and toddler aged patients. Nitric oxide also has a role in patients with pulmonary hypertension. Bronchodilators are delivered continuously when appropriate and it appears the Aerogen nebulizer is ideal for CNT. We mainly use MDI’s for intermittent therapy. Surfactant has shown some assistance in treating ARDS for low weight patients.
Our therapists participate in morning medical rounds as well as weekly multidiscipline rounds. Communications are key and we strive to make information available.
It is a privilege to care of others ill children. Our staff respects this special knowledge and treat accordingly, contributing to the PICU here at UCLA.