In 1944, Johns Hopkins surgeons performed the first landmark operation on an infant whose heart was unable to pump blood to the lungs to provide enough oxygen to the body. Surgeon Alfred Blalock, with technician Vivien Thomas guiding him, implanted a shunt developed by Blalock and pediatric cardiologist Helen Taussig to increase blood flow to the lungs. The so-called Blue Baby procedure saved the lives of thousands of children and played a major role in launching the field of modern cardiac surgery. The breakthrough also had the effect of attracting world-class pediatric heart specialists, including cardiac surgeon Bret Mettler and cardiologist Shelby Kutty, to Johns Hopkins to build The Blalock-Taussig-Thomas Pediatric and Congenital Heart Center. Most recently, it has added the first dedicated pediatric cardiac intensive care unit (PCICU) at Johns Hopkins Children’s Center.
While one-year survival for infants with critical congenital heart defects has been improving over time, mortality remains high. Advanced surgical approaches allowing early intervention, along with specialized cardiac critical care of these children, has translated into better outcomes. Research shows 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 a necessity to ensure high-quality outcomes.
Developing such a model multidisciplinary pediatric cardiac ICU to achieve those benefits, however, is not without its challenges. There are a limited number of trained pediatric cardiac intensivists who are board certified in pediatrics, pediatric cardiology and critical care medicine. The unit will be composed of cardiac critical care specialists with specialized training, nurse practitioners with training in cardiac critical care, and dedicated PCICU nurses. There will also be efforts to advance outcomes in the PCICU and optimize practice through scientific inquiry and quality improvement.
In addition to the evidence-based medicine research approach, there will be a strong focus on the family experience and parents as partners in care.
Caring for patients and families whose lives have been changed forever with the diagnosis they received, the belief is that providing holistic care will provide them with opportunities to live those lives in a rich and full way. The unit's approach will be to engage them and allow them to be part of the healing and care decisions for their child.