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The Chief of the Division of Critical Care is Dr. Robert N. Sladen, who is Medical Director of the Cardiothoracic and Surgical Intensive Care Units and Medical Director of Respiratory Therapy at Columbia Medical Center. Dr. Sladen is a Past-President of the American Society of Critical Care Anesthesiologists (ASSCA). In addition to Dr Sladen, the Division Faculty consists of a group of dedicated critical care anesthesiologists, including Drs. Mary Ellen Bass, Tricia Brentjens, Sumeet Goswami, Desmond Jordan, Joseph Meltzer, Vivek Moitra, Oliver Panzer, Peter Salgo, Gebhard Wagener and Staffan Wahlander. The Division provides Medical Direction for the Cardiothoracic Intensive Care Unit (CTICU, 21 beds) and the Surgical Intensive Care Unit (SICU, 16 beds) at Columbia University Medical Center. Together, the units admit about 2400 patients a year, and provide postoperative care for patients undergoing transplantation (heart, lung and liver), ventricular assist device insertion, CABG and valvular surgery, major thoracic surgery, major vascular surgery and a wide variety of general and subspecialty surgical procedures. The units are “closed” in the sense that all orders must be written by the ICU team, but there is close collaboration with the Surgery services involved. Strong emphasis is given to the importance of a multidisciplinary approach to critical care involving colleagues from other services, nurses and paramedical personnel. The Division is responsible for the training of Anesthesiology Critical Care Fellows, as well as residents in anesthesiology and surgery, as well as medical students on the CTICU-SICU subinternship. The teaching experience embraces all aspects of critical care, including placement and management of invasive hemodynamic monitors, ventilator management, use of drug infusion techniques, nutritional support, infectious disease control and medical ethics. Anesthesiology residents spend a minimum of two months in critical care during their CA-1 and CA-2 years, working under the direct supervision of the Critical Care Fellows and ICU Attendings. The first rotation is a month in SICU, where anesthesiology residents work together with junior residents in surgery. The emphasis is on the fundamentals of critical care, acute pain management, nutritional support and management of sepsis. The patient mix includes liver transplantation, thoracic, vascular, general and subspecialty surgery. The second rotation is a month in CTICU, taken after the cardiothoracic anesthesiology rotation. The anesthesiology residents work together with a PGY-2 surgery resident and physician assistants. The emphasis is on hemodynamic and ventilatory management and postoperative care after cardiac transplantation, insertion of ventricular assist devices, valve replacement and on- and off-bypass revascularization. During both rotations, residents supervise and teach medical students on the ICU subinternship. We offer an elective Senior ICU Resident rotation in SICU and CTICU during the CA-3 year. This rotation is essentially a “Junior Fellowship” in that CA-3 residents work side-by-side with the ICU Fellows, provide medical direction and supervise and teach junior house staff and medical students, and have the same call schedule as the ICU Fellows. Residents may apply for the Anesthesiology Critical Care Medicine (ACCM) Fellowship for their CA-4 year. The Fellowship is accredited by the American Board of Anesthesiology for training for Special Qualifications in Critical Care Medicine. Critical Care Educational Activities for Residents ICU Teaching Conference: Every Monday, Tuesday, Friday 1:30 p.m. – 2:30 p.m. Venue: SICU Conference Room, Milstein Hospital 4th Floor
This Conference is organized and coordinated by Drs. Sladen and Moitra. Three days a week a one-hour tutorial is presented to the ICU residents, medical students, physician assistants and nurse practitioners. It provides didactic coverage of the ICU Core Curriculum to supplement rounds and bedside teaching by the ICU Faculty. Lecturers include the ICU Faculty, Fellows, CUMC Faculty (e.g. pulmonologists, cardiologists, ID specialists, nephrologists etc.), and Visiting Professors. The Conference is also a venue for in-services on new devices, equipment and protocols.
ICU Morbidity and Mortality Conference: Second Friday of each month, 1:30 p.m. – 2:30 p.m. Venue: SICU Conference Room, Milstein Hospital 4th Floor The ICU Morbidity and Mortality Conference is coordinated by the ICU Fellows. They report on all mortalities in CTICU and SICU during the preceding month, with comments and discussion by the ICU Attendings as appropriate. One or two cases representing sentinel events or major morbidity are selected by the Fellows for more detailed discussion. Critical Care Grand Rounds: Every Thursday 3:00 p.m. – 4:00 p.m., September through June. Venue: Room 5-411 Garden North, Milstein Hospital, 5th Floor
Critical Care Grand Rounds is a conference open to all staff at Columbia University Medical Center with an interest in critical care medicine. The audience includes Faculty and House Staff, Nursing Staff, Therapists, Pharmacists and Medical Students. Lectures are presented by Faculty at Columbia University and Visiting Professors who are experts in critical care and related fields. Our Fellows participate in giving ICU case presentations at Critical Care Grand Rounds at least twice each year.
Robert Sladen, M.D., FCCM Mary Ellen Bass, M.D.
Joseph Meltzer, M.D. Vivek Moitra, M.D.
Professor of Anesthesiology Gebhard Wagener, M.D.
Harriet Park
Ms Anke Freude |
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Division of Critical Care Medicine