Critical Care Medicine

The faculty and fellows of the UNC Division of Pulmonary and Critical Care Medicine manage and practice in state-of-the-art combined 18 bed medical intensive care units (MICU). The ICU is the main foci of the care, education and research missions of this group. All patients in the adjacent units receive care from an ICU team that is comprised of the attending physician, Pulmonary/Critical Care Medicine Fellows, Internal Medicine residents and 4th year medical students. All attending physicians are Board Certified in Pulmonary Diseases and Critical Care Medicine. The ICU nursing staff reflect the subspecialty orientations of the units and are directed by a single nurse-manager. Standard and advanced critical care services are available to evaluate and treat complications of all major organs and multi-system diseases. These include full hemodynamic and respiratory monitoring, intubated and mask mechanical ventilation, hemodialysis, and apheresis.

About 120 patients with acute or chronic critical illness are admitted each month. These patients come through the UNC Hospitals Emergency Department, from the medical or surgical acute care units, and as transfers from other hospitals. Common presenting problems are respiratory failure, sepsis and shock, malignant hypertension, gastrointestinal hemorrhage, renal failure, liver failure, neurological illnesses, and multi-system organ failure. Areas of particular strength are hematological emergencies (e.g. thrombotic thrombocytopenia purpura), sickle cell disease, hemophilia, organ transplantation complications, vasculitis, and cystic fibrosis. The ICU team works closely with the interventional radiology, renal dialysis, apheresis and other specialized treatment services to evaluate and effectively manage critically ill patients with single and multi-system organ failure.

The ICU physician team has hospital-based consultants from all subspecialties of medicine and surgery available to provide comprehensive evaluation and treatment of all foreseeable problems, and combinations thereof. The interventional radiology service provides directed embolization for bleeding, thrombolytic therapy for major clots, transvenous intrahepatic portosystemic shunt (TIPS) and vascular stent placements, and other services as clinically needed. The dialysis service provides routine hemodialysis, peritoneal dialysis, ultrafiltration, continuous veno-venous hemodialysis, and other therapies as needed. The apheresis team performs plasma exchange (PLEX), RBC exchange transfusion, leukopheresis and other services. Gastroenterology provides full endoscopy services and treatments, including variceal banding, sclerosis of bleeding ulcer and endoscopic retrograde cholecystopancreatography (ERCP). The trauma and general surgery service provides full-time in-house consultations. The transplant teams for all major organs (including kidney, pancreas, liver, heart, lung and bone marrow) provide detailed records and expert consultative services. UNC Hospitals has accredited critical care programs in medicine, surgery, pediatrics and anesthesiology. The directors of these programs work together regularly to provide excellent care and training across all age groups, problems and specialties.

Leadership

Medical Director: James R. Yankaskas, M.D.
Associate Medical Director: Shannon S. Carson, M.D.
Nursing Manager: Lewis McKenzie, R.N., B.S.N.

Clinical Services: For referrals and transfers call 919-862-6264 and ask for the MICU resident on call.

Critical Care Research

Many projects include subjects from other UNC Hospital ICUs, including the Coronary Care Unit, the Surgical, Neurosurgical, Cardiothoracic and Pediatrics ICUs, the Burn Unit and the Critical Care Step-down Unit.   Clinical research studies are currently active in the MICU.  Click here to view a list of current clinical trials.