Critical Care:

Adult Anesthesia Critical Care Services

Overview

There are two primary surgical ICUs that Anesthesiology residents will rotate through (CVC ICU & SICU) as well as two other ICUs where patients requiring operations will be cared for (TBICU & NICU). All together, there are 70 adult Surgical ICU beds, accounting for over 4000 admissions/year. The complete range of operations are represented by this population, often including complex ‘re-do’ operations, repairs/reconstructions after previous surgeries, transfers from other institutions. Experience will also be obtained by consulting on, or caring for patients in the 20 bed Medical ICU (MICU), or the 10 bed Cardiology ICU (CICU) who may require emergent airway management or who may be going to the ORs.

CVC ICU

The CVC ICU is a 24 bed unit where patients recovering from or requiring cardiac, thoracic, vascular operations will be cared for. There is approximately 1200 admissions/year to this unit. Patient and disease categories include post cardiotomy, major thoracic operations of the lung, esophagus, mediastinum, acute aortic dissections, the entire array of aortic and major vascular reconstructions, mechanical assist devices for acute and chronic heart failure including ventricular assist devices, total artificial hearts, ECMO, and transplantation of heart and lung.

The ICU is divided into two teams of residents, ICU Physician extenders (NPs & Pas) Intensivists as well as a complete compliment of ancillary medical providers. Fellows from Critical Care, Cardiac Anesthesiology and Cardiology compliment the teams. These two tedams combine for night coverage with in-house call averaging every fourth night for residents.

SICU

The SICU is a 20 bed unit where patients from all the major branches of surgery are cared for. The SICU admits over 1500 cases/year. The SICU also accepts overflow patients from other adult ICUs including medical ICUs. The SICU team is comprised of both Anesthesiology and Surgery residents, fellows and faculty. There is always a junior and senior resident as well as an in-house fellow on call. In house call averages every fourth night.

Organizational Structure

The ICU staff intensivists (either anesthesiologist or surgeons) are responsible for the supervision, direction and coordination of clinical activities in the ICU. The ICU attending is present in the ICU on a daily basis and is available at night by phone and pager. This coverage is provided on a weekly basis from Monday to Monday. In the CVC ICU, anesthesiology residents provide the majority of house staff coverage, with rotating cardiology, cardiac anesthesiology and critical care fellows providing some in-house coverage from time to time. Anesthesiology residents provide half the in-house coverage in the SICU with junior and senior surgery residents from a variety of services sharing the other half. Ideally, on-call teams in the SICU comprise an anesthesiology with a surgery resident. Critical Care fellows provide in-house coverage in the SICU and 24/7 beeper coverage in the CVC ICU. ICU Nurse Practitioners and Physician Assistants augment both day time work and night call 24/7 in the CVC ICU.

Faculty

Andrew L. Rosenberg, MD - Chief, Division of Anesthesiology Critical Care

Brian Woodcock, MB ChB, MRCP, FRCA – Director, Cardiothoracic ICU

Jehad Albataineh, MD – Assistant Professor, Anesthesiology

Paul Kazanjian, MD – Assistant Professor, Anesthesiology

Lena Napolitano, MD – Chief, Division of Acute Care Surgery

Jonathan Haft, MD – Cardiac Surgery Section

Yasser El Kouatli, MD - Clinical Lecturer, Anesthesia

Visiting Professors

Paul Stonelake, MD

Anesthesiology Critical Care Fellows

James Blum, MD

Marc Orlewicz, MD

Surgery Critical Care Fellows

Melissa Brunsvold, MD

Awori Hayanga, MD

David Frank Leonard-Vidal, MD

Nabil Issa, MD

Jennifer Cannon, MD

Dept. of Anesthesiology, Univ. of Michigan Medical School

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