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TABLE 2

PICU Resources by Level of Care

Resources by Organ SystemQuaternary or Specialized FacilityTertiaryCommunity
Cardiovascular    
 Hemodynamic monitoring    
  Noninvasive Essential Essential Essential 
  Invasive Essential Essential Essential 
 Inotropic support Essential Essential Essential 
 Echocardiogram (24-h availability) Essential Essential Essential 
 ECMO or ECLS Essential Optional NE 
 VADs Essential Optional NE 
 Transplant: heart Desirable Optional NE 
Gastrointestinal    
 Upper and lower endoscopy Essential Essential Desirable 
 Transplant: liver Desirable Optional NE 
Hematologic    
 Plasmapheresis or leukapheresis Essential Essential Desirable 
 Transplant: bone marrow Essential Optional NE 
Neurologic    
 Intracranial pressure monitoring Essential Essential Desirable 
 External ventricular drain Essential Essential Desirable 
 Lumbar drain Essential Essential Desirable 
 Continuous EEG Essential Essential Optional 
 Video EEG Essential Essential Optional 
Respiratory    
 Noninvasive ventilation (HFNC, CPAP, BIPAP, NPV) Essential Essential Essential 
 Conventional mechanical ventilation Essential Essential Essential 
 Advanced mechanical ventilation (HIFV, HFOV) Essential Essential Desirable 
 Conventional inhalation therapies (heliox or continuous albuterol) Essential Essential Essential 
 Nitric oxide Essential Essential Desirable 
 Advanced inhalation gases (flolan or anesthetic agents) Essential Desirable Optional 
 Bronchoscopy Essential Essential Desirable 
 Transplant: lungs Desirable Optional NE 
Renal    
 Continuous renal replacement therapy Essential Essential Optional 
 Hemodialysis Essential Essential Optional 
 Peritoneal dialysis Essential Essential Optional 
 Charcoal hemofiltration Essential Essential Desirable 
 Transplant: kidney Essential Optional NE 
Radiology    
 Diagnostic imaging, including CT (24-h availability) Essential Essential Essential 
 Advanced Diagnostic Imaging, including MRI (with sedation) Essential Essential Desirable 
 Interventional neuroradiology Essential Desirable Optional 
 Interventional cardiology Essential Desirable Optional 
 Cardiac MRI Essential Desirable Optional 
Resources by Organ SystemQuaternary or Specialized FacilityTertiaryCommunity
Cardiovascular    
 Hemodynamic monitoring    
  Noninvasive Essential Essential Essential 
  Invasive Essential Essential Essential 
 Inotropic support Essential Essential Essential 
 Echocardiogram (24-h availability) Essential Essential Essential 
 ECMO or ECLS Essential Optional NE 
 VADs Essential Optional NE 
 Transplant: heart Desirable Optional NE 
Gastrointestinal    
 Upper and lower endoscopy Essential Essential Desirable 
 Transplant: liver Desirable Optional NE 
Hematologic    
 Plasmapheresis or leukapheresis Essential Essential Desirable 
 Transplant: bone marrow Essential Optional NE 
Neurologic    
 Intracranial pressure monitoring Essential Essential Desirable 
 External ventricular drain Essential Essential Desirable 
 Lumbar drain Essential Essential Desirable 
 Continuous EEG Essential Essential Optional 
 Video EEG Essential Essential Optional 
Respiratory    
 Noninvasive ventilation (HFNC, CPAP, BIPAP, NPV) Essential Essential Essential 
 Conventional mechanical ventilation Essential Essential Essential 
 Advanced mechanical ventilation (HIFV, HFOV) Essential Essential Desirable 
 Conventional inhalation therapies (heliox or continuous albuterol) Essential Essential Essential 
 Nitric oxide Essential Essential Desirable 
 Advanced inhalation gases (flolan or anesthetic agents) Essential Desirable Optional 
 Bronchoscopy Essential Essential Desirable 
 Transplant: lungs Desirable Optional NE 
Renal    
 Continuous renal replacement therapy Essential Essential Optional 
 Hemodialysis Essential Essential Optional 
 Peritoneal dialysis Essential Essential Optional 
 Charcoal hemofiltration Essential Essential Desirable 
 Transplant: kidney Essential Optional NE 
Radiology    
 Diagnostic imaging, including CT (24-h availability) Essential Essential Essential 
 Advanced Diagnostic Imaging, including MRI (with sedation) Essential Essential Desirable 
 Interventional neuroradiology Essential Desirable Optional 
 Interventional cardiology Essential Desirable Optional 
 Cardiac MRI Essential Desirable Optional 

BIPAP, biphasic positive airway pressure; CPAP, continuous positive airway pressure; CT, computed tomography; ECLS, extracorporeal life support; ECMO, extracorporeal membrane oxygenation; HFNC, high-flow nasal cannula; HFOV, high-frequency oscillatory ventilation; HIFV, high-inspiratory flow ventilation; NE, not expected; NPV, negative pressure ventilation; VAD, ventricular assist device.

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