department of anesthesia and Perioperative medicine

Division of Critical Care Medicine

The physicians within our Division of Critical Care Medicine are all highly trained anesthesiologists dedicated to providing superb care to Medical University of South Carolina’s critically ill patients.  All of our critical care faculty are Board-Certified in both Anesthesiology and Critical Care Medicine.  The Division of Critical Care cares for surgical patients in the Medical/Surgical Intensive Care Unit (MSICU), where Dr. Larry Field has been the medical director since its opening in 2008.  The Medical University of South Carolina is the major tertiary referral center in the southeast United States for complex gastrointestinal medical and surgical patients and complex cancer patients; and the 18-bed MSICU admits approximately 1,000 of the sickest of these complex patients per year. 

Patients admitted to the ICU commonly require:

  • Management of the simultaneous multiorgan failure of severe sepsis syndrome
  • Respiratory support (Ventilator management or BiPAP) for:
    •  Hypoxic respiratory failure including Acute Lung Injury (ALI) and
    Acute Respiratory Distress Syndrome (ARDS), often as part of sepsis syndrome

    •  Postoperative ventilator weaning
    •  Severe pneumonia and COPD exacerbations
    •  Pulmonary edema
    •  Airway protection
  • Blood pressure control to treat severe hypotension or hypertension
  • Neurologic protection
  • Continuous dialysis for acute renal failure
  • Blood product, fluid, and electrolyte replacement
  • Sedation, analgesia, and delirium management
  • Wound, feeding tube, and drainage tube management
  • Invasive access for medication/nutrition delivery
  • Intensive/invasive hemodynamic and glucose monitoring

The Anesthesia Critical Care Faculty provide perioperative care for major abdominal surgeries, pancreatic islet cell transplants, surgical oncology procedures and complicated gastric bypass surgeries.  Anesthesiologists are particularly trained and experienced in the care of high risk perioperative patients; our specific skills and knowledge of physiology, pathophysiology, and pharmacology uniquely qualify anesthesiologists to serve perioperative and critically ill patients well.

The MSICU practices a multidisciplinary approach to critical care medicine involving nursing staff, pharmacy, respiratory therapy and dieticians in daily rounds.  Additionally, there is close collaboration between this MSICU team and the surgical/medical services.  In such a complex environment, our critical care anesthesiologists serve a central role in optimizing care during one of the most the most expensive, technologically-advanced and resource-intensive times of patients’ hospital care.

The Division of Critical Care has been granted two ACGME-accredited Anesthesiology Critical Care Fellowship positions, and the first fellow completed training during the 2010-2011 academic year.  The Division is also responsible for the education of anesthesiology and emergency medicine residents and medical students who rotate through the MSICU.  These residents rotate through the MSICU during their first and third years of residency training. See Our Anesthesiology Critical Care Fellowship Program

The Critical Care Division faculty is currently working on developing an integrated Critical Care curriculum for the education of the residency staff.  The curriculum will include a monthly multidisciplinary lecture schedule in addition to online educational tools.  Links to the online educational materials are coming soon.


Division of Critical Care Anesthesiologists:

From the Left: Drs. Larry Field, Dorothea Rosenberger, Ebony Hilton, Carlee Clark, and Horst Rieke

Larry Field, MD
Chief, Division of Critical Care Anesthesia
Associate Professor
field@musc.edu
843-876-5744

Horst Rieke, MD, PhD
Professor
riekeh@musc.edu
843-876-5744

Carlee Clark, MD
Assistant Professor
clarca@musc.edu
843-876-5744

Dorothea Rosenberger Parravano, MD, PhD
Associate Professor
parravan@musc.edu
843-792-2322

Ebony Hilton, MD
Assistant Professor
hiltone@musc.edu
843-792-2322

Other Departmental Critical Care Anesthesiologists
(also Board-Certified):

Fred Guidry, MD
Professor

Kelly Grogan, MD
Associate Professor

Fellows 

Jerrad Businger, MD
Critical Care Fellow
businger@musc.edu
843-876-5744