Welcome to LearnPICU. This site contains summaries of core topics in pediatric critical care medicine. Each topic also has associated practice board-type questions, supporting references, and summaries of seminal articles. Whether you are a medical student or a seasoned intensivist, we hope you find the resources here helpful.
 "One of the top ten websites in critical care medicine education today" (Wolbrink et al, Journal of Intensive Care Medicine 2018)
Recent News
July 18 PARAMEDIC2 Trial demonstrates improvement in 30 day survival for adults with out of hospital cardiac arrest treated with epinephrine as opposed to placebo (3.2 % vs. 2.4% survival at 30 days, p=0.02) but no difference in survival with favorable neurological outcome (2.2% vs 1.9%, OR 1.18 with CI 0.86 to 1.61) and higher rates of severe neurological impairment (31% vs 17.8%) July 2 In a retrospective analysis of 1134 patients with pARDS, Khemani et al find that those managed with PEEP lower than ARDSnet protocol had higher mortality (OR 2.05, CI 1.32-2.17). (Khemani et al, AJRCCM 2018) June 14 In a multicenter RCT by Kuppermann et al and the PECARN network of 1255 children with DKA, there was no difference in neurological outcomes based on sodium content (1/2 NS vs. NS) and rate of fluid resuscitation. (Kuppermann et al, NEJM 2018) May 25 Combes et al, in a randomized multicenter RCT of 249 adult patients with severe ARDS (P/F <50 for 3 hours, P/F <80 for 6 hours, or pH <7.25 and pCO2 >60 for 6 hours) demonstrates no significant difference in mortality utilizing VV ECMO vs. conventional mechanical ventilation with crossover (to ECMO) (RR 0.76, 0.55-1.04, p=0.09). (Combes et al, NEJM 2018) April 15 Ganesan et al, in a single center RCT of 52 pediatric patients (stopped early due to harm in intervention group) with ARDS treated with APRV vs. conventional ventilation find a two fold risk of mortality (multivariable adjusted RR 2.02, p =0.05) in the APRV group. (Ganesan et al, AJRCCM 2018) March 12 In a systematic analysis in Journal of Intensive Care, Wolbrink et al cite LearnPICU as one of the top ten websites in critical care medicine education today!
 The site is also known as Custer's Core Curriculum and was named in honor of Dr. Joseph Custer, founder of the pediatric intensive care unit at C.S. Mott Children's Hospital, a teacher and mentor to countless fellows, residents, and medical students, and who taught us that when it comes down to it, "the air goes in and out and the blood goes round and round."
 Dr. Joseph Custer
We hope you find the site helpful and welcome any comments or suggestions to improve its content and usefulness. Please contact Dr. Kevin Kuo, editor of the site, with any comments, questions, or suggestions.
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