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
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 21 iCompare Trial, a randomized trial of 63 internal medicine residencies, shows no difference in amount of times intern spent on direct patient care and education between the standard work hour group and the flexible policy cohort. Interns in the flexible policy group were less satisfied with their educational experience than their peers in the standard group. The opposite was true for program directors. Accompanying NEJM editorial. March 21 In a multicenter randomized trial of infants <12 months of age with bronchiolitis treated outside of an ICU, those who received high flow nasal cannula at 2 L/kg/min (avg weight ~ 7.3-7.6 kg) had significant less treatment failure than those who were started on regular nasal cannula at 2L/min. 61% of those that failed nasal cannula responded to HFNC (Franklin et al, NEJM 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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