"One of the top ten websites in critical care medicine education today"
(Wolbrink et al, Journal of Intensive Care Medicine 2018)

Welcome to LearnPICU! This site contains summaries of core topics in pediatric critical care medicine. It also includes quick medication and equipment references, a collection of procedural videos, a summary of key articles, board-type questions, a survival guide, and more. Whether you are a medical student or a seasoned intensivist, we hope you find the resources here helpful.

Recent News
November 27
The AAP publishes guidelines recommending isotonic fluids for maintenance fluids in hospitalized children age 28 days to 18 years.

October 18
IDEAL ICU Trial (Barbar et al, NEJM 2018) was stopped early for futility after 488 patients. The RCT compared adult patients with septic shock with renal failure (as defined by RIFLE criteria) and whether early (upon diagnosis of renal failure) or delayed (waiting 48 hours) affected outcomes (90 day mortality as primary outcome). There was no difference in overall mortality (58% in early group and 54% in delayed group, p=0.38) and 38% of those in the delayed group did not require renal replacement therapy. 

September 10
TAXI (Pediatric Critical Care Transfusion and Anemia Expertise Initiative) Guidelines for PRBC Transfusion in Critically Ill Children now published

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)

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The site began 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.