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From Peds2PICU offers advanced PICU learning including clinical cases, ECG quizzes, MCQs, algorithms, drug insights and quick teaching tools for pediatric critical care professionals.
Algorithms
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Case of the week
A focused reallife PICU case to sharpen clinical reasoning in a few minutes.
MCQs of the week
Short selftest questions to challenge and update your knowledge regularly
5 Minutes PICU
A highyield teaching slide set on a core PICU or cardiac ICU topic.
Let’s learn a drug
A rapid dive into one key drug, with dosing pearls and clinical nuances.
Article of the week
A curated research paper with practical take-home points for the unit.
Recent Blogs
Picture Quizzes
An 8-year-old child is on postoperative day four following repair of Tetralogy of Fallot. He has been recovering well in the PICU until the recent onset of labored breathing and decreased breath sounds on the right side. The chest drain, was removed yesterday. His oxygen requirement has risen from room air to high-flow nasal cannula at 40% FiO₂. He appears fatigued, with mild tachycardia and poor appetite, and the nursing staff report difficulty maintaining stable fluid and electrolyte balance. A chest X-ray reveals moderate right-sided pleural effusion.
Drain was inserted on right side, and following fluid noticed. The surgical team suspects a postoperative complication related to thoracic duct injury.
Question: What condition has most likely developed in this patient?
Identify the machine.
A 3-month-old infant, weight 4.5 kg, is admitted to the Pediatric Cardiac ICU from the emergency department for worsening cyanosis and episodic desaturations, particularly during agitation and feeding. The infant was born at term, has had poor weight gain, and has not undergone prior cardiac surgery.
On arrival to the ICU, the child is tachypneic with oxygen saturations fluctuating between 65–75% on supplemental oxygen, heart rate 160/min, and blood pressure appropriate for age. The team obtains a portable chest X-ray, shown above.
No diagnosis has been disclosed to the admitting team yet.
A 2-day-old term neonate, birth weight 3.2 kg, is admitted urgently to the Pediatric Cardiac ICU for profound cyanosis noted shortly after birth. Pregnancy and delivery were uncomplicated, and Apgar scores were reassuring. However, within hours, the infant developed persistent hypoxemia with oxygen saturations in the 60s despite 100% oxygen.
The infant is tachypneic but not in severe respiratory distress. Blood pressure is stable, pulses are palpable, and there is no obvious murmur. A diagrammatic cardiac image (shown above) is reviewed during assessment.
A 4-year-old child with severe pneumonia is mechanically ventilated for hypoxemic respiratory failure. On day 3, oxygen requirement increases (FiO₂ 0.75), PEEP is 8 cmH₂O, and plateau pressures are rising. The child develops tachycardia, increasing ventilator asynchrony, and decreased right-sided breath sounds. Bedside lung ultrasound is performed. The image above is obtained from the right lower thoracic zone using a curvilinear probe.
Quiz Question
What is the most likely diagnosis based on this ultrasound image, and what is the next best step in management?
An 8-year-old child is on postoperative day four following repair of Tetralogy of Fallot. He has been recovering well in the PICU until the recent onset of labored breathing and decreased breath sounds on the right side. The chest drain, was removed yesterday. His oxygen requirement has risen from room air to high-flow nasal cannula at 40% FiO₂. He appears fatigued, with mild tachycardia and poor appetite, and the nursing staff report difficulty maintaining stable fluid and electrolyte balance. A chest X-ray reveals moderate right-sided pleural effusion.
Drain was inserted on right side, and following fluid noticed. The surgical team suspects a postoperative complication related to thoracic duct injury.
Question: What condition has most likely developed in this patient?
Identify the machine.
A 3-month-old infant, weight 4.5 kg, is admitted to the Pediatric Cardiac ICU from the emergency department for worsening cyanosis and episodic desaturations, particularly during agitation and feeding. The infant was born at term, has had poor weight gain, and has not undergone prior cardiac surgery.
On arrival to the ICU, the child is tachypneic with oxygen saturations fluctuating between 65–75% on supplemental oxygen, heart rate 160/min, and blood pressure appropriate for age. The team obtains a portable chest X-ray, shown above.
No diagnosis has been disclosed to the admitting team yet.
A 2-day-old term neonate, birth weight 3.2 kg, is admitted urgently to the Pediatric Cardiac ICU for profound cyanosis noted shortly after birth. Pregnancy and delivery were uncomplicated, and Apgar scores were reassuring. However, within hours, the infant developed persistent hypoxemia with oxygen saturations in the 60s despite 100% oxygen.
The infant is tachypneic but not in severe respiratory distress. Blood pressure is stable, pulses are palpable, and there is no obvious murmur. A diagrammatic cardiac image (shown above) is reviewed during assessment.
A 4-year-old child with severe pneumonia is mechanically ventilated for hypoxemic respiratory failure. On day 3, oxygen requirement increases (FiO₂ 0.75), PEEP is 8 cmH₂O, and plateau pressures are rising. The child develops tachycardia, increasing ventilator asynchrony, and decreased right-sided breath sounds. Bedside lung ultrasound is performed. The image above is obtained from the right lower thoracic zone using a curvilinear probe.
Quiz Question
What is the most likely diagnosis based on this ultrasound image, and what is the next best step in management?
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ECG Quizzes
PICU Self Assesment (SA)
This section is designed to evaluate your understanding of Paediatric Intensive Care Unit (PICU) concepts while helping you develop strong critical thinking skills. Instead of simply testing memorised knowledge, it focuses on your ability to analyse clinical situations, make quick and accurate decisions, and apply your knowledge in real-life patient care scenarios.
Dr. Muhammad Shahzad
Pediatric & Cardiac Critical Care Specialist
Dr. Muhammad Shahzad is a Pediatric Intensive Care and Pediatric Cardiac Surgical ICU physician with extensive experience in postoperative congenital heart surgery, ECMO, VADs, and pediatric heart transplantation at KFSH&RC Riyadh. With more than seven years of specialized PICU and cardiac critical-care practice, he has authored over 15 research publications and contributed to clinical pathways, transplant protocols, and critical-care training.
General Pediatric
+7 Years
Pediatric ICU
+7 Years
Medical Researches