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Question: ECMO – any benefit for neonates?

10 Dec, 07 | by Bob Phillips

ECMO kitDoes extra-corporeal membrane oxygenation improve survival for severely unwell neonates with Congenital Diaphragmatic Hernia?

A neonate on the intensive care unit with an isolated congenital diaphragmatic hernia is failing on conventional ventilation. There are no exclusion criteria for extra-corporeal membrane oxygenation (ECMO). Should the neonate be transferred for ECMO?

Question: Insulin for hyperglycaemic PICU patients?

9 Oct, 07 | by Bob Phillips

Should paediatric critically ill patients receive insulin therapy to maintain strict normoglycaemia?

Blood sugar monitorJoseph, a 4 year old boy with septic shock, lactic acidosis and multi-organ failure has been admitted to the paediatric intensive care unit. Mechanical ventilation, vaso-active support, and renal replacement therapy (CVVHD) are initiated. His serum glucose level is 10.5 mmol/l. The senior consultant decides to order insulin therapy in order to maintain strict normoglycaemia, but the junior fellow argues that there is no evidence that strict normoglycaemia improves outcome in critically ill children.


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