Question: Insulin for hyperglycaemic PICU patients?

Should paediatric critically ill patients receive insulin therapy to maintain strict normoglycaemia? Joseph, 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 […]

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Unanswered Question: Do children with autism and developmental regression need EEG investigation in the absence of clinical seizures?

John diagnosed with autism at 18 months old presents to your developmental clinic at 30 months old. His mother reports developmental regression of previously acquired developmental milestones. He has now lost his previously acquired language skills and only makes incomprehensible babbles. He is otherwise clinically well and does not have any clinical seizures. You wonder […]

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Unanswered Question: What is the long term outcome for antenatally drug exposed children?

Whilst attending the adoption panels it has become clear that many of the prospective parents ask about the antenatal drug exposure of the babies and what that means for the future for these children. They are given fairly vague advice and told that we can’t be sure of the outcome and so are left with […]

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What is the best treatment for hyperkalaemia in a preterm infant?

A 720g neonate in the intensive care unit develops severe hyperkalaemia with cardiac arrhythmia. The Specialist registrar decides to give a Calcium Gluconate bolus and start an Insulin and Dextrose infusion. The new Registrar queries why Salbutamol and Ion Exchange resins were not considered as these therapies are frequently used in management of hyperkalaemia in […]

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