Fantoms
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A meta-analysis of five randomised trials of partial exchange transfusion (PET) for polycythaemia demonstrates no reduction in the risk of neurodevelopmental problems with the treatment. None of the trials was large. The total number of infants included in the meta-analysis was 295. Many were asymptomatic. In two trials utilising umbilical venous catheterisation, PET was associated with increased risk of necrotising enterocolitis (NEC). Should we continue to use this treatment? Are other techniques for exchange less invasive? Small but important effects on neurological outcome cannot be excluded without larger studies. More data from symptomatic infants are required. If a partial exchange is to be performed a meta-analysis of six studies enrolling 235 infants shows that human albumin or plasma offer no advantage over normal saline as the diluent.
See pages 2 and 7
Since the UK extracorporeal membrane oxygenation (ECMO) trial, inhaled nitric oxide and high frequency oscillatory ventilation have become
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