Failure of the cardiac or respiratory system is a common problem in the pediatric and neonatal intensive care unit. When conventional management fails to improve the child’s condition, extracorporeal life support such as extracorporeal membrane oxygenation (ECMO) can serve to provide life-saving temporary heart and lung support [1]. Renal failure often complicates care of these critically ill children on ECMO, leading to accumulation of fluid and volume overload that can worsen their heart and lung disease. Restrictive fluid management has been demonstrated to improve patient outcomes in acute lung injury.

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