Featured Research

from universities, journals, and other organizations

Fluid given to treat shock can kill: Clinical trial shows how 'standard' procedure results in children's deaths

Date:
March 14, 2013
Source:
BioMed Central Limited
Summary:
Children who are given fluid to treat shock have an increased risk of death due to cardiovascular collapse at 48 hours, according to new research.

Results from the Fluid Expansion as Supportive Therapy (FEAST) trial in East Africa show that children who are given fluid to treat shock have an increased risk of death due to cardiovascular collapse at 48 hours. These findings in BioMed Central's open access journal BMC Medicine challenge the generally held idea that early and rapid reversal of shock by fluid resuscitation translates into longer-term survival benefits.

Related Articles


The FEAST trial was conducted in six African hospitals across Kenya, Tanzania and Uganda without intensive care facilities. It included 3000 children with shock caused by conditions including sepsis and malaria but excluded children with gastroenteritis, burns, who had undergone surgery or had severe malnutrition. All the children in the trial received standard treatments, depending on their illness including antibiotics, antimalarials, anticonvulsants, glucose or whole blood if anemic, but were randomly assigned to receiving fluid resuscitation or to a control group without fluid resuscitation.

Prof Kathryn Maitland, from the Wellcome Trust Centre for Clinical Tropical Medicine at Imperial College London, who led this study explained, "The children who were given this treatment (boluses) initially responded well compared to the control group. However, this did not translate into a better recovery at 48 hours -- more children died in the group receiving boluses. The main cause of death, rather than fluid overload, was cardiovascular collapse."

This is surprising given that this treatment is standard practice elsewhere. The research team involved in this trial believe that in settings where there is a lack of intensive care facilities 'standard' procedures, such as fluid resuscitation, should not necessarily be used, especially when they have not been properly tested in clinical trials.

Commenting on this study Prof John Myburgh, from the University of New South Wales and The George Institute for Global Health, takes this one stage further and recommends that fluid resuscitation should be used with the same care as any potentially lethal drug, "Studies are beginning to show cracks in fluid resuscitation therapy and that careful monitoring is needed as well as a better understanding of dose and the way the therapy is given. The compelling results of this study from Africa question the wisdom of fluid bolus as therapy not only in pediatric patients but also in all critically ill patients."

This article marks the launch of an article collection on Medicine for Global Health in BMC Medicine. The collection will focus on public health initiatives, the development of health care policies, management of infectious and non-communicable diseases, cost-effectiveness studies and evidence-based guidelines which are needed to address the global burden of disease.


Story Source:

The above story is based on materials provided by BioMed Central Limited. Note: Materials may be edited for content and length.


Journal Reference:

  1. Kathryn Maitland, Elizabeth C George, Jennifer A Evans, Sarah Kiguli, Peter Olupot-Olupot, Samuel O Akech, Robert O Opoka, Charles Engoru, Richard Nyeko, George Mtove, Hugh Reyburn, Bernadette Brent, Julius Nteziyaremye, Ayub Mpoya, Natalie Prevatt, Cornelius M Dambisya, Daniel Semakula, Ahmed Dungu, Vincent Okunny, Ronald Wokulira, Molline Timbwa, Benedict Otii, Michael Levin, Jane Crawley, Abdel G Babiker, Diana M Gibb and FEAST trial group. Exploring mechanisms of excess mortality with early fluid resuscitation: insights from the FEAST trial. BMC Medicine, 2013 DOI: 10.1186/1741-7015-11-68

Cite This Page:

BioMed Central Limited. "Fluid given to treat shock can kill: Clinical trial shows how 'standard' procedure results in children's deaths." ScienceDaily. ScienceDaily, 14 March 2013. <www.sciencedaily.com/releases/2013/03/130313214013.htm>.
BioMed Central Limited. (2013, March 14). Fluid given to treat shock can kill: Clinical trial shows how 'standard' procedure results in children's deaths. ScienceDaily. Retrieved March 31, 2015 from www.sciencedaily.com/releases/2013/03/130313214013.htm
BioMed Central Limited. "Fluid given to treat shock can kill: Clinical trial shows how 'standard' procedure results in children's deaths." ScienceDaily. www.sciencedaily.com/releases/2013/03/130313214013.htm (accessed March 31, 2015).

Share This


More From ScienceDaily



More Health & Medicine News

Tuesday, March 31, 2015

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Solitair Device Aims to Takes Guesswork out of Sun Safety

Solitair Device Aims to Takes Guesswork out of Sun Safety

Reuters - Innovations Video Online (Mar. 31, 2015) — The Solitair device aims to take the confusion out of how much sunlight we should expose our skin to. Small enough to be worn as a tie or hair clip, it monitors the user&apos;s sun exposure by taking into account their skin pigment, location and schedule. Matthew Stock reports. Video provided by Reuters
Powered by NewsLook.com
Soda, Salt and Sugar: The Next Generation of Taxes

Soda, Salt and Sugar: The Next Generation of Taxes

Washington Post (Mar. 30, 2015) — Denisa Livingston, a health advocate for the Dinι Community Advocacy Alliance, and the Post&apos;s Abby Phillip discuss efforts around the country to make unhealthy food choices hurt your wallet as much as your waistline. Video provided by Washington Post
Powered by NewsLook.com
UnitedHealth Buys Catamaran

UnitedHealth Buys Catamaran

Reuters - Business Video Online (Mar. 30, 2015) — The $12.8 billion merger will combine the U.S.&apos; third and fourth largest pharmacy benefit managers. Analysts say smaller PBMs could also merge. Fred Katayama reports. Video provided by Reuters
Powered by NewsLook.com
S. Leone in New Anti-Ebola Lockdown

S. Leone in New Anti-Ebola Lockdown

AFP (Mar. 28, 2015) — Sierra Leone imposed a three-day nationwide lockdown Friday for the second time in six months in a bid to prevent a resurgence of the deadly Ebola virus. Duration: 01:17 Video provided by AFP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
 
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:  

Breaking News:

Strange & Offbeat Stories

 

Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:  

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile iPhone Android Web
Follow Facebook Twitter Google+
Subscribe RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins