Journal Article

Mortality after Fluid Bolus in African Children with Severe Infection

Lang, Trudie, Akech, Samuel O, Gibb, Diana M, Maitland, Kathryn, Brent, Bernadette, Crawley, Jane, Tibenderana, James K, Reyburn, Hugh, Babiker, Abdel G, Levin, Michael, Olupot-Olupot, Peter, Kiguli, Sarah, Engoru, Charles, Nyeko, Richard, Mtove, George, Evans, Jennifer A, Opoka, Robert O, Russell, Elizabeth C

2011

Overview

In this study from sub-Saharan Africa, children with severe febrile illness and impaired perfusion were randomly assigned to fluid-bolus therapy or no bolus. Albumin or saline boluses significantly increased 48-hour mortality in critically ill children with impaired perfusion. Rapid, early fluid resuscitation in patients with shock, a therapy that is aimed at the correction of hemodynamic abnormalities, is one component of goal-driven emergency care guidelines. This approach is widely endorsed by pediatric life-support training programs, which recommend the administration of up to 60 ml of isotonic fluid per kilogram of body weight within 15 minutes after the diagnosis of shock. 1 Children who do not have an adequate response to fluid resuscitation require intensive care for inotropic and ventilatory support. 1 Substantial improvements in the outcomes of pediatric septic shock have been attributed to this approach. 2 , 3 Nevertheless, evidence regarding . . .

• Publisher: Massachusetts Medical Society
• Subject: Acidosis / Africa, Eastern / Age / Albumin / Albumins - administration & dosage / Biological and medical sciences / Body weight / Child / Child mortality / Child, Preschool / Children / Clinical trials / Coma / Committees / Councils / Critical Illness - mortality / Critical Illness - therapy / Edema / Emergency medical care / Epidemiology / Female / Fever / Fluid Therapy - methods / Fluid Therapy - mortality / Fluids / Gastroenteritis / General aspects / Humans / Hypotension / Hypotension - therapy / Infant / Infections - mortality / Infections - therapy / Intensive care / Intention to Treat Analysis / Intravenous administration / Malaria / Male / Malnutrition / Medical research / Medical sciences / Mortality / Neurological complications / Pediatrics / Perfusion / Pressure / Public health. Hygiene / Public health. Hygiene-occupational medicine / Resuscitation - methods / Risk / Sepsis / Shock - mortality / Shock - therapy / Sodium Chloride - administration & dosage / Young, Natalie