Malnutrition and hypovolaemia Nutritional, Metabolic, Endocrine Malnutrition and hypovolaemia
Conditions
Interventions
Treatment will occur at the Site-Kilifi District Hospital, Kenya.
Randomisation group A: children with diarrhoea - history of acute diarrhoea (greater than 6 watery stools/day) plus a feature of sho
Sponsors
University of Oxford (UK)
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. Children greater than 6 months (either sex) with severe malnutrition defined as (one of the following): 1.1. Weight for height z score less than -3 or weight for height percentile (WAP) less than 70% 1.2. Mid-Upper Arm Circumference (MUAC) less than 11.0 cm 1.3. Oedema involving at least both feet (kwashiorkor) 2. Children who are admitted with, or develop during the course of admission, one or more of the following features of compensated or decompensated shock: 2.1. Depressed conscious state: prostration (inability to sit up) or coma (inability to localise a painful stimulus)* 2.2. Bradycardia (heart rate less than 80 beats per minute) 2.3. Evidence of shock or dehydration: 2.3.1. Capillary refill time greater than 2 seconds 2.3.2. Temperature gradient (from lower to upper part of leg elicited by running hand up the shin) 2.3.3. Weak pulse volume or systolic blood pressure less than 80 mmHg 2.3.4. Prolonged capillary refill greater than 2 seconds 2.4. Deep 'acidotic' breathing 2.5. Creatinine greater than 80 umols/L *only if still present after correction of hypoglycaemia
Exclusion criteria
Exclusion criteria: 1. Children of families who decline to consent 2. Haemoglobin less than or equal to 5 g/dl 3. Features of pulmonary oedema (defined as clinical evidence for presence of fine crepitations in both lungs plus oxygen saturations less than 90% in air) 4. Evidence of raised intracranial pressure (brain stem features of coning, systolic blood pressure greater than 90% centile for age plus falling heart rate and/or papilloedema) 5. Known congenital heart disease
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Resolution of features of shock at 4 hours. | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. In-hospital death 2. Development of serious adverse events such as pulmonary oadema and raised intracranial pressure | — |
Countries
Kenya
Outcome results
None listed