Fluid Expansion As Supportive Therapy in critically ill African children

Conditions

Severe illness with shock due to sepsis or severe malaria Infections and Infestations Other septicaemia

Alyssa Castaneda, Larissa Ocadiz, Subburaj Kannan

The FASEB Journal2021-05-01

10.1096/fasebj.2021.35.s1.02543

Genesis of Antibiotic Resistance LXXII: Turbulence Modeling (TM) of Simplified Severe Sepsis Protocol‐2 (SSSP‐2), NCT01663701: Mechanism(s) of Fluid Volume Overload/endotoxemia Induced Thrombocytopenia / Thrombotic Cascade Augment vasoplegia to elicit Leucocyte(s)‐Platelet(s)‐Erythrocyte(s) aggregates (LPE) rescind starling forces

Brianna Baca, Alejandra Huerta, Larissa Ocadiz, Subburaj Kannan

The FASEB Journal2021-05-01

10.1096/fasebj.2021.35.s1.02358

Genesis of Antibiotic Resistance (AR) LVIII: Discordant Antibiotic Stewardship contort Early Goal Directed Fluid Resuscitation therapy (EGDT) with higher incidence of Mortality in severe Sepsis: <i>A global melee</i>

Alejandra Rueda, Natalia Trejo, Mariana Miramontes, Claudia Montejano, Deisy Mercado et al. (7 authors)

The FASEB Journal2020-04-01

10.1096/fasebj.2020.34.s1.02769

Mortality risk over time after early fluid resuscitation in African children.

George EC, Kiguli S, Olupot PO, Opoka RO, Engoru C, Akech SO, Nyeko R, Mtove G, Mpoya A, Thomason MJ, Crawley J, Evans JA, Gibb DM, Babiker AG, Maitland K, Walker AS.

2019-11-273 citations

10.1186/s13054-019-2619-y

Effects of saline or albumin fluid bolus in resuscitation: evidence from re-analysis of the FEAST trial.

Levin M, Cunnington AJ, Wilson C, Nadel S, Lang HJ, Ninis N, McCulloch M, Argent A, Buys H, Moxon CA, Best A, Nijman RG, Hoggart CJ.

2019-06-1048 citations

10.1016/s2213-2600(19)30114-6

Lactate clearance as a prognostic marker of mortality in severely ill febrile children in East Africa.

Aramburo A, Todd J, George EC, Kiguli S, Olupot-Olupot P, Opoka RO, Engoru C, Akech SO, Nyeko R, Mtove G, Gibb DM, Babiker AG, Maitland K.

2018-03-0937 citations

10.1186/s12916-018-1014-x

Exploring mechanisms of excess mortality with early fluid resuscitation: insights from the FEAST trial.

Maitland K, George EC, Evans JA, Kiguli S, Olupot-Olupot P, Akech SO, Opoka RO, Engoru C, Nyeko R, Mtove G, Reyburn H, Brent B, Nteziyaremye J, Mpoya A, Prevatt N, Dambisya CM, Semakula D, Ddungu A, Okuuny V, Wokulira R, Timbwa M, Otii B, Levin M, Crawley J, Babiker AG, Gibb DM, FEAST trial group.

2013-03-14172 citations

10.1186/1741-7015-11-68

Mortality after fluid bolus in African children with severe infection.

Maitland K, Kiguli S, Opoka RO, Engoru C, Olupot-Olupot P, Akech SO, Nyeko R, Mtove G, Reyburn H, Lang T, Brent B, Evans JA, Tibenderana JK, Crawley J, Russell EC, Levin M, Babiker AG, Gibb DM, FEAST Trial Group.

2011-05-261,026 citations

10.1056/nejmoa1101549

Interventions

This is a three-arm randomised open controlled trial comparing two active fluid resuscitation strategies to control (no bolus). 2,880 children will be assigned in a ratio of 1:1:1 to one of the three

144 with decompennsated shock will be randomised to human albumin solution (HAS) or saline. Three resuscitation strategies: 1. Immediate volume resuscitation with norm

Eligibility

Sex/Gender

All

Inclusion criteria

Inclusion criteria: Children (both males and females, age range >60 days and 2s 2.2. Lower limb temperature gradient 2.3. Weak radial pulse volume 2.4. Severe tachycardia Severe tachycardia: if 180 bpm; 12 months to 5 years: >160 bpm; >5 years: >140 bpm

Exclusion criteria

Exclusion criteria: One or more of the following at admission: 1. Severe acute malnutrition 2. Gastroenteritis 3. Conditions where intravascular volume expansion is contraindicated, namely chronic renal failure, pulmonary oedema 4. Non-infectious causes of severe illness: trauma, burns, intoxication 5. Children who have already received volume expansion using an isotonic volume expander during the current illness Severe malnutrition: visible severe wasting and/or kwashiorkor Gastroenteritis: >3 watery stools in previous 24 hours Pulmonary oedema: oxygen saturation <90% on pulse oximetry plus bilateral basal crepitations

Design outcomes

Primary

Measure	Time frame
In-hospital mortality at 48 hours after randomisation.	—

Secondary

Measure	Time frame
1. Mortality at 4 weeks after randomisation 2. Mortality or neurological sequelae at 4 weeks after randomisation 3. Neurological sequelae at 4 weeks after randomisation 4. Persistent neurological sequelae at 6 months after randomisation 5. Development of hypotensive shock within 48 hours of randomisation 6. Adverse event within 48 hours of randomisation (pulmonary oedema, intracranial hypertension, severe allergic reaction in those receiving albumin)	—

Measure

Time frame

1. Mortality at 4 weeks after randomisation 2. Mortality or neurological sequelae at 4 weeks after randomisation 3. Neurological sequelae at 4 weeks after randomisation 4. Persistent neurological sequelae at 6 months after randomisation 5. Development of hypotensive shock within 48 hours of randomisation 6. Adverse event within 48 hours of randomisation (pulmonary oedema, intracranial hypertension, severe allergic reaction in those receiving albumin)

—

Countries

Kenya, Tanzania, Uganda

Outcome results

None listed