Fluid resuscitation with unbuffered electrolyte solutions may cause harm and their use should be cautioned

The FEAST study [Maitland K, et al. N Engl J Med 2011; 364: 2483–95) has created massive debate in the paediatric critical care world. Volume bolus fluid resuscitation was compared with maintenance fluids alone in more than 3000 children with fever and clinical signs of impaired perfusion and shock. The trial was stopped because of increased mortality in the bolus groups. The study group have now gone back to the original data set to explore possible reasons for this excess mortality. Levin ML et al. (Lancet Respir Med 2019; 7: 581–93. https://ift.tt/1aeEb18 S2213-2600(19)30114-6). They developed composite scores for respiratory, cardiovascular, and neurological function using vital sign data from the FEAST trial (from Kenya, Uganda and Tanzania; n=3170), and used them to compare participants from FEAST with those from four other cohorts (from UK (2), Malawi and South African; n=19 997) and to identify differences between the bolus (n=2097)...

from Archives of Disease in Childhood current issue https://ift.tt/2Z88E21