So what, no bolus?

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The FEAST trial was a confusing one – it randomised 3141 children in Uganda, Kenya, and Tanzania with severe febrile illnesses and signs of poor peripheral perfusion.  The end conclusion from this study was that children who received fluid boluses had a higher mortality rates (both short, and intermediate term) then children who didn’t receive the boluses.  How does this make sense?

This comment article from the Lancet carefully dissects the article helping us to understand the population studied as well as the measures used to determine shock.  importantly, there were several other confounding factors, including  marketed anaemia and cerebrally infection.

There’s much more to read in this excellent perspective article (from Dr. Duke, from the Children’s in Melbourne), and is important to recognise that guidelines from one country cannot always be applied to another. Check out the article here over at the Lancet.

 image BrokenSphere
 source the Lancet


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