Femme et Homme
- | Pays : -
- | Organes : -
- | Spécialités : -
Extrait
Background and study aims Shock is a life-threatening condition that occurs when the body is not getting enough blood flow. Timely and rapid infusion of isotonic fluids is the mainstay for the treatment of shock in children worldwide. The World Health Organization (WHO) recommends infusion of isotonic fluids within the first hour for resuscitation in shock for well-nourished children, and further rehydration (with Ringers Lactate) over 3-5 hours for those with severe dehydration. This is in agreement with other guidelines. However, the same WHO guidelines propose infusion of a lower volume of hypotonic fluid at a slower rate of infusion for the treatment of shock in children with severe malnutrition. The evidence for both of these guidelines is very weak. This study aims to look at the safety and tolerability of modern paediatric critical care standard approaches to managing shock compared to the current standard approach advocated by the WHO. Who can participate? Children aged over 6 months with severe malnutrition who are admitted to hospital with or develop shock. What does the study involve? Children with shock associated with diarrhoea are randomly allocated to be treated with one of two types of fluid infusion: either Ringers’ Lactate or standard WHO management (half strength Darrow’s Solution in 5% dextrose). Children with shock but without diarrhoea are randomly allocated to be treated with one of three types of fluid infusion: either 4.5% albumin, Ringers’ Lactate or standard WHO management (half strength Darrow’s solution in 5% dextrose and followed by blood transfusion for non-responders) . What are the possible benefits and risks of participating? Children will be closely monitored and fluids will be given cautiously. Each child will be clinically reassessed after each bolus. Further fluids would be withheld from children showing signs of cardiogenic shock or fluid overload. Where is the study run from? KEMRI Centre for Geographic Medicine Research (Coast) at Kilifi District Hospital (KDH), Kenya When is the study starting and how long is it expected to run for? January 2007 to February 2009 Who is funding the study? Wellcome Trust MOP to KEMRI-Wellcome Trust Programme Who is the main contact? Professor Kathryn Maitland [email protected]
Critère d'inclusion
- Malnutrition and hypovolaemia