This is a great new study to read. The New England Journal of Medicine Study June 30 2011 – ‘Mortality after Fluid Bolus in African Children with Severe Infection’.
Does this challenge what we know about fluid resuscitation in children?
I remember doing an APLS sourse and challenging some of the guidelines. Now, don’t get me wrong, I think that structured approaches are great, but I must ask, WHERE IS THE EVIDENCE?
The level of evidence in terms of fluid type and volume in children is certainly not large.
This study looked at early fluid resuscitation in children and compared:
- saline bolus vs no bolus
- albumin bolus vs saline bolus
It was a multicentre randomised control trial that randomly assigned children to groups to receive up to 40ml/kg of 5% albumin or normal saline bolus or no bolus.
The study was stopped after 3141 of the projected 3600 children were recruited as the mortality at 48 hours was significantly greater in those children receiving the fluid boluses.
Will this change my practice? It goes against all that we have been taught. Well there are some important parts of this study that need to be read.
Will it change yours? Read the paper and make your own mind up. Click here to read the paper.