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Mortality after Fluid Bolus in African Children with Severe Infection
Ist Teil von
The New England journal of medicine, 2011-06, Vol.364 (26), p.2483-2495
Ort / Verlag
Waltham, MA: Massachusetts Medical Society
Erscheinungsjahr
2011
Quelle
MEDLINE
Beschreibungen/Notizen
In this study from sub-Saharan Africa, children with severe febrile illness and impaired perfusion were randomly assigned to fluid-bolus therapy or no bolus. Albumin or saline boluses significantly increased 48-hour mortality in critically ill children with impaired perfusion.
Rapid, early fluid resuscitation in patients with shock, a therapy that is aimed at the correction of hemodynamic abnormalities, is one component of goal-driven emergency care guidelines. This approach is widely endorsed by pediatric life-support training programs, which recommend the administration of up to 60 ml of isotonic fluid per kilogram of body weight within 15 minutes after the diagnosis of shock.
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Children who do not have an adequate response to fluid resuscitation require intensive care for inotropic and ventilatory support.
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Substantial improvements in the outcomes of pediatric septic shock have been attributed to this approach.
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Nevertheless, evidence regarding . . .