Details

Autor(en) / Beteiligte

• Duke, Trevor

Titel

What the African fluid-bolus trial means

Ist Teil von

• The Lancet (British edition), 2011-11, Vol.378 (9804), p.1685-1687

Ort / Verlag

England: Elsevier Ltd

Erscheinungsjahr

2011

Quelle

MEDLINE

Beschreibungen/Notizen

• Radial pulses in infants are difficult to feel, and even the extremes of low pulse-volume under the best of conditions are often misinterpreted by health workers.3 The FEAST investigators had previously shown poor-to-moderate interobserver agreement for these signs.4 In district hospitals in resource-limited settings, clinical signs must be relied on; however, taking any of the signs of shock individually will lead to lack of specificity, especially in a heterogeneous population of febrile children without dehydration. 6 More recent studies have added weight to the ACCM-PALS approach, showing that early reversal of shock by community physicians improves outcome.7 However, that small observational study was also in North America, and used fluid, inotropic therapy, and where available, mechanical ventilation in children with bacteraemia and hypotension (58% of children had low blood pressure).