Letters WHO guidelines on fluid resuscitation in children

Authors’ reply to Southall

BMJ 2014; 348 doi: https://doi.org/10.1136/bmj.g1619 (Published 19 February 2014) Cite this as: BMJ 2014;348:g1619
  1. Sarah Kiguli, consultant paediatrician1,
  2. Samuel O Akech, research fellow2,
  3. George Mtove, research fellow3,
  4. Robert O Opoka, consultant paediatrician1,
  5. Charles Engoru, consultant paediatrician4,
  6. Peter Olupot-Olupot, consultant paediatrician5,
  7. Richard Nyeko, consultant paediatrician6,
  8. Jennifer Evans, consultant paediatrician7,
  9. Jane Crawley, consultant paediatrician8,
  10. Natalie Prevatt, research fellow9,
  11. Hugh Reyburn, senior lecturer in clinical epidemiology10,
  12. Michael Levin, consultant paediatrician9,
  13. Elizabeth C George, statistician11,
  14. Annabelle South, policy, communications and research impact coordinator11,
  15. Abdel G Babiker, statistician11,
  16. Diana M Gibb, professor of epidemiology11,
  17. Kathryn Maitland, professor of tropical paediatric infectious disease9
  1. 1Department of Paediatrics, Mulago Hospital, Makerere University, Kampala, Uganda
  2. 2Kilifi Clinical Trials Facility, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
  3. 3Department of Paediatrics, Joint Malaria Programme, Teule Hospital, Muheza, Tanzania
  4. 4Department of Paediatrics, Soroti Regional Referral Hospital, Soroti, Uganda
  5. 5Department of Paediatrics, Mbale Regional Referral Hospital Pallisa Road, Mbale, Uganda
  6. 6Department of Paediatrics, St Mary’s Hospital, Lacor, Uganda
  7. 7Department of Paediatrics University Hospital of Wales Heath Park, Cardiff, UK
  8. 8Nuffield Department of Medicine, University of Oxford, Oxford, UK
  9. 9Wellcome Trust Centre for Clinical Tropical Medicine, Department of Paediatrics, Faculty of Medicine, St Mary’s Campus, London W2 1PG, UK
  10. 10Joint Malaria Programme, Moshi, Tanzania
  11. 11Medical Research Council Clinical Trials Unit, UCL, London, UK
  1. k.maitland{at}imperial.ac.uk

Southall made several points about our recent article.1 2

He suggests that “lethal hyperchloraemia” secondary to use of normal saline in FEAST (for boluses or maintenance) resulted in excess mortality. However, he did not comment on the key finding of the trial—that the increased 48 hour mortality was identical in both normal saline bolus (10.6%) and albumin bolus (10.6%) arms compared with the no bolus control group (7.3%).3 Harm was shown for every age group, in every condition, at each …

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