Phase III trials required to resolve clinical equipoise over optimal fluid management in children with severe malaria
2007

Fluid Management in Children with Severe Malaria

Sample size: 238 publication Evidence: moderate

Author Information

Author(s): Kathryn Maitland, Samuel Akech, Samson Gwer, Richard Idro, Greg Fegan, Alice C. Eziefula, Charles R. J. C. Newton, Michael Levin

Primary Institution: Center for Geographic Medicine Research (Coast), Kenya Medical Research Institute, Kilif, Kenya

Hypothesis

Administration of colloids such as human albumin solution with volume expansion would help to retain fluid in the intravascular compartment and may also improve endothelial function.

Conclusion

The study suggests that albumin is more beneficial than Gelofusine for volume expansion in children with severe malaria.

Supporting Evidence

  • Albumin administration was associated with a lower mortality than saline.
  • Gelofusine was linked to more deaths and severe allergic reactions compared to albumin.
  • The study included 238 children receiving volume expansion.

Takeaway

This study looked at how to help very sick children with malaria by giving them fluids. It found that a special fluid called albumin is better than a cheaper option.

Methodology

The study involved randomized trials to assess the safety and response to volume expansion using different fluids.

Limitations

The small phase II study was not powered to prove that Gelofusine was superior to saline or albumin.

Participant Demographics

Children with severe malaria.

Digital Object Identifier (DOI)

10.1371/journal.pctr.0020002

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