Open Access Research article

Exploring mechanisms of excess mortality with early fluid resuscitation: insights from the FEAST trial

Kathryn Maitland12*, Elizabeth C George3, Jennifer A Evans4, Sarah Kiguli5, Peter Olupot-Olupot6, Samuel O Akech2, Robert O Opoka5, Charles Engoru7, Richard Nyeko8, George Mtove9, Hugh Reyburn109, Bernadette Brent12, Julius Nteziyaremye6, Ayub Mpoya2, Natalie Prevatt1, Cornelius M Dambisya6, Daniel Semakula5, Ahmed Ddungu5, Vicent Okuuny7, Ronald Wokulira7, Molline Timbwa2, Benedict Otii8, Michael Levin1, Jane Crawley3, Abdel G Babiker3, Diana M Gibb3 and for the FEAST trial group

Author Affiliations

1 Wellcome Trust Centre for Clinical Tropical Medicine, Department of Paediatrics, Faculty of Medicine, St Marys Campus, Norfolk Place, Imperial College, London W2 1PG, UK

2 Kilifi Clinical Trials Facility, KEMRI-Wellcome Trust Research Programme, PO Box 230, Kilifi, Kenya

3 Medical Research Council (MRC) Clinical Trials Unit, Aviation House, 125 Kingsway London, WC2B 6NH, UK

4 Department of Paediatrics University Hospital of Wales Heath Park, Cardiff, CF14 4XW, Wales, UK

5 Department of Paediatrics, Mulago Hospital, PO Box 7070, Makerere University, Kampala, Uganda

6 Department of Paediatrics, Mbale Regional Referral Hospital Pallisa Road Zone, PO Box 921, Mbale, Uganda

7 Department of Paediatrics, Soroti Regional Referral Hospital, PO Box 289, Soroti, Uganda

8 Department of Paediatrics, St Mary's Hospital, PO Box 180, Lacor, Uganda

9 Department of Paediatrics Joint Malaria Programme, Teule Hospital, PO Box 81, Muheza, Tanzania

10 Joint Malaria Programme, PO Box 2228, KCMC, Moshi, Tanzania

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BMC Medicine 2013, 11:68  doi:10.1186/1741-7015-11-68


See related article: http://www.biomedcentral.com/1741-7015/11/67

Published: 14 March 2013

Additional files

Additional file 1:

Figure S1: Box and whisker plots and bar charts of bedside vital status observations, oxygen saturation and hypoglycemia by arm (fluid arms combined) versus control arm. Table S1: Admission presentation syndromes by randomization arm (FEAST A only). Figure S2 : Hazard ratios and 95% confidence intervals of boluses compared to no bolus for mortality over different levels of oxygen saturation at baseline. Figure S3: Hazard ratios and 95% confidence intervals for boluses compared to no bolus for mortality over different levels of hemoglobin at baseline. Table S2: Terminal clinical events for 297 children that died within 48 hours by baseline presentation. Figure S4a: Cumulative incidence for bolus and no-bolus arms by cardiogenic only, neurological only or respiratory only terminal clinical events. Figure S4b: Cumulative incidence by bolus versus no bolus for combined causes: respiratory and neurological, cardiogenic and neurological, and unknown or other terminal clinical events. Table S3a: Terminal clinical event by 48 hours by randomization arm (bolus versus no bolus) and by whether they were enrolled before or after the protocol amendment. Table S3b: Terminal clinical event by 48 hours by randomization arm (bolus versus no bolus) by malaria status. Table S3c: Terminal clinical events in those with anemia and those without anemia at baseline. Percentages are out of all those enrolled in that arm within the anemia group or non-anemia group (totals are at the top of each column). Table S4a: Mortality at 48 hours with and without persisting features of shock at one hour. Table S4b: Mortality at 48 hours in those with or without hypoxia at baseline.

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