Fluid Expansion As Supportive Therapy in critically ill African children (FEAST)

FEAST试验是一项针对非洲重症儿童的大型随机对照试验，旨在检验在入院时在标准病例管理中加入快速输液是否比单独使用标准管理能提高生存率。在撒哈拉以南非洲，儿童严重感染的住院病死率保持在15-30%。在这个地区，每年有100多万儿童死于医院的严重感染。目前，抗疟药物和抗微生物药物是治疗的主要手段，然而，由于严重疾病的并发症，大多数死亡发生在早期，并且在确定的治疗有时间采取行动之前。在这种情况下，医生必须依靠支持性治疗来治疗并发症，以改善结果。由于缺乏临床研究，确定哪些是最好的挽救生命的治疗方法一直很困难。快速补液以纠正体液不足是一种标准的支持性治疗，是重症儿童紧急管理的常规做法。目前，仍然不愿采用这种方法，因此在非洲医院，儿童的护理液很少或没有额外的液。如果快速输液的益处得到证实，那么FEAST试验每年可能挽救数千名幼儿的生命。

FEAST trial is a large randomised controlled trial in African children with severe illness examining whether the addition of rapid fluid infusion at hospital admission to standard case management improves survival compared to standard management alone. In sub-Saharan Africa case fatality rates in hospital for severe infections in children remains at 15-30%. In this region well over a million children die of severe infection in hospital each year. Currently, antimalarial and antimicrobial drugs are the mainstay of treatment, however most deaths occur early, due to the complications of severe illness, and before definitive treatments have time to act. In this situation doctors have to rely upon supportive therapies to treat complications to try to improve outcome. Defining which are the best life-saving treatments has been frustrated by the lack of clinical studies. Rapid fluid infusion to correct fluid deficits is a standard supportive treatment and practised routinely for the emergency management of children with severe illness. Currently, reticence to adopt this approach remains and thus in African hospitals children are managed with little fluid or no additional fluid. If the benefits of rapid fluid infusion were shown, then FEAST trial could potentially save thousands of lives of young children annually.