Joint BAPEN and Nutrition Society Symposium on 'Feeding size 0: the science of starvation'. Severe malnutrition: therapeutic challenges and treatment of hypovolaemic shock.
The systematic failure to recognise and appropriately treat children with severe malnutrition has been attributed to the elevated case-fatality rates, often as high as 50%, that still prevail in many hospitals in Africa. Children admitted to Kilifi District Hospital, on the coast of Kenya, with severe malnutrition frequently have life-threatening features and complications, many of which are not adequately identified or treated by WHO guidelines. Four main areas have been identified for research: early identification and better supportive care of sepsis; evidence-based fluid management strategies; improved antimicrobial treatment; rational use of nutritional strategies. The present paper focuses on the identification of children with sepsis and on fluid management strategies.
Maitland
Kathryn
K
KEMRI-Wellcome Trust Programme, Kilifi, Kenya. kmaitland@kilifi.kemri-wellcome.org
D002648:Child; D005440:Fluid Therapy / Q000379:methods*; D006801:Humans; D007630:Kenya; D018529:Nutritional Support; D017410:Practice Guidelines as Topic; D011502:Protein-Energy Malnutrition / Q000150:complications / Q000401:mortality / Q000628:therapy*; D016032:Randomized Controlled Trials as Topic; D018805:Sepsis / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D012769:Shock / Q000209:etiology / Q000628:therapy*; D013217:Starvation / Q000150:complications / Q000401:mortality / Q000628:therapy*