Imperial College London
Alternate

ProfessorKathMaitland

Faculty of Medicine, Department of Surgery & Cancer

Professor of Tropical Paediatric Infectious Disease
 
 
 
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Contact

 

k.maitland CV

 
 
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Location

 

Based full-time at KEMRI/Wellcome Programme, KenyaQueen Elizabeth and Queen Mary HospitalSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Houston:2019:10.1186/s12916-019-1356-z,
author = {Houston, KA and Gibb, J and Olupot-Olupot, P and Obonyo, N and Mpoya, A and Nakuya, M and Muhindo, R and Uyoga, S and Evans, JA and Connon, R and Gibb, DM and George, EC and Maitland, K},
doi = {10.1186/s12916-019-1356-z},
journal = {BMC Medicine},
title = {Gastroenteritis aggressive versus slow treatment for rehydration (GASTRO): a phase II rehydration trial for severe dehydration: WHO plan C versus slow rehydration},
url = {http://dx.doi.org/10.1186/s12916-019-1356-z},
volume = {17},
year = {2019}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BackgroundWorld Health Organization rehydration management guidelines (plan C) for severe dehydration are widely practiced in resource-poor settings, but never formally evaluated in a trial. The Fluid Expansion as a Supportive Therapy trial raised concerns regarding the safety of bolus therapy for septic shock, warranting a formal evaluation of rehydration therapy for gastroenteritis.MethodsA multi-centre open-label phase II randomised controlled trial evaluated two rehydration strategies in 122 Ugandan/Kenyan children aged 60 days to 12 years with severe dehydration secondary to gastroenteritis. We compared the safety and efficacy of standard rapid rehydration using Ringer’s lactate (100 ml/kg over 3 h (6 h if < 1 year), incorporating 0.9% saline boluses for children with shock (plan C) versus slower rehydration: 100 ml/kg Ringer’s lactate over 8 h (all ages) without boluses (slow: experimental). The primary outcome was the frequency of serious adverse events (SAE) within 48 h including cardiovascular, respiratory and neurological complications. Secondary outcomes included clinical, biochemical and physiological measures of response to treatment by intravenous rehydration.ResultsOne hundred twenty-two eligible children (median (IQR) age 8 (6–12) months) were randomised to plan C (n = 61) or slow (n = 61), with two (2%) lost to follow-up at day 7). Following randomisation mean (SD) time to start intravenous rehydration started was 15 min (18) in both arms. Mean (SD) fluid received by 1 hour was greater in plan C (mean 20.2 ml/kg (12.2) and 33.1 ml/kg (17) for children < 1 year and >− 1 year respectively) versus 10.4 ml/kg (6.6) in slow arm. By 8 hours volume received were similar mean (SD) plan C: 96.3 ml/kg (15.6) and 97.8 ml/kg (10.0) for children < 1 and ≥ 1 year respectively vs 93.2 ml/kg (12.2) in slow arm. By 48-h, three (5%) plan C vs two (3%) slow had an SAE
AU  - Houston,KA
AU  - Gibb,J
AU  - Olupot-Olupot,P
AU  - Obonyo,N
AU  - Mpoya,A
AU  - Nakuya,M
AU  - Muhindo,R
AU  - Uyoga,S
AU  - Evans,JA
AU  - Connon,R
AU  - Gibb,DM
AU  - George,EC
AU  - Maitland,K
DO  - 10.1186/s12916-019-1356-z
PY  - 2019///
SN  - 1741-7015
TI  - Gastroenteritis aggressive versus slow treatment for rehydration (GASTRO): a phase II rehydration trial for severe dehydration: WHO plan C versus slow rehydration
T2  - BMC Medicine
UR  - http://dx.doi.org/10.1186/s12916-019-1356-z
UR  - http://hdl.handle.net/10044/1/70728
VL  - 17
ER  -
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