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Fluids in the management of sepsis in children: a review of guidelines in the aftermath of the FEAST trial
  1. Juan Emmanuel Dewez1,
  2. Ruud Gerard Nijman2,
  3. Shunmay Yeung1,2
  1. 1 Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK
  2. 2 Department of Paediatrics, Imperial College Healthcare NHS Trust, London, UK
  1. Correspondence to Dr Juan Emmanuel Dewez, Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK; manuel.dewez{at}

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A recent editorial discusses how the Fluid Expansion as Supportive Therapy (FEAST) trial,1 the only phase III randomised controlled trial assessing fluid bolus therapy (FBT) in severely ill African children, had little impact on guidelines despite the increased mortality risk in children receiving FBT. The editorial mentions the 2013 WHO guideline which partially considers the FEAST trial results, and the 2014 American College of Critical Care Medicine guideline which does not.

We reviewed paediatric sepsis guidelines from the USA, the Surviving Sepsis Campaign and …

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  • Contributors JED, RGN and SY conceptualised the literature review. JED and RGN conducted the search, the data extraction and data synthesis. JED, RGN and SY wrote the letter.

  • Funding This project has received funding from the European Union’s Horizon 2020 research and innovation programme under Grant Agreement No. 668303.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Patient consent for publication Not required.

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