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How, if at all, has the FEAST Trial affected your fluid management strategy?
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Fluid Bolus
Started by turkeyjerky
It has certainly made me more judicious in using large volume fluid resuscitation in all of my pediatric patients with septic shock in sub-Saharan Africa. We should always be cautious in extrapolating results from a study to populations other than that which was studied. In particular, the causative agents of septic shock are likely to be significantly different between sub-Saharan Africa and Washington, DC, where I practice. Also, the baseline health of the patients prior to illness is likely quite different. 92.7% survival versus 89.4% is small enough (even if it is statistically significant) that I wouldn't feel comfortable generalizing the results to my patient population.
- Erick
- Erick
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Not a single iota.
While the headline got my attention initially, after I had looked through the study, I realized that it was not relevant to my practice as a pediatrician at a hospital that has a high volume, well staffed, high acuity PICU. Really, anywhere in the US this study has no relevance.
While the headline got my attention initially, after I had looked through the study, I realized that it was not relevant to my practice as a pediatrician at a hospital that has a high volume, well staffed, high acuity PICU. Really, anywhere in the US this study has no relevance.
D
deleted109597
The only group I would possibly change management of here in the States is the septic sickler/cancer/anemic patient. Otherwise no extrapolation.
As others have stated, this study is not generalizable to the population most of us take care of-- there might be great internal validity, but external validity is just not there. This is classic epidemiology in action. The only way to decide whether a study is generalizable is to use your existing knowledge base of the subject at hand. The group studied and our groups are not exchangeable.
The take home of that study was if you are sick from malaria, fluid doesn't help your mortality (but Mefloquine might)
