FEAST or famine
The dangers of dehydration are well recognized. What about over-hydration? Too much fluid can kill as surely as too little. The FEAST ( F luid E xpansion A s S upportive T herapy) Study reported in the New England Journal of Medicine in 2011 changed the conventional thinking on how to hydrate a sick child. Over 3000 seriously ill African children with fever and poor blood circulation were treated with different intravenous fluid regimes on arrival at hospital. The 48-hour mortality was 3.3% higher in children treated with a larger fluid volume. This might not seem like much but 3.3% of the half of the 3000 children who received the extra fluids equals 50 children! The children died due to cardiac collapse 2 to 11 hours after treatment with the higher volume of intravenous fluids. The children admitted with malaria at the MSF hospital in Kenema already have a stressed heart when they arrive. The parasite breaks down red blood cells which clump up and narrow the corona...