Evidence map›Paper›PMID 28905004›Full record

ArticleWellcome open research2017

Gastroenteritis Aggressive Versus Slow Treatment For Rehydration (GASTRO). A pilot rehydration study for severe dehydration: WHO plan C versus slower rehydration.

Kirsty A Houston, Jack G Gibb, Ayub Mpoya, Nchafatso Obonyo, Peter Olupot-Olupot, Margeret Nakuya, Jennifer A Evans, Elizabeth C George, Diana M Gibb, Kathryn Maitland

Open access · goldAbstract read
In one paragraph

Article in Wellcome open research, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact, top 90% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 3 citations in OpenAlex.

  1. Trial
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 5 institutions in 3 countries.

Kirsty A HoustonKEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.
Jack G GibbKEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.
Ayub MpoyaKEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.
Nchafatso ObonyoKEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.
Peter Olupot-OlupotMbale Regional Referral Hospital, Mbale, Uganda.
Margeret NakuyaSoroti Regional Referral Hospital, Soroti, Uganda.
Jennifer A EvansDepartment of Paediatrics , University Hospital of Wales, Cardiff, UK.
Elizabeth C GeorgeMedical Research Council (MRC) Clinical Trials Unit, University College London, London, UK.
Diana M GibbMedical Research Council (MRC) Clinical Trials Unit, University College London, London, UK.
Kathryn MaitlandKEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.ORCID https://orcid.org/0000-0002-0007-0645
Kenya Medical Research Institute · KEMRC Clinical Trials Unit at UCL · GBMbale Hospital · UGSoroti Hospital · UGUniversity Hospital of Wales · GB

Funding

Medical Research Council G0601027Wellcome Trust
6 · The paper itself

Abstract

backgroundThe World Health Organization (WHO) rehydration management guidelines (Plan C) for children with acute gastroenteritis (AGE) and severe dehydration are widely practiced in resource-poor settings, yet have never been formally evaluated in a clinical trial. A recent audit of outcome of AGE at Kilifi County Hospital, Kenya noted that 10% of children required high dependency care (20% mortality) and a number developed fluid-related complications. The fluid resuscitation trial, FEAST, conducted in African children with severe febrile illness, demonstrated higher mortality with fluid bolus therapy and raised concerns regarding the safety of rapid intravenous rehydration therapy. Those findings warrant a detailed physiological study of children's responses to rehydration therapy incorporating quantification of myocardial performance and haemodynamic changes.  Methods: GASTRO is a multi-centre, unblinded Phase II randomised controlled trial of 120 children aged 2 months to 12 years admitted to hospital with severe dehydration secondary to AGE. Children with severe malnutrition, chronic diarrhoea and congenital/rheumatic heart disease are excluded. Children will be enrolled over 18 months in 3 centres in Kenya and Uganda and followed until 7 days post-discharge. The trial will randomise children 1:1 to standard rapid rehydration using Ringers Lactate  (WHO plan 'C' - 100mls/kg over 3-6 hours according to age, plus additional 0.9% saline boluses for children presenting in shock) or to a slower rehydration regimen (100mls/kg given over 8 hours and without the addition of fluid boluses). Enrolment started in November 2016 and is on-going. Primary outcome is frequency of adverse events, particularly related to cardiovascular compromise and neurological sequelae.  Secondary outcomes focus on clinical, biochemical, and physiological measures related to assessment of severity of dehydration, and response to treatment by intravenous rehydration. DISCUSSION: Results from this pilot will contribute to generating robust definitions of outcomes (in particular for non-mortality endpoints) for a larger Phase III trial.

Indexed as

acute gastroenteritischildrendehydrationintravenous fluidsWHO

Identifiers

PMID28905004
PMCPMC5571888
OpenAlexW2742226170

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.