UK researchers warned that thousands of children could be dying since the World Health Organization has not updated guidelines for treating children going into shock.
Critics claimed the advice to give large quantities of fluid was deadly, and found it "disappointing and puzzling” that the last update published in 2013 did not recommend a change.
In response, the WHO stated it had to be very vigilant when changing guidelines and that they were working towards publication of a new set of interim guidelines by early 2015.
Severe infections such as malaria, or fluid loss could cause critically ill patients to go into shock which changes the way blood flows around the body, resulting in patients looking pale.
The currently recommended treatment is "rapid fluid resuscitation", meaning a large injection of fluid via a drip.
While this brings children out of shock, findings of a 2011 study suggested it was also deadly. In comparison to children slowly given small quantities of fluid, three more children out of every 100 treated would die with fluid resuscitation.
Further underlining the claim, the report mentioned that in those with the most severe shock, 48% died with the resuscitation compared with 20% given the low fluid doses.
Prof Kathryn Maitland, a paediatrician with the Medical Research Council and Imperial College London, was concerned that almost three years after the report, the WHO still had not updated the guidelines.
Maitland added that there was a lack of data on the precise number children being diagnosed with shock, but that if hospitals followed the guidelines, there would be excess mortality, potentially running into thousands.
The WHO said the study was published shortly before the last update completion and that systematically assessing all the evidence on managing shock would have delayed the other guidelines.
Dr Elizabeth Mason, the WHO's director of maternal, newborn, child and adolescent health, described it as a rather difficult judgement, justified by the WHO not making decisions based on one study alone, even if it was fairly groundbreaking.
She concluded that the World Health Organisation had to be very vigilant in making recommendations, and that a systematic review of the evidence was required. Alternatively, WHO guidelines would be changed in the wake of every new study.
What is your opinion on this? Should the study findings have been taken into consideration? Let us know by commenting below.
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14 January 2014