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They were a very high risk group, accounting for about 10% of all deaths in the trial; 24/50 (48%) of children who received boluses died within 48 hours compared with 3/15 (20%) of control children meeting WHO criteria12 an absolute increase in risk of 28% and relative risk of 240% (P=0.07 pandora necklaces, two sided Fisher’s exact test). Although the FEAST trial was not powered to detect differences between arms for children in the WHO defined shock, a basic principle of clinical trials is that subgroup results should be interpreted within the context of the overall trial results, which provide a more reliable assessment of the effect of the intervention than an analysis restricted to patients in the subgroup.16 17 The result in the subgroup is consistent with the overall result.Concern has also been expressed about the consequences of not giving bolus fluids to children with moderate hypotension and severe dehydration. Again, FEAST was not powered to detect differences in these subgroups, but the results are consistent with harm from use of bolus resuscitation.12In children with hypotension (defined in FEAST as systolic blood pressure 50 75, 60 75, and 70 85 mm Hg in children aged 5 years respectively https://www.pandorajewelryuk.com/, in line with clinical use) there was a trend towards increased mortality in the bolus arms (absolute difference 9.4%, 95% confidence interval 2.6% to 21.4%).
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