Randomized controlled trial of interventions for treatment of shock in children with severe acute malnutrition and cholera or other dehydrating diarrhoeas

Children suffering from severe acute malnutrition (SAM) have an increased risk of death when they have cholera. They often present with shock, where the blood circulation becomes very poor. This can happen due to severe dehydration resulting from cholera or from severe sepsis. Differentiating between severe dehydration and shock due to severe sepsis is challenging. Some hospitals use dopamine to raise blood pressure after a child has not responded to intravenous fluids, but WHO recommends blood transfusion. 

We will conduct a clinical trial in children with SAM and shock due to cholera or severe sepsis at the ICDDRB Hospital Hospital in Dhaka. A total of 174 eligible children with informed consent from parents will be randomised to either dopamine or blood transfusion. Recovery from shock will be compared between the two treatments. 

The results will clarify the treatment of SAM and shock and save thousands of children’s lives worldwide.