Routine Treatment for Shock Kills 3 Out of 100 Children

The routine intravenous administration of fluids to children in shock is killing them. It had never been tested before now—just presumed to be beneficial. How many thousands of children have died for that presumption?

by Heidi Stevenson

27 May 2011

If your child is severely ill with a high fever, you need to know that the standard treatment, injection of fluids, has been killing them. Over the years, thousands, if not millions, of children have probably been killed by the routine approach of giving intravenous fluids to children in shock.

Sick feverish children who arrive in hospitals so ill that they're in shock are routinely given intravenous liquids, a bolus dose to counteract the dehydration that is common in such situations. It has never been studied to see if such treatment is effective. In spite of the claim that modern medicine is evidence-based, the simple fact is that this treatment had never been tested before.

So, without ever bothering to do a study to test the approach, doctors in emergency situations routinely give intravenous injections of fluids to feverish children in shock—and they have simply assumed that it was beneficial. Now, a humble study done by African doctors, who frequently face the situation, has shown that it's killing about 3 out of a hundred children treated with these boluses.

Before continuing, it should be made clear that there are exceptions to this rule. In some conditions, such as cholera and other diarrheal diseases, the situation is different. In these cases, death is induced by loss of fluids, so the primary treatment is restoration of the lost fluids.

Shock

Shock is a critical medical condition. It is an acute failure of the circulatory system to bring oxygen to most of the body. Fainting is a typical symptom. Naturally, there can be signicant loss of fluids in the event of high fevers. So, the logic—such as it is—has been that forcing fluids into the circulatory system will replace what nature is missing. It is, of course, hubris to presume to know better than millions of years of evolution or the designs of God, whichever view you take. But then, what would modern medicine be without hubris?

Shock slows circulation. Here is how a popular website that promotes modern medicine explains their view:

Think of the cardiovascular system of the body as similar to the oil pump in your car. For efficient functioning, the electrical pump needs to work to pump the oil, there needs to be enough oil, and the oil lines need to be intact. If any of these components fail, oil pressure falls and the engine may be damaged. In the body, if the heart, blood vessels, or bloodstream (circulation) fail, then the body fails.⁽¹⁾

There's just one problem with the analogy. Human beings are not automobiles. Hearts are not oil pumps. And the circulatory system in humans is not analogous to oil lines in cars. Even if the analogy were valid, there is another significant point that's being missed: Refilling the car's circulatory system with oil does not resolve the underlying problem of why the car has lost oil.

The Study

The study, "Mortality after Fluid Bolus in African Children with Severe Infection", just published in the New England Journal of Medicine,⁽²⁾ was performed by African doctors in Africa. Rather humorously, funding came from the UK's Medical Research Council and Big Pharma's Baxter Healthcare, which provided the resuscitation fluids that the study demonstrated do far more harm than good.

The results were conclusive: About 33 children out of a thousand are killed by the boluses! Of the children who survived, there was no statistical difference in neurological damage between those who received boluses and those who didn't. It also made no difference whether the bolus received was saline-based or albumin-based.

As is so common in most medical journal reports that run counter to the prevailing paradigm, the authors' conclusion was rather mild:

In conclusion, the results of this study challenge the importance of bolus resuscitation as a lifesaving intervention in resource-limited settings for children with shock who do not have hypotension and raise questions regarding fluid-resuscitation guidelines in other settings as well.

What's neatly sidestepped is just how thoroughly the study demonstrates how deeply flawed the modern medical paradigm is. Evidence based medicine clearly isn't evidence based.

That old canard about "evidence-based medicine" is once again shown for what it is: nice-sounding words to promote a system of medicine that is based on a failed paradigm.

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