In this World Shared Practice Forum Podcast, Dr. Kathryn Maitland discusses the findings of the GASTROSAM trial, which investigates the safety and efficacy of intravenous rehydration for children with severe acute malnutrition and gastroenteritis. The trial explores the effectiveness of intravenous fluids as a safe alternative to current rehydration guidelines for malnourished children. Dr. Maitland reviews the trial’s design, key outcomes, and implications for clinical practice, providing valuable insights for healthcare professionals involved in pediatric care in resource-limited settings.

LEARNING OBJECTIVES

- Understand the key findings of the GASTROSAM trial and their implications for rehydration practices in children with severe acute malnutrition.

- Identify the challenges and limitations of current rehydration guidelines for malnourished children in resource-limited settings.

- Discuss the safety concerns associated with intravenous rehydration and how the GASTROSAM trial addresses these issues.

- Explore the importance of simplifying the rehydration guidelines for children in resource-limited settings

AUTHORS

Kathryn Maitland, FMedSc, OBE

Professor of Tropical Paediatric Infectious Disease

Department of Surgery & Cancer

Faculty of Medicine

Director of ICCARE Centre at the Institute for Global Health Innovation,

Imperial College, London

Jeffrey Burns, MD, MPH

Emeritus Chief

Division of Critical Care Medicine

Department of Anesthesiology, Critical Care and Pain Medicine

Boston Children's Hospital

Professor of Anesthesia

Harvard Medical School

DATE

Initial publication date: September 22, 2025.

ARTICLES REFERENCED

- Maitland K, Ouattara SM, Sainna H, et al. Intravenous Rehydration for Severe Acute Malnutrition with Gastroenteritis. N Engl J Med. Published online June 13, 2025. doi:10.1056/NEJMoa2505752

- Maitland K, Kiguli S, Opoka RO, et al. Mortality after fluid bolus in African children with severe infection. N Engl J Med. 2011;364(26):2483-2495. doi:10.1056/NEJMoa1101549

- Brent B, Obonyo N, Akech S, et al. Assessment of Myocardial Function in Kenyan Children With Severe, Acute Malnutrition: The Cardiac Physiology in Malnutrition (CAPMAL) Study. JAMA Netw Open. 2019;2(3):e191054. Published 2019 Mar 1. doi:10.1001/jamanetworkopen.2019.1054

TRANSCRIPT

https://cdn.bfldr.com/D6LGWP8S/at/xvv7vchn4skmc6m6wv25xfw/UPDATED_202509_WSP_Maitland_Transcript.pdf

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CITATION

Maitland K, Burns JP. GASTROSAM Key Insights: Safe Rehydration for Malnourished Children. 09/2025. OPENPediatrics. Online Podcast. https://soundcloud.com/openpediatrics/gastrosam-key-insights-safe-rehydration-for-malnourished-children-by-k-maitland-openpediatrics.