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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

Please visit: http://www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children’s Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open-access thus at no expense to the user. For further information on how to enroll, please email: openpediatrics@childrens.harvard.edu


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.

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