SynthesisBMJ (Clinical research ed.)2010
Choice of fluids for resuscitation in children with severe infection and shock: systematic review.
Synthesis in BMJ (Clinical research ed.), 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
25 citing papers in PubMed, 4 syntheses or guidelines pooled it, 86 citations in OpenAlex.
- Fluid resuscitation in children with severe infection and septic shock: a systematic review and meta-analysis.European journal of pediatrics · 2024Pooled it
- Dengue haemorrhagic fever or dengue shock syndrome in children.BMJ clinical evidence · 2015Pooled it
- Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock, 2012.Intensive care medicine · 2013Guideline
- Mortality after fluid bolus in children with shock due to sepsis or severe infection: a systematic review and meta-analysis.PloS one · 2012Pooled it
- Preoperative Risk Factors for Predicting Postoperative Human Serum Albumin Infusion after Hip Fracture Surgery: Development and Validation of a NomogramBalkan medical journal · 2023Trial
- The Ultimate Buzzkill: When Dengue Hits Hard.Cureus · 2025Article
- Review
- Parents' prioritised outcomes for trials investigating treatments for paediatric severe infection: a qualitative synthesis.Archives of disease in childhood · 2019Article
- Fluid Bolus Therapy in Pediatric Sepsis: Current Knowledge and Future Direction.Frontiers in pediatrics · 2018Review
- Haemodynamic assessment and support in sepsis and septic shock in resource-limited settings.Transactions of the Royal Society of Tropical Medicine and Hygiene · 2017Review
- Effects of volume resuscitation on the microcirculation in animal models of lipopolysaccharide sepsis: a systematic review.Intensive care medicine experimental · 2016Review
- Cross-Sectional Guidelines for Therapy with Blood Components and Plasma Derivatives: Chapter 5 Human Albumin - Revised.Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie · 2016Article
- Continuous renal replacement therapy in children: fluid overload does not always predict mortality.Pediatric nephrology (Berlin, Germany) · 2016Article
- Management of severe paediatric malaria in resource-limited settings.BMC medicine · 2015Review
- Fluid management of shock in severe malnutrition: what is the evidence for current guidelines and what lessons have been learned from clinical studies and trials in other pediatric populations?Food and nutrition bulletin · 2014Review
- WHO guidelines on fluid resuscitation in children: missing the FEAST data.BMJ (Clinical research ed.) · 2014Article
- Pathophysiology and management of septic acute kidney injury.Pediatric nephrology (Berlin, Germany) · 2014Review
- After the FEAST--fluid resuscitation in pediatric sepsis.Indian journal of pediatrics · 2013Article
- Cardiac function in Ghanaian children with severe malaria.Intensive care medicine · 2012Article
- Recommendations for sepsis management in resource-limited settings.Intensive care medicine · 2012Review
Corrections and comments
- Commented on by
Authors and funding
3 authors at 2 institutions in 2 countries.
Funding
Abstract
objectiveTo systemically review the evidence from clinical trials comparing the use of crystalloids and colloids for fluid resuscitation in children with severe infection. DATA SOURCES: Medline (1950-2008), PubMed, the Cochrane Library, Embase (1980-2008), and reference lists. Eligibility criteria Published studies comparing fluid resuscitation with crystalloid or colloidal solutions in severe infectious illness in children aged >1 month to <or=12 years. Controlled trials and randomised controlled trials were separately selected by two unblinded investigators who also independently extracted data.
main outcome measuresEfficacy in the treatment of shock, mortality, and reported adverse events.
resultsNine trials fulfilled criteria, eight of which compared crystalloids with colloids. All trials were conducted in settings with poor resources and predominantly included patients with malaria or dengue haemorrhagic shock. None of the trials had mortality as a primary outcome. Three out of six studies that reported at least one death showed better survival in children resuscitated with colloids compared with crystalloids (Peto fixed odds ratio ranging from 0.18 (95% confidence interval 0.02 to 1.42) to 0.48 (0.06 to 3.99)). Studies contributing data on mortality had some methodological limitations so caution is recommended when interpreting this finding. Studies were heterogeneous so combined estimates were not calculated. The review was limited by inclusion of only published studies.
conclusionsThe current evidence on choice of fluids for resuscitation in children with infections is weak. While existing trials have provided important evidence in malaria and dengue, resuscitation in children with paediatric sepsis, for which colloids could theoretically be of benefit, has not been studied. The evidence from existing studies is not robust enough to make any definitive recommendations over the choice of resuscitation fluid and a definitive trial is required to address this.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.