Observational studyCritical care (London, England)2015
A positive fluid balance is an independent prognostic factor in patients with sepsis.
Observational study in Critical care (London, England), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 225 papers, 10 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.
Association of Respiratory Variation of Superior Vena Cava in Transthoracic View and Fluid Responsiveness in Critically Ill Patients
VEXUS-REA : Evaluation of Ultrasound Parameters of Venous Congestion in Patients in a Medical Intensive Care Unit
Who cites it
225 citing papers in PubMed, 10 syntheses or guidelines pooled it, 482 citations in OpenAlex.
- Fluid balance and mortality in adult ICU patients with sepsis or septic shock: a systematic review and meta-analysis of observational studies.BMC anesthesiology · 2025Pooled it
- Is restriction of intravenous fluid beneficial for septic shock in ICU patients? A meta-analysis of randomized controlled trials.BMC anesthesiology · 2025Pooled it
- Changes in pulse pressure variation induced by passive leg raising test to predict preload responsiveness in mechanically ventilated patients with low tidal volume in ICU: a systematic review and meta-analysis.Critical care (London, England) · 2025Pooled it
- Physical and Chemical Compatibility of Medications Commonly Used in Critically Ill Patients With Balanced Crystalloids: A Systematic Review.The Annals of pharmacotherapy · 2024Pooled it
- Study based on bibliometric analysis: potential research trends in fluid management for sepsis.Frontiers in medicine · 2024Pooled it
- Pooled it
- Value of variation of end-tidal carbon dioxide for predicting fluid responsiveness during the passive leg raising test in patients with mechanical ventilation: a systematic review and meta-analysis.Critical care (London, England) · 2022Pooled it
- [S3 Guideline Sepsis-prevention, diagnosis, therapy, and aftercare : Long version].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2020Guideline
- Liberal Versus Restrictive Intravenous Fluid Therapy for Early Septic Shock: Rationale for a Randomized Trial.Annals of emergency medicine · 2018Pooled it
- Association Between Fluid Balance and Outcomes in Critically Ill Children: A Systematic Review and Meta-analysis.JAMA pediatrics · 2018Pooled it
- Deresuscitation Informed by Ultrasound in Patients With Septic Shock Trial: A Pilot Randomized Controlled Study.Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine · 2026Trial
- Effects of dynamic versus static parameter-guided fluid resuscitation in patients with sepsis: A randomized controlled trial.F1000Research · 2024Trial
- Fluid balance control in critically ill patients: results from as-treated analyses of POINCARE-2 randomized trial.Critical care (London, England) · 2023Trial
- Fluid balance control in critically ill patients: results from POINCARE-2 stepped wedge cluster-randomized trial.Critical care (London, England) · 2023Trial
- Early Restrictive or Liberal Fluid Management for Sepsis-Induced Hypotension.The New England journal of medicine · 2023Trial
- Non-interventional follow-up versus fluid bolus in RESPONSE to oliguria in hemodynamically stable critically ill patients: a randomized controlled pilot trial.Critical care (London, England) · 2022Trial
- Diuretics decrease fluid balance in patients on invasive mechanical ventilation: the randomized-controlled single blind, IRIHS study.Critical care (London, England) · 2021Trial
- Trial
- Effects of very early start of norepinephrine in patients with septic shock: a propensity score-based analysis.Critical care (London, England) · 2020Trial
- Restricted fluid resuscitation in suspected sepsis associated hypotension (REFRESH): a pilot randomised controlled trial.Intensive care medicine · 2018Trial
165 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionIntravenous fluid administration is an essential component of sepsis management, but a positive fluid balance has been associated with worse prognosis. We analyzed whether a positive fluid balance and its persistence over time was an independent prognostic factor in septic patients.
methodsWe prospectively studied fluid intake and output for 7 days in 173 consecutive adult patients treated for sepsis in our Department of Intensive Care.
resultsOf the 173 patients, 59 died (34 %). Mean daily fluid intake was higher in non-survivors than in survivors (59 ± 24 ml/kg vs. 48 ± 23 ml/kg, p = 0.03), but output volumes were similar. As a result, the daily fluid balance was more than twice as large in the non-survivors as in the survivors (29 ± 22 vs. 13 ± 19 ml/kg, p <0.001). Persistence of a positive fluid balance over time was associated with increased mortality. Using a multivariable time-dependent Cox model, a positive fluid balance was independently associated with higher mortality (adjusted hazard ratio 1.014 [1.007-1.022] per ml/kg increase, p <0.001).
conclusionsPersistence of a positive daily fluid balance over time was quite strongly associated with a higher mortality rate in septic patients.
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.