Evidence map›Paper›PMID 26690683›Full record

Trial reportTrials2015

Fluid loading in abdominal surgery - saline versus hydroxyethyl starch (FLASH Trial): study protocol for a randomized controlled trial.

Emmanuel Futier, Matthieu Biais, Thomas Godet, Lise Bernard, Christine Rolhion, Justine Bourdier, Dominique Morand, Bruno Pereira, Samir Jaber, FLASH trial management committee

Registry-linked trialOpen access · goldAbstract readComparative StudyMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in Trials, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02502773 (Fluid Loading in Abdominal Surgery), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.6field-weighted citation impact, top 28% of its field
1 · What the graph read from 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.

2 · The registry

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.

NCT02502773 phase3completednot on this mapstarted 2016, after this paper: background citation

Fluid Loading in Abdominal Surgery: Saline Versus Hydroxyethyl Starch: A Double-blinded Multicenter Prospective Randomized Trial (FLASH Study)

TypeinterventionalSponsorUniversity Hospital, Clermont-FerrandRan2016 to 2018Enrolled826ConditionsPostoperative Morbidity, Postoperative MortalityArmsHydroxethyl starch
3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 8 citations in OpenAlex.

  1. Trial
  2. Trial
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 3 institutions in 1 country.

Emmanuel FutierCHU de Clermont-Ferrand, Département Anesthésie et Réanimation, Pôle Médecine Périopératoire (MPO), Hôpital Estaing, 1 place Lucie Aubrac, 63001, Clermont-Ferrand cedex 1, France. efutier@chu-clermontferrand.fr.
Matthieu BiaisCHU de Bordeaux, Service Anesthésie et Réanimation III, Unité de Neuro-Réanimation, Hôpital Pellegrin, Tripode, Bordeaux, F-33076, France. matthieu.biais@chu-bordeaux.fr.
Thomas GodetCHU de Clermont-Ferrand, Département Anesthésie et Réanimation, Pôle Médecine Périopératoire (MPO), Hôpital Estaing, 1 place Lucie Aubrac, 63001, Clermont-Ferrand cedex 1, France. tgodet@chu-clermontferrand.fr.
Lise BernardCHU de Clermont-Ferrand, Pôle Pharmacie, et EA 467 C-BIOSENSS, BP 10448, Clermont-Ferrand, F-63003, France. l_bernard@chu-clermontferrand.fr.
Christine RolhionCHU de Clermont-Ferrand, Direction de la Recherche Clinique (DRCI), Clermont-Ferrand, F-63003, France. crolhion@chu-clermontferrand.fr.
Justine BourdierCHU de Clermont-Ferrand, Direction de la Recherche Clinique (DRCI), Clermont-Ferrand, F-63003, France. jbourdier@chu-clermontferrand.fr.
Dominique MorandCHU de Clermont-Ferrand, Direction de la Recherche Clinique (DRCI), Clermont-Ferrand, F-63003, France. dmorand@chu-clermontferrand.fr.
Bruno PereiraCHU de Clermont-Ferrand, Biostatistics unit, Direction de la Recherche Clinique (DRCI), Clermont-Ferrand, F-63003, France. bpereira@chu-clermontferrand.fr.
Samir JaberCHU de Montpellier, Département Anesthésie et Réanimation B (DAR B), Hôpital Saint-Eloi, et INSERM U-1046, Montpellier, F-34295, France. s-jaber@chu-montpellier.fr.
FLASH trial management committee
Centre Hospitalier Universitaire de Clermont-Ferrand · FRInserm · FRUnité de recherche sur les maladies cardiovasculaires et métaboliques · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundInappropriate fluid therapy during surgery is associated with significant morbidity and mortality. Few studies have examined the effects of particular types of fluids (crystalloid or colloid solutions) in surgical patients, especially with the goal of hemodynamic optimization. Isotonic saline is the most commonly used fluid worldwide but may be associated with potential nephrotoxicity. Hydroxyethyl starch (HES) solutions are widely used in surgical patients as a component of goal-directed fluid optimization strategies, but several large multicenter studies have suggested increased rates of acute kidney injury and adverse events with the use of HES in ICU patients. Despite what may be inferred from physiological studies, the benefit and harm of 0.9 % saline and HES during hemodynamic therapy have not been clearly established in surgical patients. METHODS/

designThe FLASH trial is an investigator-initiated, prospective, multicenter, randomized, double-blinded, two-arm trial, randomizing 826 patients with moderate-to-high risk of postoperative complications to receive 6 % HES 130/0.4 or 0.9 % saline during individualized goal-directed fluid optimization. The primary outcome measure is a composite of death or major postoperative complications within 14 days following surgery. The sample size will allow the detection of a 10 % absolute between-group difference in the primary outcome measure with a type 1 error rate of 5 % and power of 95 %, assuming a 5 % mortality rate and 20 % morbidity (thus 25 % for the composite endpoint). DISCUSSION: The FLASH trial may provide important data on the efficacy and safety of commonly used fluid solutions and could have a significant impact on future treatment of surgical patients.

trial registrationClinicalTrials.gov Identifier: NCT02502773 . Registered 16 June 2015.

Indexed as

LaparotomyAbdomenClinical ProtocolsDouble-Blind MethodFluid TherapyFranceHumansHydroxyethyl Starch DerivativesPostoperative ComplicationsProspective StudiesResearch DesignSodium ChlorideTime FactorsTreatment OutcomeHydroxyethyl Starch DerivativesSodium Chloride

Identifiers

PMID26690683
PMCPMC4687283
OpenAlexW2221074368

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

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.