Trial reportArchives of disease in childhood2019
Restricted fluid bolus volume in early septic shock: results of the Fluids in Shock pilot trial.
Trial report in Archives of disease in childhood, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06478797 (Adrenaline in Early Sepsis Resuscitation in Children- A Randomised Controlled Pilot Study in the Emergency Department), which is not on this map. Cited by 37 papers, 5 of them syntheses that pooled it.
What it found
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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.
Adrenaline in Early Sepsis Resuscitation in Children- A Randomised Controlled Pilot Study in the Emergency Department (ANDES CHILD)
Who cites it
37 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- 2025 Korean Guidelines for Cardiopulmonary Resuscitation: Part 8. Pediatric advanced life support.Clinical and experimental emergency medicine · 2026Guideline
- Surviving Sepsis Campaign International Guidelines for the Management of Sepsis and Septic Shock in Children 2026.Intensive care medicine · 2026Pooled it
- Fluid resuscitation in children with severe infection and septic shock: a systematic review and meta-analysis.European journal of pediatrics · 2024Pooled it
- COVID-19 PICU guidelines: for high- and limited-resource settings.Pediatric research · 2020Guideline
- Surviving sepsis campaign international guidelines for the management of septic shock and sepsis-associated organ dysfunction in children.Intensive care medicine · 2020Guideline
- REstrictive versus StandarD FlUid Management in Mechanically Ventilated ChildrEn Admitted to PICU: a pilot randomized controlled trial (REDUCE-1).Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2026Trial
- Trial
- Levetiracetam as an alternative to phenytoin for second-line emergency treatment of children with convulsive status epilepticus: the EcLiPSE RCT.Health technology assessment (Winchester, England) · 2020Trial
- Levetiracetam versus phenytoin for second-line treatment of paediatric convulsive status epilepticus (EcLiPSE): a multicentre, open-label, randomised trial.Lancet (London, England) · 2019Trial
- Permissive versus restrictive temperature thresholds in critically ill children with fever and infection: a multicentre randomized clinical pilot trial.Critical care (London, England) · 2019Trial
- Restricted fluid resuscitation in suspected sepsis associated hypotension (REFRESH): a pilot randomised controlled trial.Intensive care medicine · 2018Trial
- Proteomic profiling and pathway analyses reveal molecular signatures and immune networks in pediatric sepsis.Inflammation research : official journal of the European Histamine Research Society ... [et al.] · 2026Article
- Early inotropic support without fluid bolusWorld journal of clinical pediatrics · 2026Article
- The SQUEEZE pilot trial: a trial to determine whether septic shock reversal is quicker in pediatric patients randomized to an early goal directed fluid-sparing strategy vs. usual care.Pilot and feasibility studies · 2025Article
- Epinephrine vs Norepinephrine as the Initial Vasoactive Agent in Pediatric Septic Shock: A Feasibility Randomized Controlled Trial for Recruitment Rates and Protocol Adherence, the Epinephrine vs Norepinephrine in Pediatric Septic Shock Trial.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2025Article
- Review
- Article
- Fluid bolus therapy in pediatric sepsis: a narrative review.European journal of medical research · 2022Review
- Medication and Fluid Management of Pediatric Sepsis and Septic Shock.Paediatric drugs · 2022Review
- Current Practice of Fluid Maintenance and Replacement Therapy in Mechanically Ventilated Critically Ill Children: A European Survey.Frontiers in pediatrics · 2022Article
Corrections and comments
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Authors and funding
14 authors.
Funding
Abstract
objectiveTo determine the feasibility of Fluids in Shock, a randomised controlled trial (RCT) of restricted fluid bolus volume (10 mL/kg) versus recommended practice (20 mL/kg).
designNine-month pilot RCT with embedded mixed-method perspectives study.
setting13 hospitals in England. PATIENTS: Children presenting to emergency departments with suspected infection and shock after 20 mL/kg fluid.
interventionsPatients were randomly allocated (1:1) to further 10 or 20 mL/kg fluid boluses every 15 min for up to 4 hours if still in shock.
main outcome measuresThese were based on progression criteria, including recruitment and retention, protocol adherence, separation, potential trial outcome measures, and parent and staff perspectives.
resultsSeventy-five participants were randomised; two were withdrawn. 23 (59%) of 39 in the 10 mL/kg arm and 25 (74%) of 34 in the 20 mL/kg arm required a single trial bolus before the shock resolved. 79% of boluses were delivered per protocol in the 10 mL/kg arm and 55% in the 20 mL/kg arm. The volume of study bolus fluid after 4 hours was 44% lower in the 10 mL/kg group (mean 14.5 vs 27.5 mL/kg). The Paediatric Index of Mortality-2 score was 2.1 (IQR 1.6-2.7) in the 10 mL/kg group and 2.0 (IQR 1.6-2.5) in the 20 mL/kg group. There were no deaths. Length of hospital stay, paediatric intensive care unit (PICU) admissions and PICU-free days at 30 days did not differ significantly between the groups. In the perspectives study, the trial was generally supported, although some problems with protocol adherence were described.
conclusionsParticipants were not as unwell as expected. A larger trial is not feasible in its current design in the UK. TRIAL REGISTRATION NUMBER: ISRCTN15244462.
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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.