ArticleJournal of the Intensive Care Society2020
Fluid management and deresuscitation practices: A survey of critical care physicians.
Article in Journal of the Intensive Care Society, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 2 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
28 citing papers in PubMed, 2 syntheses or guidelines pooled it, 59 citations in OpenAlex.
- European Society of Intensive Care Medicine Clinical Practice Guideline on fluid therapy in adult critically ill patients: Part 3-fluid removal at de-escalation phase.Intensive care medicine · 2025Guideline
- Internal jugular vein ultrasound for the diagnosis of hypovolemia and hypervolemia in acutely ill adults: a systematic review and meta-analysis.Internal and emergency medicine · 2022Pooled it
- Fluid balance control in critically ill patients: results from as-treated analyses of POINCARE-2 randomized trial.Critical care (London, England) · 2023Trial
- Optimizing Fluid Management Guided by Volumetric Parameters in Patients with Sepsis and ARDS.International journal of molecular sciences · 2023Trial
- Feasibility of conservative fluid administration and deresuscitation compared with usual care in critical illness: the Role of Active Deresuscitation After Resuscitation-2 (RADAR-2) randomised clinical trial.Intensive care medicine · 2022Trial
- The fluid paradox: dissociation between clinical and ultrasound parameters of fluid overload - results of the INCIVEX exploratory study.Anaesthesiology intensive therapy · 2026Observational
- A negative fluid balance may compromise nutritional delivery in mechanically ventilated critically ill children: a retrospective observational cohort study.Critical care (London, England) · 2026Observational
- Resuscitation Targets, Fluids, and Vasoactives in Septic Shock.Clinics in chest medicine · 2026Review
- Bridging evidence and practice: implementation science and bundled care strategies for fluid management in critically ill neonates.Frontiers in medicine · 2026Article
- Impact of Venous CONgestion on Organ Function and Outcomes in Sepsis (ICON-Sepsis): a prospective observational cohort study protocol.BMJ open · 2025Article
- Physician awareness of fluid volume administered with intravenous antibiotics: a structured interview-based study.Clinical and experimental emergency medicine · 2025Article
- Unsupervised machine learning analysis to identify patterns of ICU medication use for fluid overload prediction.medRxiv : the preprint server for health sciences · 2024Article
- Machine learning vs. traditional regression analysis for fluid overload prediction in the ICU.Scientific reports · 2023Observational
- Precision fluid and vasoactive drug therapy for critically ill patients.Pharmacotherapy · 2023Review
- Fluid management and deresuscitation practices - An opportunity for collaboration.Journal of the Intensive Care Society · 2023Article
- Review
- Percent fluid overload for prediction of fluid de-escalation in critically ill patients in Saudi Arabia: a prospective observational study.Acute and critical care · 2023Article
- Article
- How I personalize fluid therapy in septic shock?Critical care (London, England) · 2023Review
- Fluid management of emergency department patients with sepsis-A survey of fluid resuscitation practices.Acta anaesthesiologica Scandinavica · 2022Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Accumulation of a positive fluid balance is common in critically ill patients, and is associated with adverse outcomes, including mortality. However, there are few randomised clinical trials to guide clinicians as to the most appropriate fluid strategy following initial resuscitation and on the use of deresuscitation (removal of accumulated fluid using diuretics and/or renal replacement therapy). To inform the design of randomised trials, we surveyed critical care physicians with regard to perceptions of fluid overload in critical care, self-reported practice, acceptability of a variety of approaches to deresuscitation, appropriate safety parameters, and overall acceptability of a randomised trial of deresuscitation. Of 524 critical care specialists completing the survey, the majority practiced in mixed medical/surgical intensive care units in the United Kingdom. Most (309 of 363 respondents, 85%) believed fluid overload to be a modifiable source of morbidity; there was strong support (395 of 457, 86%) for a randomised trial of deresuscitation in critical illness. Marked practice variability was evident among respondents. In a given clinical scenario, self-reported practice ranged from the administration of fluid (N = 59, 14%) to the administration of a diuretic (N = 285, 67%). The majority (95%) considered it appropriate to administer diuretics for fluid overload in the setting of noradrenaline infusion and to continue to administer diuretics despite mild dysnatraemias, hypotension, metabolic alkalosis, and hypokalaemia. The majority of critical care physicians view fluid overload as a common and modifiable source of morbidity; deresuscitation is widely practiced, and there is widespread support for randomised trials of deresuscitation in critical illness.
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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.