ArticleIntensive care medicine2023
Long-term effects of restriction of intravenous fluid in adult ICU patients with septic shock.
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Article in Intensive care medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.
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19citing papers in PubMed, 2 pooled it
5.4field-weighted citation impact, top 3% of its field
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Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 25 citations in OpenAlex.
- Health-Related Quality of Life of Adult Sepsis Survivors Following Critical Illness: A Systematic Review.Critical care explorations · 2025Pooled it
- Early management of adult sepsis and septic shock: Korean clinical practice guidelines.Acute and critical care · 2024Guideline
- Effects of an early restrictive versus liberal fluid strategy on long-term patient-centered outcomes in sepsis-induced hypotension: an open-label, randomized controlled trial.American journal of respiratory and critical care medicine · 2026Trial
- Long-term mortality and health-related quality of life with lower versus higher oxygenation targets in intensive care unit patients with COVID-19 and severe hypoxaemia.Intensive care medicine · 2024Trial
- Protocolized reduction of non-resuscitation fluids versus usual care in septic shock patients (REDUSE): a randomized multicentre feasibility trial.Critical care (London, England) · 2024Trial
- Effects of restrictive fluid therapy on the time to resolution of hyperlactatemia in ICU patients with septic shock. A secondary post hoc analysis of the CLASSIC randomized trial.Intensive care medicine · 2024Trial
- Long-term outcomes of out-of-hospital cardiac arrest survivors in New Zealand: A prospective, longitudinal cohort study.Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2026Article
- Patient-reported outcomes and experience measures in clinical trials of critically ill adults with sepsis: a scoping review.Annals of the American Thoracic Society · 2026Article
- Restrictive Versus Liberal Fluid Strategy for Initial Resuscitation in Sepsis and Septic Shock: A Systematic Review and Meta Analysis.Journal of clinical medicine research · 2026Article
- Albumin for Adult ICU Patients With Shock: Protocol for the INCEPT-Albumin Platform Trial Domain.Acta anaesthesiologica Scandinavica · 2026Article
- Prediction model for quality of life in sepsis survivors one year after discharge.World journal of emergency medicine · 2026Article
- A causal inference framework to compare the effectiveness of life-sustaining ICU therapies-using the example of cancer patients with sepsis.International journal of cancer · 2026Article
- Association of active fluid de-escalation timing with clinical outcomes in patients with septic shock: a multicenter cohort study.BMC infectious diseases · 2026Article
- Optimal time and volume of fluid resuscitation in patients with sepsis: a nationwide multicenter cohort study.Scientific reports · 2025Article
- Prognostic impact of early versus delayed loop diuretic administration in sepsis: a propensity score-matched analysis using the MIMIC-IV database.Translational andrology and urology · 2025Article
- Identifying septic shock subgroups to tailor fluid strategies through multi-omics integration.Nature communications · 2024Article
- Fluid Management in Acute Respiratory Failure.Critical care clinics · 2024Review
- Review
- The predictive values of admission characteristics for 28-day all-cause mortality in septic patients with diabetes mellitus: a study from the MIMIC database.Frontiers in endocrinology · 2023Article
Corrections and comments
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Authors and funding
61 authors at 20 institutions in 10 countries.
Maj-Brit Nørregaard KjærDepartment of Intensive Care, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark. maj-brit.noerregaard.kjaer@regionh.dk.ORCID 0000-0002-6536-0504
Tine Sylvest MeyhoffDepartment of Intensive Care, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.ORCID 0000-0002-1840-1596
Praleene SivapalanDepartment of Intensive Care, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.ORCID 0000-0002-0442-0032
Anders GranholmDepartment of Intensive Care, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.ORCID 0000-0001-5799-7655
Peter Buhl HjortrupDepartment of Intensive Care, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.ORCID 0000-0002-3847-3247
Martin Bruun MadsenDepartment of Intensive Care, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.ORCID 0000-0001-5832-2262
Morten Hylander MøllerDepartment of Intensive Care, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.ORCID 0000-0002-6378-9673
Ingrid EgerodDepartment of Intensive Care, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.ORCID 0000-0002-9576-4390
Jørn WetterslevCollaboration for Research in Intensive Care (CRIC), Copenhagen, Denmark.ORCID 0000-0001-7778-1771
Theis LangeCollaboration for Research in Intensive Care (CRIC), Copenhagen, Denmark.
Maria CronhjortSection of Anaesthesia and Intensive Care, Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden.ORCID 0000-0002-0444-8553
Jon Henrik LaakeDivision of Emergencies and Critical Care, Department of Anaesthesiology and Intensive Care Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway.ORCID 0000-0001-6157-5359
Stephan M JakobDepartment of Intensive Care Medicine, University Hospital Bern (Inselspital), University of Bern, Bern, Switzerland.ORCID 0000-0002-2195-0473
Marek NalosMedical Intensive Care Unit, First Department of Internal Medicine, Faculty of Medicine, Teaching Hospital and Biomedical Center in Pilsen, Charles University, Pilsen, Czech Republic.
Marlies OstermannDepartment of Intensive Care, Guy's and St Thomas' Hospital, London, UK.ORCID 0000-0001-9500-9080
Doug GouldClinical Trial Unit, Intensive Care National Audit & Research Centre (ICNARC), London, UK.ORCID 0000-0003-4148-3312
Maurizio CecconiDepartment of Biomedical Sciences, Humanitas University Pieve Emanuele, Milan, Italy.
Manu L N G MalbrainDepartment of Intensive Care Medicine, University Hospital Brussels (UZB), Jette, Belgium.
Christian AhlstedtDepartment of Perioperative Medicine and Intensive Care, Karolinska University Hospital Huddinge, Stockholm, Sweden.
Louise Bendix KielDepartment of Anaesthesia and Intensive Care, Copenhagen University Hospital, Bispebjerg, Copenhagen, Denmark.
Morten H BestleDepartment of Anaesthesia and Intensive Care, Copenhagen University Hospital-North Zealand, Hilleroed, Denmark.ORCID 0000-0001-6585-2659
Lars NebrichDepartment of Anaesthesia and Intensive Care, Zealand University Hospital, Køge, Denmark.
Thomas HildebrandtDepartment of Anaesthesia and Intensive Care, Zealand University Hospital, Roskilde, Denmark.
Lene RussellCopenhagen Academy for Medical Education and Simulation, Rigshospitalet, Copenhagen, Denmark.ORCID 0000-0001-7352-8728
Marianne VangDepartment of Anaesthesia and Intensive Care, Randers Hospital, Randers, Denmark.
Michael Lindhart RasmussenDepartment of Anaesthesia and Intensive Care, Herning Hospital, Herning, Denmark.
Christoffer SøllingDepartment of Anaesthesia and Intensive Care, Viborg Hospital, Viborg, Denmark.
Anne Craveiro BrøchnerCollaboration for Research in Intensive Care (CRIC), Copenhagen, Denmark.ORCID 0000-0001-6453-6152
Mette KragCollaboration for Research in Intensive Care (CRIC), Copenhagen, Denmark.ORCID 0000-0002-5246-8727
Carmen PfortmuellerDepartment of Intensive Care Medicine, University Hospital Bern (Inselspital), University of Bern, Bern, Switzerland.
Miroslav KrizMedical Intensive Care Unit, First Department of Internal Medicine, Faculty of Medicine, Teaching Hospital and Biomedical Center in Pilsen, Charles University, Pilsen, Czech Republic.
Martin SiegemundIntensive Care Unit, Basel University Hospital, Basel, Switzerland.
Giovanni AlbanoDepartment of Anaesthesia and Intensive Care, Humanitas Gavazzeni Hospital Bergamo, Bergamo, Italy.
Søren Rosborg AagaardDepartment of Anaesthesia and Intensive Care, Aalborg University Hospital, Aalborg, Denmark.
Helle BundgaardDepartment of Anaesthesia and Intensive Care, Randers Hospital, Randers, Denmark.
Vera CroneDepartment of Anaesthesia and Intensive Care, Holbæk Hospital, Holbæk, Denmark.
Sine WichmannDepartment of Anaesthesia and Intensive Care, Copenhagen University Hospital-North Zealand, Hilleroed, Denmark.ORCID 0000-0003-0360-8655
Bror JohnstadDepartment of Intensive Care, Hospital Innland Hamar, Hamar, Norway.
Yvonne Karin MartinDepartment of Anesthesia and Intensive Care Medicine, Hospital Østfold Kalnes, Grålum, Norway.ORCID 0009-0009-9807-6268
Philipp SeidelDepartment of Intensive Care Medicine, Stavanger University Hospital, Stavanger, Norway.
Johan MårtenssonDepartment of Perioperative Medicine and Intensive Care, Karolinska University Hospital, Solna, Sweden.ORCID 0000-0001-8739-7896
Jacob HollenbergDepartment of Clinical Science and Education, Södersjukhuset, Medical Intensive Care Unit, Center for Resuscitation Science, Karolinska Institutet, Solna, Sweden.
Mats WistrandDepartment of Emergency Medicine, Capio St Görans Hospital, Stockholm, Sweden.
Abele DonatiDepartment of Biomedical Sciences and Public Health, Università Politecnica Delle Marche, Ancona, Italy.
Enrico BarbaraAnesthesia and Intensive Care Unit, Humanitas Research Hospital, Castellanza, Italy.
Thomas KarvunidisMedical Intensive Care Unit, First Department of Internal Medicine, Faculty of Medicine, Teaching Hospital and Biomedical Center in Pilsen, Charles University, Pilsen, Czech Republic.
Alexa HollingerIntensive Care Unit, Basel University Hospital, Basel, Switzerland.
Andrea CarsettiDepartment of Biomedical Sciences and Public Health, Università Politecnica Delle Marche, Ancona, Italy.ORCID 0000-0001-6096-6251
Nuttha LumlertgulDepartment of Intensive Care, Guy's and St Thomas' Hospital, London, UK.
Eva Joelsson-AlmSection of Anaesthesia and Intensive Care, Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden.ORCID 0000-0002-9041-2468
Nikolas LambirisDepartment of Perioperative Medicine and Intensive Care, Karolinska University Hospital, Solna, Sweden.
Tayyba Naz AslamDivision of Emergencies and Critical Care, Department of Anaesthesiology and Intensive Care Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
Fredrik Femtehjell FribergDepartment of Intensive Care, Hospital Innland Hamar, Hamar, Norway.
Gitte Kingo VesterlundDepartment of Intensive Care, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.ORCID 0000-0001-5221-3938
Camilla Bekker MortensenDepartment of Anaesthesia and Intensive Care, Zealand University Hospital, Køge, Denmark.ORCID 0000-0001-5202-3552
Stine Rom VestergaardDepartment of Anaesthesia and Intensive Care, Aalborg University Hospital, Aalborg, Denmark.
Sidsel Fjordbak CaspersenDepartment of Anaesthesia and Intensive Care, Zealand University Hospital, Køge, Denmark.
Diana Bertelsen JensenDepartment of Anaesthesia and Intensive Care, Copenhagen University Hospital, Bispebjerg, Copenhagen, Denmark.
Morten BorupDepartment of Anaesthesia and Intensive Care, Kolding, University Hospital of Southern Denmark, Odense, Denmark.
Bodil Steen RasmussenCollaboration for Research in Intensive Care (CRIC), Copenhagen, Denmark.
Anders PernerDepartment of Intensive Care, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.ORCID 0000-0002-4668-0123
Copenhagen University Hospital · DKAalborg University Hospital · DKCharles University · CZKarolinska Institutet · SEKarolinska University Hospital · SEOslo University Hospital · NOUniversity of Copenhagen · DKZealand University Hospital Køge · DKBispebjerg Hospital · DKMarche Polytechnic University · ITRegional Hospital Randers · DKSt Thomas' Hospital · GBUniversity Hospital of Basel · CHUniversity of Bern · CHCentre for Research in Intensive Care · DKHolbæk Sygehus · DKHumanitas Gavazzeni · ITHumanitas University · ITInland Hospital · NOIntensive Care National Audit & Research Centre · GB
Funding
AgNovos Healthcare NNF17OC0028608.
Abstract
purposeTo assess long-term outcomes of restrictive versus standard intravenous (IV) fluid therapy in adult intensive care unit (ICU) patients with septic shock included in the European Conservative versus Liberal Approach to Fluid Therapy in Septic Shock in Intensive Care (CLASSIC) trial.
methodsWe conducted the pre-planned analyses of mortality, health-related quality of life (HRQoL) using EuroQol (EQ)-5D-5L index values and EQ visual analogue scale (VAS), and cognitive function using Mini Montreal Cognitive Assessment (Mini MoCA) test at 1 year. Deceased patients were assigned numerical zero for HRQoL as a state equal to death and zero for cognitive function outcomes as worst possible score, and we used multiple imputation for missing data on HRQoL and cognitive function.
resultsAmong 1554 randomized patients, we obtained 1-year data on mortality in 97.9% of patients, HRQoL in 91.3%, and cognitive function in 86.3%. One-year mortality was 385/746 (51.3%) in the restrictive-fluid group versus 383/767 (49.9%) in the standard-fluid group, absolute risk difference 1.5%-points [99% confidence interval (CI) - 4.8 to 7.8]. Mean differences were 0.00 (99% CI - 0.06 to 0.05) for EQ-5D-5L index values, - 0.65 for EQ VAS (- 5.40 to 4.08), and - 0.14 for Mini MoCA (- 1.59 to 1.14) for the restrictive-fluid group versus the standard-fluid group. The results for survivors only were similar in both groups.
conclusionsAmong adult ICU patients with septic shock, restrictive versus standard IV fluid therapy resulted in similar survival, HRQoL, and cognitive function at 1 year, but clinically important differences could not be ruled out.
Indexed as
Shock, SepticAdultCritical CareHumansIntensive Care UnitsQuality of LifeSurvivorsCognitive functionCritical illnessIntravenous fluidLong-term outcomesQuality of lifeSepsisSeptic shock
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