Evidence map›Paper›PMID 37932787›Full record

Trial reportCritical care (London, England)2023

Fluid balance control in critically ill patients: results from as-treated analyses of POINCARE-2 randomized trial.

Adil Mansouri, Marie Buzzi, Sébastien Gibot, Claire Charpentier, Francis Schneider, Guillaume Louis, Hervé Outin, Alexandra Monnier, Jean-Pierre Quenot, Julio Badie and 5 more

Registry-linked trialAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Critical care (London, England), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02765009 (Effects of Fluid Balance Control in Critically Ill Patients), 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
–field-weighted citation impact
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.

NCT02765009 nacompletednot on this map

Effects of Fluid Balance Control in Critically Ill Patients: A Multicenter Randomized Study

TypeinterventionalSponsorCentral Hospital, Nancy, FranceRan2016 to 2020Enrolled1,411ConditionsFluid Shifts, Critical CareArmsdiuretics, albumin, fluid restriction, renal replacement
3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
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

15 authors.

Adil MansouriCHRU Nancy Hôpitaux de Brabois, INSERM, CIC, Epidémiologie Clinique, Université de Lorraine, 9 Allée du Morvan, 54000, Vandœuvre-lès-Nancy, Nancy, France.
Marie BuzziCHRU Nancy Hôpitaux de Brabois, INSERM, CIC, Epidémiologie Clinique, Université de Lorraine, 9 Allée du Morvan, 54000, Vandœuvre-lès-Nancy, Nancy, France. m.buzzi@chru-nancy.fr.
Sébastien GibotService de Réanimation Médicale, CHRU Nancy, Université de Lorraine, 54000, Nancy, France.
Claire CharpentierService d'Anesthésie Réanimation Chirurgicale, CHRU Nancy, Université de Lorraine, 54000, Nancy, France.
Francis SchneiderService de Médecine Intensive-Réanimation, CHU Strasbourg, INSERM U 1121, Hôpital de Hautepierre, 67000, Strasbourg, France.
Guillaume LouisService de Réanimation Polyvalente, CHR Metz-Thionville, 57000, Metz, France.
Hervé OutinService de Réanimation, CHI Poissy Saint-Germain, 78303, Poissy, France.
Alexandra MonnierService de Médecine Intensive-Réanimation Médicale, Nouvel Hôpital Civil, CHU Strasbourg, Université de Strasbourg, 67000, Strasbourg, France.
Jean-Pierre QuenotService de Médecine Intensive-Réanimation, CHU Dijon-Bourgogne, 21000, Dijon, France.
Julio BadieService de Réanimation Médicale, Hôpital Nord Franche-Comté, 90015, Belfort, France.
Laurent ArgaudService de Réanimation Médicale, Hospices Civils de Lyon, Hôpital Edouard Herriot, 69000, Lyon, France.
Cédric BruelService de Réanimation Polyvalente, Groupe Hospitalier Paris Saint-Joseph, 75000, Paris, France.
Marc SoudantCHRU Nancy Hôpitaux de Brabois, INSERM, CIC, Epidémiologie Clinique, Université de Lorraine, 9 Allée du Morvan, 54000, Vandœuvre-lès-Nancy, Nancy, France.
Nelly AgrinierCHRU Nancy Hôpitaux de Brabois, INSERM, CIC, Epidémiologie Clinique, Université de Lorraine, 9 Allée du Morvan, 54000, Vandœuvre-lès-Nancy, Nancy, France.
the POINCARE-2 group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIntention-to-treat analyses of POINCARE-2 trial led to inconclusive results regarding the effect of a conservative fluid balance strategy on mortality in critically ill patients. The present as-treated analysis aimed to assess the effectiveness of actual exposure to POINCARE-2 strategy on 60-day mortality in critically ill patients.

methodsPOINCARE‑2 was a stepped wedge randomized controlled trial. Eligible patients were ≥ 18 years old, under mechanical ventilation and had an expected length of stay in ICU > 24 h. POINCARE-2 strategy consisted of daily weighing over 14 days, and subsequent restriction of fluid intake, administration of diuretics, and/or ultrafiltration. We computed a score of exposure to the strategy based on deviations from the strategy algorithm. We considered patients with a score ≥ 75 as exposed to the strategy. We used logistic regression adjusted for confounders (ALR) or for an instrumental variable (IVLR). We handled missing data using multiple imputations.

resultsA total of 1361 patients were included. Overall, 24.8% of patients in the control group and 69.4% of patients in the strategy group had a score of exposure ≥ 75. Exposure to the POINCARE-2 strategy was not associated with 60-day all-cause mortality (ALR: OR 1.2, 95% CI 0.85-1.55; IVLR: OR 1.0, 95% CI 0.76-1.33).

conclusionActual exposure to POINCARE-2 conservative strategy was not associated with reduced mortality in critically ill patients. Trial registration POINCARE-2 trial is registered at ClinicalTrials.gov (NCT02765009). Registered 29 April 2016.

Indexed as

Critical IllnessWater-Electrolyte BalanceAdolescentAdultHumansIntensive Care UnitsClinical trialComplex interventionCritical careInstrumental variableWater–electrolyte balance

Identifiers

PMID37932787
PMCPMC10626740

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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.