Evidence map›Paper›PMID 38626729›Full record

Observational studyBlood purification2024

Current Fluid Management Practice in Critically Ill Adults on Continuous Renal Replacement Therapy: A Binational, Observational Study.

Kyle C White, Kevin B Laupland, Marlies Ostermann, Ary Serpa Neto, Michelle L Gatton, Rod Hurford, Pierre Clement, Barnaby Sanderson, Rinaldo Bellomo

Open access · greenAbstract readObservational StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Blood purification, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
2.7field-weighted citation impact, top 9% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.

  1. Guideline
  2. Trial
  3. Article
  4. Article
  5. Article
  6. Review
  7. Ultrafiltration Tolerance and Improving Outcomes with Continuous Renal Replacement Therapies.Clinical journal of the American Society of Nephrology : CJASN · 2025
    Article
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

9 authors at 6 institutions in 1 country.

Kyle C WhiteIntensive Care Unit, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.
Kevin B LauplandQueensland University of Technology (QUT), Brisbane, Queensland, Australia.
Marlies OstermannKing's College London, Guy's and St Thomas' Hospital, Department of Critical Care, London, UK.
Ary Serpa NetoAustralian and New Zealand Intensive Care Research Centre (ANZIC-RC), School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Michelle L GattonQueensland University of Technology (QUT), Brisbane, Queensland, Australia.
Rod HurfordIntensive Care Unit, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.
Pierre ClementDepartment of Intensive Care Services, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
Barnaby SandersonKing's College London, Guy's and St Thomas' Hospital, Department of Critical Care, London, UK.
Rinaldo BellomoDepartment of Critical Care, University of Melbourne, Melbourne, Victoria, Australia.
Royal Brisbane and Women's Hospital · AUAustralian and New Zealand Intensive Care Society · AUPrincess Alexandra Hospital · AUQueensland University of Technology · AUThe Royal Melbourne Hospital · AUThe University of Queensland · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionIn critically ill patients undergoing continuous renal replacement therapy (CRRT), a positive fluid balance (FB) is associated with adverse outcomes. However, current FB management practices in CRRT patients are poorly understood. We aimed to study FB and its components in British and Australian CRRT patients to inform future trials.

methodsWe obtained detailed electronic health record data on all fluid-related variables during CRRT and hourly FB for the first 7 days of treatment.

resultsWe studied 1,616 patients from three tertiary intensive care units (ICUs) in two countries. After the start of CRRT, the mean cumulative FB became negative at 31 h and remained negative over 7 days to a mean nadir of -4.1 L (95% confidence interval (CI) of -4.6 to -3.5). The net ultrafiltration (NUF) rate was the dominant fluid variable (-67.7 mL/h; standard deviation (SD): 75.7); however, residual urine output (-34.7 mL/h; SD: 54.5), crystalloid administration (48.1 mL/h; SD: 44.6), and nutritional input (36.4 mL/h; SD: 29.7) significantly contributed to FB. Patients with a positive FB after 72 h of CRRT were more severely ill, required high-dose vasopressors, and had high lactate concentrations (5.0 mmol/L; interquartile range: 2.3-10.5). A positive FB was independently associated with increased hospital mortality (odds ratio: 1.70; 95% CI; p = 0.004).

conclusionIn the study ICUs, most CRRT patients achieved a predominantly NUF-dependent negative FB. Patients with a positive FB at 72 h had greater illness severity and haemodynamic instability. Achieving equipoise for conducting trials that target a negative early FB in such patients may be difficult.

Indexed as

Continuous Renal Replacement TherapyCritical IllnessFluid TherapyAcute Kidney InjuryAdultAgedAustraliaFemaleHumansIntensive Care UnitsMaleMiddle AgedWater-Electrolyte BalanceAcute kidney injuryCritical illnessFluid managementRenal replacement therapyWater and electrolyte imbalance

Identifiers

PMID38626729
PMCPMC11309063
OpenAlexW4394840659

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.