Evidence map›Paper›PMID 38760833›Full record

Trial reportCritical care (London, England)2024

Protocolized reduction of non-resuscitation fluids versus usual care in septic shock patients (REDUSE): a randomized multicentre feasibility trial.

Anja Lindén, M Spångfors, M H Olsen, J Fisher, G Lilja, F Sjövall, M Jungner, M Lengquist, T Kander, L Samuelsson and 12 more

Registry-linked trialAbstract readRandomized Controlled TrialMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Critical care (London, England), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05249088 (Protocolized Reduction of Non-resuscitation Fluids Versus Usual Care in Septic Shock Patients), which is not on this map. Cited by 7 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 2 pooled it
–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.

NCT05249088 nacompletednot on this map

Protocolized Reduction of Non-resuscitation Fluids Versus Usual Care in Septic Shock Patients: A Multicentre Feasibility Trial

TypeinterventionalSponsorRegion SkaneRan2022 to 2023Enrolled98ConditionsShock, SepticArmsProtocolised reduction of non-resuscitation fluids, Usual care
3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. Article
  6. Article
  7. Trials and the importance of usual care.Critical care (London, England) · 2024
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

22 authors.

Anja LindénAnesthesiology and Intensive Care, Department of Clinical Sciences Lund, Lund University, Lund, Sweden. anja.linden.icu@gmail.com.
M SpångforsAnesthesiology and Intensive Care, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.
M H OlsenCopenhagen Trial Unit, Centre for Clinical Intervention Research, The Capital Region, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.
J FisherAnesthesiology and Intensive Care, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.
G LiljaNeurology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.
F SjövallAnesthesiology and Intensive Care, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.
M JungnerAnesthesiology and Intensive Care, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.
M LengquistAnesthesiology and Intensive Care, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.
T KanderAnesthesiology and Intensive Care, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.
L SamuelssonDepartment of Anesthesiology and Intensive Care, Östersund Hospital, Östersund, Sweden.
J JohanssonDepartment of Anesthesiology and Intensive Care, Östersund Hospital, Östersund, Sweden.
E PalmnäsDepartment of Operation and Intensive Care, Hallands Hospital Halmstad, Halmstad, Sweden.
J UndénAnesthesiology and Intensive Care, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.
J OrasDepartment of Anesthesiology and Intensive Care Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
M CronhjortKarolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, Stockholm, Sweden.
M ChewDepartment of Anesthesiology and Intensive Care, Linköping University Hospital, Linköping, Sweden.
A LinderInfectious Diseases, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.
M LipcseyAnaesthesiology and Intensive Care Medicine, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
N NielsenAnesthesiology and Intensive Care, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.
J C JakobsenDepartment of Anesthesiology and Intensive Care, Kristianstad Hospital, Kristianstad, Sweden.
P BentzerAnesthesiology and Intensive Care, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.
REDUSE Trial Group

Funding

Swedish National Health Service ALF 86626
6 · The paper itself

Abstract

background/purposeNon-resuscitation fluids constitute the majority of fluid administered for septic shock patients in the intensive care unit (ICU). This multicentre, randomized, feasibility trial was conducted to test the hypothesis that a restrictive protocol targeting non-resuscitation fluids reduces the overall volume administered compared with usual care.

methodsAdults with septic shock in six Swedish ICUs were randomized within 12 h of ICU admission to receive either protocolized reduction of non-resuscitation fluids or usual care. The primary outcome was the total volume of fluid administered within three days of inclusion.

resultsMedian (IQR) total volume of fluid in the first three days, was 6008 ml (interquartile range [IQR] 3960-8123) in the restrictive fluid group (n = 44), and 9765 ml (IQR 6804-12,401) in the control group (n = 48); corresponding to a Hodges-Lehmann median difference of 3560 ml [95% confidence interval 1614-5302]; p < 0.001). Outcome data on all-cause mortality, days alive and free of mechanical ventilation and acute kidney injury or ischemic events in the ICU within 90 days of inclusion were recorded in 98/98 (100%), 95/98 (98%) and 95/98 (98%) of participants respectively. Cognition and health-related quality of life at six months were recorded in 39/52 (75%) and 41/52 (79%) of surviving participants, respectively. Ninety out of 134 patients (67%) of eligible patients were randomized, and 15/98 (15%) of the participants experienced at least one protocol violation.

conclusionProtocolized reduction of non-resuscitation fluids in patients with septic shock resulted in a large decrease in fluid administration compared with usual care. A trial using this design to test if reducing non-resuscitation fluids improves outcomes is feasible.

trial registrationClinicaltrials.gov, NCT05249088, 18 February 2022. https://clinicaltrials.gov/ct2/show/NCT05249088.

Indexed as

Feasibility StudiesFluid TherapyIntensive Care UnitsShock, SepticAgedFemaleHumansMaleMiddle AgedSwedenFeasibilityFluid therapyNon-resuscitation fluidsRandomized controlled trialSeptic shock

Identifiers

PMID38760833
PMCPMC11100208

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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.