GuidelineIntensive care medicine2024
European Society of Intensive Care Medicine clinical practice guideline on fluid therapy in adult critically ill patients. Part 1: the choice of resuscitation fluids.
Guideline in Intensive care medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 54 papers, 9 of them syntheses that pooled 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.
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
54 citing papers in PubMed, 9 syntheses or guidelines pooled it.
- Hyper-oncotic albumin administration reduces mortality in acute Respiratory Distress Syndrome compared to crystalloid: a systematic review and meta-analysis.Annals of medicine · 2026Pooled it
- Hyperoncotic Albumin (20%) Versus Crystalloids for Mortality in Adults with Sepsis and Septic Shock: An Updated Systematic Review and Meta-Analysis.Medical sciences (Basel, Switzerland) · 2026Pooled it
- Mortality effect of albumin fluid resuscitation in adults with septic shock: a systematic review and dual frequentist-bayesian meta-analysis of randomised trials.Critical care (London, England) · 2026Pooled it
- Buffered solutions versus 0.9% saline for resuscitation in critically ill adults and children.The Cochrane database of systematic reviews · 2026Pooled it
- External validity limitations of randomized trials cited in adult critical care clinical practice guidelines: a systematic review of guidelines published from 2015 to 2020.Frontiers in medicine · 2026Pooled it
- European Resuscitation Council and European Society of Intensive Care Medicine guidelines 2025: post-resuscitation care.Intensive care medicine · 2025Guideline
- Optimizing Fluid Resuscitation Strategies: A Network Meta-analysis of Effectiveness and Safety for Hemorrhagic Shock Patients in Emergency Settings.The western journal of emergency medicine · 2025Pooled it
- ESICM guidelines on circulatory shock and hemodynamic monitoring 2025.Intensive care medicine · 2025Guideline
- 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
- Clinical value of the venous volume excess ultrasound score (VExUS) for volume management following cardiopulmonary bypass (CPB).Journal of ultrasound · 2026Trial
- Evaluation of the effects of Plasma-Lyte 148 or 0.9% saline on acid-base balance in patients undergoing neurosurgery: a randomized clinical trial.Einstein (Sao Paulo, Brazil) · 2026Trial
- Dynamic Changes in Serum Choline Acetyltransferase and Acetylcholinesterase in Septic versus Non-Septic ICU Patients: A Prospective Exploratory Study.Journal of inflammation research · 2026Trial
- The effects of balanced crystalloid versus plasma on endothelial injury, systemic inflammation, and coagulation in experimental endotoxaemia: a randomised human volunteer study.British journal of anaesthesia · 2026Trial
- Article
- The ultrasound gap in de-resuscitation trials: A systematic review of physiological assessment deficits.The ultrasound journal · 2026Article
- A global consensus on the critical care management of acute-on-chronic liver failure patients: the APASL ACLF Beijing Position Paper.Hepatology international · 2026Article
- Cardiac Surgery Management in Patients With Liver Cirrhosis.Reviews in cardiovascular medicine · 2026Review
- Fluids in sepsis.BJA education · 2026Review
- European Society of Intensive Care Medicine Clinical Practice Guideline on fluid therapy in adult critically ill patients: A path toward improved patient management.Journal of intensive medicine · 2026Article
- Impact of Balanced Crystalloids vs Saline by Resuscitation Strategy in Sepsis: A Secondary Analysis of the Crystalloid Liberal or Vasopressor Early Resuscitation in Sepsis Trial.CHEST critical care · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
18 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThis is the first of three parts of the clinical practice guideline from the European Society of Intensive Care Medicine (ESICM) on resuscitation fluids in adult critically ill patients. This part addresses fluid choice and the other two will separately address fluid amount and fluid removal.
methodsThis guideline was formulated by an international panel of clinical experts and methodologists. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology was applied to evaluate the certainty of evidence and to move from evidence to decision.
resultsFor volume expansion, the guideline provides conditional recommendations for using crystalloids rather than albumin in critically ill patients in general (moderate certainty of evidence), in patients with sepsis (moderate certainty of evidence), in patients with acute respiratory failure (very low certainty of evidence) and in patients in the perioperative period and patients at risk for bleeding (very low certainty of evidence). There is a conditional recommendation for using isotonic saline rather than albumin in patients with traumatic brain injury (very low certainty of evidence). There is a conditional recommendation for using albumin rather than crystalloids in patients with cirrhosis (very low certainty of evidence). The guideline provides conditional recommendations for using balanced crystalloids rather than isotonic saline in critically ill patients in general (low certainty of evidence), in patients with sepsis (low certainty of evidence) and in patients with kidney injury (very low certainty of evidence). There is a conditional recommendation for using isotonic saline rather than balanced crystalloids in patients with traumatic brain injury (very low certainty of evidence). There is a conditional recommendation for using isotonic crystalloids rather than small-volume hypertonic crystalloids in critically ill patients in general (very low certainty of evidence).
conclusionsThis guideline provides eleven recommendations to inform clinicians on resuscitation fluid choice in critically ill patients.
Indexed as
Identifiers
38771364What OpenQuestion holds
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.