Trial reportActa anaesthesiologica Scandinavica2026
Restrictive Versus Standard Intravenous Fluid Therapy and Endothelial Glycocalyx Shedding in ICU Patients With Septic Shock-A Preplanned Sub-Study of the Randomized CLASSIC Trial.
Trial report in Acta anaesthesiologica Scandinavica, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04282252 (The Effect of Restrictive Fluid Management on Cardiac Function and Glycocalyx Degradation, a Preplanned Substudy of the CLASSIC Trial), which is not on this map. Cited by 2 papers.
What it found
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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.
The Effect of Restrictive Fluid Management on Cardiac Function and Glycocalyx Degradation, a Preplanned Substudy of the CLASSIC Trial
Who cites it
2 citing papers in PubMed.
- Restrictive versus standard intravenous fluid therapy and NTproBNP in ICU patients with septic shock - a sub-study of the randomised CLASSIC trial.BMC anesthesiology · 2026Trial
- Restrictive Versus Standard Intravenous Fluid Therapy and Endothelial Glycocalyx Shedding in ICU Patients With Septic Shock-A Preplanned Sub-Study of the Randomized CLASSIC Trial.Acta anaesthesiologica Scandinavica · 2026Trial
Corrections and comments
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Authors and funding
14 authors.
Funding
Abstract
Shedding of the endothelial glycocalyx may be a pathophysiological mechanism in septic shock, to which intravenous (IV) fluid therapy may contribute. We aimed to investigate the effects of restrictive versus standard IV fluid therapy on glycocalyx shedding in adult intensive care unit (ICU) patients with septic shock. In this preplanned sub-study of the CLASSIC trial, ICU patients with septic shock were randomized to restrictive or standard IV fluid therapy at one Danish and one Swedish ICU between February 2020 and October 2021. Plasma markers of glycocalyx shedding were measured at four timepoints: within the first hour after randomization (T0), the following morning (T1), the morning after (T2), at ICU discharge or up to 90 days after randomization (T3). The primary outcome was the change in plasma hyaluronan levels from T0 to T1. A total of 54 patients were included, below the planned sample size of 200, leading to important differences between groups. Mean hyaluronan levels decreased by 11 ng/mL (95% CI 35-41) more in the restrictive group compared to the standard group from T0 to T1. The interaction effect between group and time was non-significant (p value: 0.872). In this underpowered sub-study we found no statistically significant difference in endothelial glycocalyx shedding between adult ICU patients with septic shock randomized to restrictive versus standard IV fluid therapy. We consider these findings hypothesis-generating; further research is needed to confirm these results. EDITORIAL COMMENT: In this substudy of the CLASSIC trial, glycocalyx degredation products and related substances were measured serially in sepsic study participants randomized to restrictive or usual fluid treatment protocols. No differences between treatment glycocalyx degredation product and related substance levels were observed. Trial Registration: ClinicalTrials.gov identifier: NCT04282252.
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