Evidence map›Paper›PMID 41987014›Full record

Trial reportBMC anesthesiology2026

Restrictive versus standard intravenous fluid therapy and NTproBNP in ICU patients with septic shock - a sub-study of the randomised CLASSIC trial.

Jens Christensen, Praleene Sivapalan, Tine Sylvest Meyhoff, Hans Järnbert-Pettersson, Anders Perner, Morten Hylander Møller, Theis Lange, Peter Buhl Hjortrup, Eva Joelsson-Alm, Sandra Jonmarker and 4 more

Registry-linked trialAbstract readRandomized Controlled TrialComparative Study
In one paragraph

Trial report in BMC anesthesiology, 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. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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.

NCT04282252 phase4completednot on this map

The Effect of Restrictive Fluid Management on Cardiac Function and Glycocalyx Degradation, a Preplanned Substudy of the CLASSIC Trial

TypeinterventionalSponsorKarolinska InstitutetRan2020 to 2022Enrolled54ConditionsSeptic ShockArmsI.V. SOLUTIONS
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

14 authors.

Jens ChristensenDepartment of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden. jens.christensen@ki.se.
Praleene SivapalanCopenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.
Tine Sylvest MeyhoffCopenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.
Hans Järnbert-PetterssonDepartment of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
Anders PernerCopenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.
Morten Hylander MøllerCopenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.
Theis LangeUniversity of Copenhagen, Section of Biostatistics, Copenhagen, Denmark.
Peter Buhl HjortrupCopenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.
Eva Joelsson-AlmDepartment of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
Sandra JonmarkerDepartment of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
Fredric SjöbergDepartment of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
Johan MårtenssonDepartment of Physiology and Pharmacology, Section of Anaesthesia and Intensive Care, Karolinska Institutet, Stockholm, Sweden.
Anna Håkansson GladhDepartment of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
Maria CronhjortDepartment of Clinical Sciences, Danderyd Hospital, Anaesthesia and Intensive Care at KI DS, Stockholm, Sweden.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCardiac dysfunction is common in septic shock and may be influenced by intravenous (IV) fluid therapy. We aimed to investigate the effects of restrictive versus standard IV fluid therapy on plasma N-terminal pro B-type natriuretic peptide (NTproBNP), a marker of cardiac dysfunction, in adult intensive care unit (ICU) patients with septic shock.

methodsThis prospective exploratory sub-study of the randomised CLASSIC trial enrolled adult ICU patients with septic shock at one Danish and one Swedish ICU between February 2020 and October 2021. Patients were randomised to restrictive versus standard IV fluid therapy. Plasma NTproBNP was measured at randomisation (T0), the following morning (T1), the morning after (T2), and at ICU discharge or day 90 (T3). The exploratory outcome was the between-group difference in NTproBNP across timepoints assessed using mixed models.

resultsFifty-four patients were included. NTproBNP levels did not differ significantly between groups at any timepoint. At T1, mean NTproBNP levels were 7667 ng/L in the restrictive group and 8913 ng/L in the standard group, with an estimated between-group difference of -1245 (95% CI -4065–1575). Similarly, no statistically significant differences were observed at T2 and T3. No group-by-time interaction was observed (p = 0.925).

conclusionsNo statistically significant difference in plasma NTproBNP between adult ICU patients with septic shock randomised to restrictive versus standard IV fluid therapy was seen. Uniformly elevated levels could suggest that NTproBNP in septic shock primarily reflects systemic inflammation rather than fluid-induced cardiac loading. Results should be interpreted with caution due to the small sample size.

trial registrationClinicalTrials.gov NCT04282252. Registered 31 January 2020.

Indexed as

Fluid TherapyNatriuretic Peptide, BrainPeptide FragmentsShock, SepticAgedBiomarkersFemaleHumansIntensive Care UnitsMaleMiddle AgedProspective StudiesBiomarkersNatriuretic Peptide, BrainPeptide Fragmentspro-brain natriuretic peptide (1-76)Cardiac dysfunctionFluid therapyNTproBNPRandomised controlled trialSeptic shock

Identifiers

PMID41987014
PMCPMC13085469

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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.