Evidence map›Paper›PMID 9550953›Full record

SynthesisBMJ (Clinical research ed.)1998

Fluid resuscitation with colloid or crystalloid solutions in critically ill patients: a systematic review of randomised trials.

G Schierhout, I Roberts

Registry-linked trialOpen access · bronzeAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ (Clinical research ed.), 1998. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00966628 (The Effect of Hypertonic Sodium Lactate on sVCAM-1 Level as a Surrogate Marker of Endothelial Capillary Leakage in Pediatric Dengue Shock Syndrome Patients), which is not on this map. Cited by 90 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
90citing papers in PubMed, 10 pooled it
44.6field-weighted citation impact, top 1% 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.

NCT00966628 phase3unknown statusnot on this mapstarted 2008, after this paper: background citation

The Effect of Hypertonic Sodium Lactate on sVCAM-1 Level as a Surrogate Marker of Endothelial Capillary Leakage in Pediatric Dengue Shock Syndrome Patients

TypeinterventionalSponsorInnogene Kalbiotech Pte. LtdRan2008 to 2009Enrolled50ConditionsDengue Shock SyndromeArmsHypertonic sodium lactate, Ringer's lactate
3 · Its place in the literature

Who cites it

90 citing papers in PubMed, 10 syntheses or guidelines pooled it, 665 citations in OpenAlex.

  1. Pooled it
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  5. Guideline
  6. Recommendations for the use of albumin and immunoglobulins.Blood transfusion = Trasfusione del sangue · 2009
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  17. Plasma colloid osmotic pressure in healthy infants.Critical care (London, England) · 2001
    Trial
  18. Randomised trial of fluid restriction in ventilated very low birthweight infants.Archives of disease in childhood. Fetal and neonatal edition · 2000
    Trial
  19. Albumin in neonates: use it or lose it.Pediatric research · 2026
    Article
  20. Article

30 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

2 authors at 1 institution in 1 country.

G SchierhoutDepartment of Epidemiology and Public Health, University College London Medical School.
I Roberts
University College London · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo determine the effect on mortality of rescuscitation with colloid solutions compared with resuscitation with crystalloids.

designSystematic review of randomised controlled trials of resuscitation with colloids compared with crystalloids for volume replacement of critically ill patients; analysis stratified according to patient type and quality of allocation concealment. SUBJECTS: 37 randomised controlled trials were eligible, of which 26 unconfounded trials compared colloids with crystalloids (n = 1622). (The 10 trials that compared colloid in hypertonic crystalloid with isotonic crystalloid (n = 1422) and one trial that compared colloid in isotonic crystalloid with hypertonic crystalloid (n = 38) are described in the longer version on our website www.bmj.com).

main outcome measuresMortality from all causes at end of follow up for each trial.

resultsResuscitation with colloids was associated with an increased absolute risk of mortality of 4% (95% confidence interval 0% to 8%), or four extra deaths for every 100 patients resuscitated. The summary effect measure shifted towards increased mortality with colloids when only trials with adequate concealment of allocation were included. There was no evidence for differences in effect among patients with different types of injury that required fluid resuscitation.

conclusionsThis systematic review does not support the continued use of colloids for volume replacement in critically ill patients.

Indexed as

ColloidsCritical IllnessCrystallizationFluid TherapyFollow-Up StudiesHumansHypertonic SolutionsIsotonic SolutionsRandomized Controlled Trials as TopicResuscitationRisk FactorsSurvival AnalysisTreatment OutcomeWounds and InjuriesColloidsHypertonic SolutionsIsotonic Solutions

Identifiers

PMID9550953
PMCPMC28497
OpenAlexW2045041613

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.