Geo-economic Influence on the Effect of Fluid Volume for Sepsis Resuscitation: A Meta-Analysis
Authors' conclusion
In sepsis trials, the effect of fluid resuscitation approach differed by setting, with higher volume of fluid resuscitation associated with increased mortality in LMICs and in settings with restricted access to mechanical ventilation.
Study context
- Population
- Patients with sepsis or septic shock in RCTs of fluid resuscitation (excluding hypertonic fluids, colloids, depletion-based interventions), up to January 2023
- Participants
- 11,798 patients · 29 studies
- Comparison
- Higher vs lower fluid volumes for sepsis resuscitation, by income group
- Outcome
- Mortality by income group
Methodological detailssubgroup analysis by country income group
- Subgroup analysis by country income group
Pooled result
As reported in the abstract
Higher volume vs Lower volumeOdds ratio (95% CI)
LMICs
1.47(1.14–1.90)
HICs
1.00(0.87–1.16)
Further pooled results
| Outcome | OR (95% CI) | |
|---|---|---|
| Need for mechanical ventilation by income groupHigher volume vs Lower volume · LMICs | 1.24 (1.08–1.43) | |
| Need for mechanical ventilation by income groupHigher volume vs Lower volume · HICs | 1.02 (0.80–1.29) | |
| Mortality by self-reported access to mechanical ventilationHigher volume vs Lower volume · limited access | 1.45 (1.09–1.93) | |
| Mortality by self-reported access to mechanical ventilationHigher volume vs Lower volume · other settings | 1.09 (0.93–1.28) | |
| 0.512Odds ratio (log scale) |
Median
| Outcome | LMICs | HICs | P value |
|---|---|---|---|
| Baseline mortality, LMIC vs HIC studies | 37% (IQR 26–41) | 29% (IQR 17–38) | P = 0.06 |
- Mortality by self-reported access to mechanical ventilation: interaction P = 0.02 for subgroup differences
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Geo-economic Influence on the Effect of Fluid Volume for Sepsis Resuscitation: A Meta-Analysis. Am J Respir Crit Care Med. Published 1 March 2024. doi:10.
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