Impact on fluid balance of an optimized restrictive strategy targeting non-resuscitative fluids in intensive care patients with septic shock: a single-blind, multicenter, randomized, controlled, pilot study
Authors' conclusion
In ICU patients with septic shock, an optimized restrictive fluid strategy targeting hidden fluid intakes did not reduce the overall fluid balance at day 5.
Study context
- Population
- ICU patients aged 18–85 years with septic shock in the first 24 h of vasopressor infusion, three French hospitals48 analysed
- Participants
- 50 patients
- Comparison
- Optimized restrictive fluid strategy vs standard fluid strategy
- Optimized restrictive strategyn = 24
- Controln = 24reference
- Primary endpoint
- Cumulative fluid balance (ml/kg)
- Follow-up
- First 5 days
Methodological detailssingle-blind, multicentre, parallel, pilot, Patients and statisticians blinded, clinicians not
- Single-blind
- Multicentre
- Parallel
- Pilot
- Patients and statisticians blinded, clinicians not
Primary result
Cumulative fluid balance · After 5 days
Absolute difference
13.2
95% CI - 15.2; 41.6
P = 0.42
By group
As reported in the abstract
Further findings
ml/kg
| Outcome | Optimized restrictive strategy | Control | Mean difference (ml/kg) (CI) | P value | |
|---|---|---|---|---|---|
| Fluid received · first 5 days | 89.7 (IQR 35–128.9) | 114.3 (IQR 78.8–168.5) | 35.9 (0.0–71.8) | P = 0.0506 | |
| −50050100Difference, ml/kg (linear scale) |
Mortality and days alive without life support · 28 days
- Similar between groups
Safety
Events
| Outcome | Optimized restrictive strategy | Control |
|---|---|---|
| Severe hypernatremia | 1 | 2 |
| AKI KDIGO 3 | 4 | 7 |
Original publication
Impact on fluid balance of an optimized restrictive strategy targeting non-resuscitative fluids in intensive care patients with septic shock: a single-blind, multicenter, randomized, controlled, pilot study. Crit Care. Published 21 December 2024. doi:10.
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