Restrictive versus standard intravenous (IV) fluid therapy in adult intensive care unit (ICU) patients with septic shock—Bayesian analyses of the CLASSIC trial
An erratum to this article was published (Acta Anaesthesiol Scand, Jan 2025 ↗)
Primary result · MortalityResult — go to the resultAbsolute difference 0.2 %-points 95% CrI −5.0 to 5.4Authors' conclusion
We could not rule out clinically important effects of restrictive IV fluid therapy on mortality, SAEs or days alive without life-support, but substantial effects on SARs were unlikely.
Study context
- Population
- Adult ICU patients with septic shock
- Comparison
- Restrictive vs standard IV fluid therapy
- Primary endpoint
- Mortality
- Follow-up
- 90 days
Methodological detailspre-planned, Bayesian analysis, weakly informative priors
- Pre-planned
- Bayesian analysis
- Weakly informative priors
Primary result
As reported in the abstract
Absolute difference
0.2 %-points
95% CrI −5.0 to 5.4
Restrictive vs Standard
absolute difference 0.2 %-points (95% CrI −5.0 to 5.4)
- Posterior probability of no clinically important difference (absolute risk difference ≤2%-points)
- 56%
Further findings
Serious adverse events (SAEs) · 90 days
- Posterior probability of benefit with restrictive IV fluid
- 72%
- Posterior probability of no clinically important difference
- 49%
Days alive without life-support · 90 days
- Posterior probability of benefit with restrictive IV fluid
- 61%
- Posterior probability of no clinically important difference
- 38%
Heterogeneity in treatment effects (HTE) on mortality by previous IV fluid volumes (continuous) (subgroup)
- Probability of HTE; potentially relatively lower mortality with restrictive IV fluids with higher previous IV fluids
- 97%
- No substantial evidence of HTE in the other analyses
Safety
Serious adverse reactions (SARs) · 90 days
- Posterior probability of benefit with restrictive IV fluid
- 52%
- Posterior probability of no clinically important difference
- 90%
Original publication
Restrictive versus standard IV fluid therapy in adult ICU patients with septic shock—Bayesian analyses of the CLASSIC trial. Acta Anaesthesiol Scand. Published 23 October 2023. doi:10.
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