Hemodynamics, fluids & transfusion
The effectiveness of tissue-perfusion-guided resuscitation in shock: A systematic review and meta-analysis
Authors' conclusion
It promotes personalized fluid stewardship by significantly reducing early fluid administration and may be associated with shorter ICU LOS.
Study context
- Population
- Adults with shock
- Participants
- 2,394 adults · 8 randomized controlled trials (RCTs)
- Comparison
- Tissue-perfusion-guided therapy vs standard care
- Outcome
- 30-day and 90-day mortality
Methodological detailsrandom-effect model, RoB2 risk of bias, PRISMA 2020
- Random-effect model
- RoB2 risk of bias
- PRISMA 2020
Pooled result
As reported in the abstract
Mortality
TP-GT vs Standard careRelative risk (95% CI)P value
30-day mortality
0.96(0.83–1.10)
P = 0.4990-day mortality
0.94(0.82–1.07)
P = 0.17Further pooled results
| Outcome | MD (day) (95% CI) | P value | |
|---|---|---|---|
| ICU LOSFragile in sensitivity analyses | −0.72 (−1.42 to −0.01) | P = 0.048 | |
| −2−101Difference, day (linear scale) |
| Outcome | MD (mL) (95% CI) | P value | |
|---|---|---|---|
| Fluid volume administered · first 6-8 h of resuscitation | −466.95 (−917.17 to −16.72) | P = 0.046 | |
| −1000−5000500Difference, mL (linear scale) |
Original publication
The effectiveness of tissue-perfusion-guided resuscitation in shock: A systematic review and meta-analysis. Ann Intensive Care. Published 25 June 2026. doi:10.
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