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Protocolized reduction of non-resuscitation fluids versus usual care in septic shock patients (REDUSE) : a randomized multicentre feasibility trial
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- Lindén, Anja (författare)
- Lund University,Lunds universitet,Anestesiologi och intensivvård,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Kliniska Vetenskaper, Helsingborg,Institutionen för kliniska vetenskaper, Lund,Anesthesiology and Intensive Care,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Clinical Sciences, Helsingborg,Department of Clinical Sciences, Lund,Helsingborg Hospital,Lund Univ, Dept Clin Sci Lund, Anesthesiol & Intens Care, Lund, Sweden.;Helsingborg Hosp, Dept Anesthesiol & Intens Care, Charlotte Yhlens Gata 10, S-25223 Helsingborg, Sweden.,Lund Univ, Dept Clin Sci Lund, Infect Dis, Lund, Sweden.
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- Spångfors, M (författare)
- Lund University,Lunds universitet,Anestesiologi och intensivvård,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Centrum för hjärtstopp,Forskargrupper vid Lunds universitet,SWECRIT,Anesthesiology and Intensive Care,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Center for cardiac arrest,Lund University Research Groups,Central Hospital Kristianstad,Lund Univ, Dept Clin Sci Lund, Anesthesiol & Intens Care, Lund, Sweden.;Kristianstad Hosp, Dept Anesthesiol & Intens Care, Kristianstad, Sweden.
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- Olsen, M H (författare)
- Copenhagen Univ Hosp, Rigshosp, Copenhagen Trial Unit, Copenhagen, Denmark.;Copenhagen Univ Hosp, Rigshosp, Dept Neuroanaesthesiol, Copenhagen, Denmark.,Copenhagen University Hospital,Copenhagen Univ Hosp, Denmark; Copenhagen Univ Hosp, Denmark
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- BMC, 2024
- 2024
- Engelska.
- Ingår i: Critical care (London, England). - : BMC. - 1364-8535 .- 1466-609X. ; 28:1
- Tidskriftsartikel (refereegranskat)
Abstract
Ämnesord
Stäng
- BACKGROUND/PURPOSE: Non-resuscitation fluids constitute the majority of fluid administered for septic shock patients in the intensive care unit (ICU). This multicentre, randomized, feasibility trial was conducted to test the hypothesis that a restrictive protocol targeting non-resuscitation fluids reduces the overall volume administered compared with usual care.METHODS: Adults with septic shock in six Swedish ICUs were randomized within 12 h of ICU admission to receive either protocolized reduction of non-resuscitation fluids or usual care. The primary outcome was the total volume of fluid administered within three days of inclusion.RESULTS: Median (IQR) total volume of fluid in the first three days, was 6008 ml (interquartile range [IQR] 3960-8123) in the restrictive fluid group (n = 44), and 9765 ml (IQR 6804-12,401) in the control group (n = 48); corresponding to a Hodges-Lehmann median difference of 3560 ml [95% confidence interval 1614-5302]; p < 0.001). Outcome data on all-cause mortality, days alive and free of mechanical ventilation and acute kidney injury or ischemic events in the ICU within 90 days of inclusion were recorded in 98/98 (100%), 95/98 (98%) and 95/98 (98%) of participants respectively. Cognition and health-related quality of life at six months were recorded in 39/52 (75%) and 41/52 (79%) of surviving participants, respectively. Ninety out of 134 patients (67%) of eligible patients were randomized, and 15/98 (15%) of the participants experienced at least one protocol violation.CONCLUSION: Protocolized reduction of non-resuscitation fluids in patients with septic shock resulted in a large decrease in fluid administration compared with usual care. A trial using this design to test if reducing non-resuscitation fluids improves outcomes is feasible.TRIAL REGISTRATION: Clinicaltrials.gov, NCT05249088, 18 February 2022. https://clinicaltrials.gov/ct2/show/NCT05249088.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Anestesi och intensivvård (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Anesthesiology and Intensive Care (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Infektionsmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Infectious Medicine (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Nyckelord
- Humans
- Male
- Shock, Septic/therapy
- Female
- Feasibility Studies
- Middle Aged
- Fluid Therapy/methods
- Aged
- Intensive Care Units/organization & administration
- Sweden
- Septic shock; Fluid therapy; Non-resuscitation fluids; Randomized controlled trial; Feasibility
Publikations- och innehållstyp
- art (ämneskategori)
- ref (ämneskategori)
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- Lindén, Anja
- Spångfors, M
- Olsen, M H
- Fisher, J
- Lilja, G
- Sjövall, F
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- Jungner, M
- Lengquist, M
- Kander, T
- Samuelsson, L
- Johansson, J
- Palmnäs, E
- Undén, J
- Oras, J
- Cronhjort, M
- Chew, M
- Linder, A
- Lipcsey, Miklós
- Nielsen, N
- Jakobsen, J C
- Bentzer, P
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