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Conservative versus liberal fluid resuscitation for septic patients at risk for fluid overload: A systematic review with meta-analysis
IF 3.2 3区 医学 Q2 CRITICAL CARE MEDICINE
Journal of critical care
Pub Date : 2025-02-28 DOI: 10.1016/j.jcrc.2025.155045
Aadil Bharwani , Joanna C. Dionne , María L. Pérez , Marina Englesakis , Tine Sylvest Meyhoff , Praleene Sivapalan , Fernando G. Zampieri , M. Elizabeth Wilcox

Background

Intravenous fluid resuscitation forms a crucial part of the sepsis bundle. However, the perception is that patients with comorbidities such as congestive heart failure, chronic kidney disease, and cirrhosis receive lower volumes due to concerns regarding potential for fluid overload. We review outcomes relating to resuscitation with conservative versus liberal volumes in specific patient populations.

Methods

We searched MEDLINE, Embase+Embase Classic, Cochrane library, Web of Science, CINAHL Complete, and ClinicalTrials.gov for studies that compared outcomes related to different volumes of resuscitation in adult patients with sepsis, along with congestive heart failure, chronic kidney disease, cirrhosis. The primary outcome was all-cause mortality up to 30 days post-discharge. Secondary outcomes included length of stay, intubation rates and duration, and use of vasopressors.

Results

A total of 37 observational studies were included. We found no statistically significant difference in all-cause mortality (Odds Ratio [OR] 1.01; 95 % Confidence Interval [CI] 0.86–1.19), rates of ICU admission (Risk Ratio [RR] 0.89; 95 % CI 0.70–1.11), hospital length of stay (Mean Difference [MD] -0.01; 95 % -0.18-0.15), ICU length of stay (MD -0.06; 95 % CI -0.30-0.18), intubation rates (OR 1.00; 95 % 0.76–1.32), duration of mechanical ventilation (MD 0.01; 95 % CI -0.31-0.32) or use of vasopressors (RR 0.81; 95 % CI 0.64–1.02).

Conclusions

Among patients with comorbid conditions presenting with sepsis, we found no differences in outcomes related to the volume of fluid administered. Further evidence is needed to guide decisions regarding volume of fluid to administer in these patient populations given the lack of high certainty evidence.
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引用次数: 0
Data-driven modeling of inflammation in a canine model of volumetric muscle loss injury suggests distinct type 17 immune responses in response to hydrogel extracellular matrix alone or in combination with topical electrical stimulation
IF 3.2 3区 医学 Q2 CRITICAL CARE MEDICINE
Journal of critical care
Pub Date : 2025-02-27 DOI: 10.1016/j.jcrc.2024.154962
Ruben Zamora , Jinling Yin , Fayten El-Dehaibi , Derek A. Barclay , Scott A. Johnson , Gary An , Stephen F. Badylak , Yoram Vodovotz
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引用次数: 0
Early dynamic prediction of organ system deterioration in intensive care unit (ICU) patients using machine learning
IF 3.2 3区 医学 Q2 CRITICAL CARE MEDICINE
Journal of critical care
Pub Date : 2025-02-27 DOI: 10.1016/j.jcrc.2024.154954
Nidhi Soley , Siqi Zhang , Jiashan Zong , Joseph Greenstein , Casey Overby Taylor , Timothy Ruchti , Pedro Alejandro Mendez-Tellez
{"title":"Early dynamic prediction of organ system deterioration in intensive care unit (ICU) patients using machine learning","authors":"Nidhi Soley ,&nbsp;Siqi Zhang ,&nbsp;Jiashan Zong ,&nbsp;Joseph Greenstein ,&nbsp;Casey Overby Taylor ,&nbsp;Timothy Ruchti ,&nbsp;Pedro Alejandro Mendez-Tellez","doi":"10.1016/j.jcrc.2024.154954","DOIUrl":"10.1016/j.jcrc.2024.154954","url":null,"abstract":"","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"86 ","pages":"Article 154954"},"PeriodicalIF":3.2,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143509418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Network analysis of single-nucleotide polymorphisms (SNPs) associated with aberrant inflammation in trauma patients suggests a role for programs involving CD55 and delineates novel SNPs associated with a Type 17 immune phenotype
IF 3.2 3区 医学 Q2 CRITICAL CARE MEDICINE
Journal of critical care
Pub Date : 2025-02-27 DOI: 10.1016/j.jcrc.2024.154963
Fayten El-Dehaibi , Ruben Zamora , Jinling Yin , Timthy R. Billiar , Yoram Vodovotz
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引用次数: 0
Quantitative modeling for personalized tranexamic acid dosing in trauma care
IF 3.2 3区 医学 Q2 CRITICAL CARE MEDICINE
Journal of critical care
Pub Date : 2025-02-27 DOI: 10.1016/j.jcrc.2024.154967
Guanyun Liu , Amanda E. Shick , Caroline M. Cook , Valeria Urrego-Hernandez , Maya Shamash , Pranav Kulkarni , Mitchell J. Cohen , Amor A. Menezes
{"title":"Quantitative modeling for personalized tranexamic acid dosing in trauma care","authors":"Guanyun Liu ,&nbsp;Amanda E. Shick ,&nbsp;Caroline M. Cook ,&nbsp;Valeria Urrego-Hernandez ,&nbsp;Maya Shamash ,&nbsp;Pranav Kulkarni ,&nbsp;Mitchell J. Cohen ,&nbsp;Amor A. Menezes","doi":"10.1016/j.jcrc.2024.154967","DOIUrl":"10.1016/j.jcrc.2024.154967","url":null,"abstract":"","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"86 ","pages":"Article 154967"},"PeriodicalIF":3.2,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143509031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Limitations of remarkable human brains demand decision-support
IF 3.2 3区 医学 Q2 CRITICAL CARE MEDICINE
Journal of critical care
Pub Date : 2025-02-27 DOI: 10.1016/j.jcrc.2024.154969
Alan Morris , Christopher Horvat , R. Scott Evans , Stephen Rees
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引用次数: 0
Clinical experimental method compliance quantification challenges
IF 3.2 3区 医学 Q2 CRITICAL CARE MEDICINE
Journal of critical care
Pub Date : 2025-02-27 DOI: 10.1016/j.jcrc.2024.154968
Alan Morris , Kang Hoe Lee , Christopher Horvat , R. Scott Evans , Stephen Rees
{"title":"Clinical experimental method compliance quantification challenges","authors":"Alan Morris ,&nbsp;Kang Hoe Lee ,&nbsp;Christopher Horvat ,&nbsp;R. Scott Evans ,&nbsp;Stephen Rees","doi":"10.1016/j.jcrc.2024.154968","DOIUrl":"10.1016/j.jcrc.2024.154968","url":null,"abstract":"","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"86 ","pages":"Article 154968"},"PeriodicalIF":3.2,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143509032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Dynamic prediction of major adverse kidney events in sepsis-associated acute kidney injury using deep learning
IF 3.2 3区 医学 Q2 CRITICAL CARE MEDICINE
Journal of critical care
Pub Date : 2025-02-27 DOI: 10.1016/j.jcrc.2024.154971
Kullaya Takkavatakarn , Wonsuk Oh , Hernando Gomez , Umesh Gidwani , John Oropello , Roopa Kohli-Seth , John Kellum , Girish Nadkarni , Ankit Sakhuja
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引用次数: 0
Modeling organ crosstalk and cellular adaptation in response to clinical intervention during multiple organ dysfunction syndrome
IF 3.2 3区 医学 Q2 CRITICAL CARE MEDICINE
Journal of critical care
Pub Date : 2025-02-27 DOI: 10.1016/j.jcrc.2024.154965
Stefanos Papadopoulos, Robert S. Parker, Gilles Clermont
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引用次数: 0
Wave power analysis to assess cardiovascular alterations in sepsis
IF 3.2 3区 医学 Q2 CRITICAL CARE MEDICINE
Journal of critical care
Pub Date : 2025-02-27 DOI: 10.1016/j.jcrc.2024.154956
Marta Carrara , Diletta Guberti , Riccardo Asnaghi , Manuela Ferrario
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引用次数: 0
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