Evidence map›Paper›PMID 40953281›Full record

SynthesisCritical care explorations2025

Dynamic Measures of Fluid Responsiveness to Guide Resuscitation in Patients With Sepsis and Septic Shock: A Systematic Review and Meta-Analysis.

Jocelyn Wang, Leann Marie Blake, Nicolas Orozco, Kyle Fiorini, Chris McChesney, Marat Slessarev, Ross Prager, Aleksandra Leligdowicz, Sameer Sharif, Kimberley Lewis and 11 more

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Critical care explorations, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Review
  3. Changes in COJournal of clinical medicine · 2026
    Article
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors.

Jocelyn WangSchulich School of Medicine and Dentistry, Western University, London, ON, Canada.
Leann Marie BlakeSchulich School of Medicine and Dentistry, Western University, London, ON, Canada.
Nicolas OrozcoCentro de Investigaciones Clínicas, Fundación Valle del Lili, Cali, Colombia.
Kyle FioriniDivision of Critical Care, Department of Medicine, Schulich School of Medicine and Dentistry, Windsor, ON, Canada.
Chris McChesneyDepartment of Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
Marat SlessarevDivision of Critical Care, Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
Ross PragerDivision of Critical Care, Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
Aleksandra LeligdowiczDivision of Critical Care, Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
Sameer SharifDivision of Emergency Medicine, Department of Medicine, McMaster University, Hamilton, ON, Canada.
Kimberley LewisDivision of Critical Care, Department of Medicine, McMaster University, Hamilton, ON, Canada.
Bram RochwergDivision of Critical Care, Department of Medicine, McMaster University, Hamilton, ON, Canada.
Kimia HonarmandDivision of Critical Care, Department of Medicine, Mackenzie Health, Vaughan, ON, Canada.
Ian M BallDivision of Critical Care, Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
Robert ArntfieldDivision of Critical Care, Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
Michelle WongDivision of Critical Care, Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
Diyaa BokharyDivision of Critical Care, Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
Ahmad BafarajDivision of Critical Care, Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
Logan Van NynattenDivision of Critical Care, Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
Henri FeroDivision of Critical Care, Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
Evan RussellDivision of Critical Care, Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
John BasmajiDivision of Critical Care, Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo determine the impact of using dynamic measures of fluid responsiveness in guiding the resuscitation of adult patients with sepsis and septic shock. DATA SOURCE: We searched MEDLINE, Embase, and unpublished sources from inception to February 3, 2025. STUDY SELECTION: We included randomized controlled trials (RCTs) that evaluated the use of dynamic measures of fluid responsiveness to guide resuscitation compared with any other method in patients with sepsis and septic shock. DATA EXTRACTION: We collected data regarding study and patient characteristics, definitions of fluid responsiveness, modality for assessing fluid responsiveness, and outcome data. We performed a random-effects meta-analysis and rated the certainty of the evidence using the Grading of Recommendations Assessment, Development, and Evaluation framework. DATA SYNTHESIS: We included nine eligible RCTs (n = 698 patients). The use of dynamic measures of fluid responsiveness to guide IV fluid (IVF) administration of patients with septic shock probably reduces 28-day mortality (relative risk] 0.61; 95% CI, 0.42-0.90, moderate certainty), may reduce the risk of acute kidney injury (AKI) (RR 0.66; 95% CI, 0.44-0.98, low certainty), and cumulative fluid balance on day 3 (mean difference -1.57L; 95% CI, -2.44 L to -0.69 L, low certainty). The use of dynamic measures of fluid responsiveness has an uncertain effect on ICU mortality, ICU and hospital length of stay, need for and duration of mechanical ventilation, need for renal replacement therapy, vasoactive medication administration, duration of vasopressor use, and IVF administration on day 1.

conclusionsIn adult patients with sepsis and septic shock, using dynamic measures of fluid responsiveness may improve survival and reduce the risk of AKI. Future studies should evaluate the impact of this intervention on other important clinical outcomes and determine the comparative efficacy of specific modalities for assessing fluid responsiveness.

Indexed as

Fluid TherapyResuscitationSepsisShock, SepticAcute Kidney InjuryHumansRandomized Controlled Trials as Topiccritical carefluid responsivenesshemodynamicssepsisshock

Identifiers

PMID40953281
PMCPMC12440473

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.