Evidence map›Paper›PMID 41736143›Full record

Trial reportCritical care (London, England)2026

The effect of plasma versus crystalloids on intravascular volume, tissue perfusion and tissue oxygenation: a randomized controlled trial in a human endotoxemia model.

Bashar N Hilderink, Daan P van den Brink, Derek J B Kleinveld, Robert B Klanderman, Philip C Spinella, Nicole P Juffermans

Abstract readComparative StudyRandomized Controlled Trial
In one paragraph

Trial report in Critical care (London, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. 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

6 authors.

Bashar N Hilderink *Erasmus MC, Department of Intensive Care Medicine, Erasmus University of Rotterdam, Dr. Molewaterplein 40, 3015 GD, Rotterdam, Netherlands. b.hilderink@erasmusmc.nl.
Daan P van den Brink *Department of Anesthesiology, Sint Antonius Ziekenhuis, Nieuwegein, The Netherlands.
Derek J B KleinveldErasmus MC, Department of Anesthesiology, Erasmus University of Rotterdam, Rotterdam, Netherlands.
Robert B KlandermanAmsterdam UMC, Laboratory of Experimental Intensive Care and Anesthesiology, University of Amsterdam, Amsterdam, Netherlands.
Philip C SpinellaDepartment of Surgery and Critical care Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Nicole P JuffermansErasmus MC, Department of Intensive Care Medicine, Erasmus University of Rotterdam, Dr. Molewaterplein 40, 3015 GD, Rotterdam, Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFluid resuscitation is a cornerstone of shock treatment to ensure sufficient tissue perfusion. However, large volumes of crystalloids are associated with adverse outcomes and plasma has been suggested as an alternative fluid. This trial investigated the effect of plasma transfusion on circulation, tissue perfusion, and mitochondrial oxygen tension (mitoPO2) compared with balanced crystalloids in a human endotoxemia model.

methodsTwelve healthy volunteers were subjected to 2 ng/kg lipopolysaccharide (LPS) infusion. Six participants received 10 ml/kg of plasma. In the control group, 10 ml/kg of balanced crystalloids was infused. Non-invasive cardiac index (CI), markers of the microcirculation and mitoPO2 were measured at prespecified time points. Blood volume was estimated by hemoglobin levels at each timepoint. Differences in groups over time were tested using linear mixed modeling. Wilcoxon rank-sum test was used to test the statistical difference between groups at each timepoint.

resultsLPS infusion resulted in a systemic inflammatory reaction with an increase in temperature and leukocytes. Heart rate and CI increased, while systemic vascular resistance (SVRI) decreased. Capillary refill time, mitoPO2 and perfused sublingual vessels all deteriorated, indicative of hyperdynamic vasodilation with redistribution of blood volume. Plasma increased intravascular volume by 4 ml/kg one hour after infusion, whereas intravascular volume remained at baseline with crystalloids (p < 0.01). Subsequently, CI increased more in the plasma group compared to the crystalloid group (p < 0.05). Tissue perfusion was improved in the plasma group, with shorter capillary refill time (p < 0.05) and a higher proportion of perfused vessels compared to the crystalloid group (p < 0.05). After fluid infusion, mitoPO2 increased less in the plasma group compared to the crystalloid group (p < 0.05).

conclusionsIn healthy endotoxemic volunteers without shock, plasma infusion augmented intravascular blood volume and cardiac output, resulting in improved microcirculatory tissue perfusion compared to crystalloids. However, plasma did not restore the reduction in skin mitoPO2 as much as crystalloids.

trial registrationEudraCT ID: EUCTR2020-005045-17-NL. Date of registration: 14-12-2021

Indexed as

Blood VolumeEndotoxemiaPlasmaAdultCrystalloid SolutionsFemaleFluid TherapyHumansIsotonic SolutionsLipopolysaccharidesMaleOxygenCrystalloid SolutionsIsotonic SolutionsLipopolysaccharidesOxygenCrystalloidHemodynamicInflammationLPSMitochondrial oxygen tensionPlasmaSepsis

Identifiers

PMID41736143
PMCPMC13041369

What Socratic holds

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LicenceCC BY-NC-ND
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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.