Evidence map›Paper›PMID 42005608›Full record

ArticleResuscitation plus2026

Volume therapy for cardiac arrest: a systematic review and meta-analysis.

Johannes Wittig, Shinichiro Ohshimo, Anders Aneman, Carrie Kah-Lai Leong, Brian J O'Neil, Yew Woon Chia, Jacqueline Eleonora Ek, Peter Paal, Lars W Andersen, Marie K Jessen and 3 more

Abstract read
In one paragraph

Article in Resuscitation plus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

13 authors.

Johannes WittigResearch Center for Emergency Medicine, Aarhus University Hospital, Aarhus, Denmark.
Shinichiro OhshimoDepartment of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Anders AnemanIntensive Care Unit, Liverpool Hospital, South Western Sydney Local Health District, South Western Clinical School, University of New South Wales, Sydney, Australia.
Carrie Kah-Lai LeongDepartment of Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore.
Brian J O'NeilDepartment of Emergency Medicine, Wayne State University, School of Medicine, Detroit, MI, USA.
Yew Woon ChiaDepartment of Cardiology, Tan Tock Seng Hospital, Singapore.
Jacqueline Eleonora EkDepartment of Medicine, Mater Dei Hospital, Msida, Malta.
Peter PaalDepartment of Anaesthesiology and Intensive Care Medicine, St. John of God Hospital, Paracelsus Medical University, Salzburg, Austria.
Lars W AndersenDepartment of Clinical Medicine, Aarhus University, Aarhus, Denmark.
Marie K JessenDepartment of Clinical Medicine, Aarhus University, Aarhus, Denmark.
Asger GranfeldtDepartment of Clinical Medicine, Aarhus University, Aarhus, Denmark.
Mathias J HolmbergDepartment of Clinical Medicine, Aarhus University, Aarhus, Denmark.
International Liaison Committee on Resuscitation (ILCOR) Advanced Life Support Task Force

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: To perform a systematic review and meta-analysis of intra-cardiac arrest and post-cardiac arrest intravascular volume therapy in adults and children. Methods: Searches were performed in Ovid Medline, Ovid Embase, and the Cochrane Library on October 30, 2025. Randomized trials and non-randomized studies evaluating volume therapy during cardiac arrest and after return of spontaneous circulation were included. Two reviewers independently screened articles, extracted data, and assessed risk of bias. Meta-analyses were performed when appropriate. Certainty of evidence was assessed using GRADE methodology. Results: Fifty-eight articles were included representing 14 trials enrolling 4815 patients and 44 observational studies including 710,118 patients. All randomized trials enrolled adult patients. Of the observational studies, two included paediatric patients and eight included mixed populations. For non-traumatic intra-cardiac arrest, trials of specific interventions, including hypertonic saline with hydroxyethyl starch (which is no longer used in clinical practice) and cold crystalloid infusion, showed no difference in outcomes. For traumatic intra-cardiac arrest, direct evidence was limited to a single trial subgroup analysis showing no difference between blood products and crystalloids. For post-cardiac arrest, trials of cold crystalloid infusion and balanced versus unbalanced crystalloids showed no differences in outcomes. Randomized trials were assessed to have some concern to high risk of bias. Observational studies were at serious or critical risk of bias with inconsistent results. The certainty of evidence was low to very low. Conclusion: This systematic review found no trials directly comparing volume therapy to no volume therapy during cardiopulmonary resuscitation. The available trials, which compared different types of volume therapy strategies in adult patients, showed no significant difference in clinical outcomes across non-traumatic, traumatic, and post-cardiac arrest settings. Additional randomized trials are needed to establish the role of intra- and post-cardiac arrest volume therapy.

Indexed as

Blood transfusionCardiopulmonary resuscitationColloidsCrystalloid solutionsFluid therapyHeart arrest

Identifiers

PMID42005608
PMCPMC13084413

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.