{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T17:16:46Z","timestamp":1776705406654,"version":"3.51.2"},"reference-count":23,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2016,3,31]],"date-time":"2016-03-31T00:00:00Z","timestamp":1459382400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004348","name":"Stockholms L\u00e4ns Landsting","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004348","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2016,8]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Several studies have shown an association between a positive fluid balance and increased mortality in patients with septic shock. This may have led to a more restrictive use of intravenous fluids. The association between fluid accumulation and mortality in the setting of a more restrictive use of intravenous fluids, however, is uncertain. We therefore aimed to investigate the association between a cumulative fluid balance 3\u00a0days after randomization and 90\u2010day mortality in a recent Nordic multicentre cohort of patients with septic shock.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A post hoc analysis of patients from the Transfusion Requirements in Septic Shock (<jats:styled-content style=\"fixed-case\">TRISS<\/jats:styled-content>) trial treated for 3\u00a0days or more in the <jats:styled-content style=\"fixed-case\">ICU<\/jats:styled-content> after randomization. The patients were categorized into four groups depending on their weight\u2010adjusted cumulative fluid balance after 3\u00a0days. We performed multivariable Cox regression analysis, adjusting for important prognostics (study site, age, chronic cardiovascular and chronic lung disease, haematologic malignancy, chronic dialysis, source of infection, baseline <jats:styled-content style=\"fixed-case\">SOFA<\/jats:styled-content> score and plasma lactate).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median cumulative fluid balance of the 841 included patients was 2480\u00a0ml (<jats:styled-content style=\"fixed-case\">IQR<\/jats:styled-content> 47\u20105045). The median time from <jats:styled-content style=\"fixed-case\">ICU<\/jats:styled-content> admission to inclusion in the trial was 22\u00a0h. The overall 90\u2010day mortality was 52%. There was no statistically significant association between fluid balance 3\u00a0days from inclusion and 90\u2010day mortality after the adjustment for the prognostics (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.37).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In our cohort of patients with septic shock and a comparably low cumulative fluid balance, there was no association between fluid balance and mortality. However, the study design and the limited power preclude strong conclusions. There is an urgent need for high\u2010quality trials assessing the benefit and harm of different fluid volume strategies in patients with septic shock.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aas.12723","type":"journal-article","created":{"date-parts":[[2016,3,31]],"date-time":"2016-03-31T08:05:00Z","timestamp":1459411500000},"page":"925-933","source":"Crossref","is-referenced-by-count":21,"title":["Association between fluid balance and mortality in patients with septic shock: a post hoc analysis of the <scp>TRISS<\/scp> trial"],"prefix":"10.1111","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0444-8553","authenticated-orcid":false,"given":"M.","family":"Cronhjort","sequence":"first","affiliation":[{"name":"Section\u00a0of Anaesthesiology and Intensive Care Department of Clinical Science and Education Karolinska Institutet S\u00f6dersjukhuset Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P. B.","family":"Hjortrup","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Copenhagen University Hospital Rigshospitalet Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L. B.","family":"Holst","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Copenhagen University Hospital Rigshospitalet Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"Joelsson\u2010Alm","sequence":"additional","affiliation":[{"name":"Section\u00a0of Anaesthesiology and Intensive Care Department of Clinical Science and Education Karolinska Institutet S\u00f6dersjukhuset Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"M\u00e5rtensson","sequence":"additional","affiliation":[{"name":"Section\u00a0of Anaesthesia and Intensive Care Medicine Department of Physiology and Pharmacology Karolinska Institutet Stockholm Sweden"},{"name":"Department of Intensive Care Austin Hospital Melbourne Vic. Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Svensen","sequence":"additional","affiliation":[{"name":"Section\u00a0of Anaesthesiology and Intensive Care Department of Clinical Science and Education Karolinska Institutet S\u00f6dersjukhuset Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Perner","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Copenhagen University Hospital Rigshospitalet Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,3,31]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-199010000-00001"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200109-016OC"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/SHK.0b013e318157e926"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-012-2769-8"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa010307"},{"key":"e_1_2_7_7_1","first-page":"331","article-title":"[The effect of early goal\u2010directed therapy on treatment of critical patients with severe sepsis\/septic shock: a multi\u2010center, prospective, randomized, controlled study]","volume":"22","year":"2010","journal-title":"Zhongguo Wei Zhong Bing Ji Jiu Yi Xue"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-015-3822-1"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/2110-5820-1-1"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/0885066613478899"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e3181feeb15"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1500896"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1401602"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1404380"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1406617"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/1745-6215-14-150"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/cc11682"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000194725.48928.3A"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/cc13072"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/cc11333"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa062200"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-015-3850-x"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-014-3638-4"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-015-3820-3"}],"container-title":["Acta Anaesthesiologica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Faas.12723","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aas.12723","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,5]],"date-time":"2023-10-05T09:49:47Z","timestamp":1696499387000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/aas.12723"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,3,31]]},"references-count":23,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2016,8]]}},"alternative-id":["10.1111\/aas.12723"],"URL":"https:\/\/doi.org\/10.1111\/aas.12723","archive":["Portico"],"relation":{},"ISSN":["0001-5172","1399-6576"],"issn-type":[{"value":"0001-5172","type":"print"},{"value":"1399-6576","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,3,31]]}}}