{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T13:01:53Z","timestamp":1792587713690,"version":"4.5.0"},"reference-count":35,"publisher":"BMJ","issue":"10","funder":[{"DOI":"10.13039\/501100004571","name":"Minist\u00e8re des Affaires Sociales et de la Sant\u00e9","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004571","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2017,8,15]]},"published-print":{"date-parts":[[2017,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare the haemodynamic effect of crystalloids and colloids during acute severe hypovolaemic shock.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>\n                      Exploratory subgroup analysis of a multicentre randomised controlled trial (Colloids Versus Crystalloids for the Resuscitation of the Critically Ill, CRISTAL, ClinicalTrials.gov\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT00318942\">NCT00318942<\/jats:ext-link>\n                      ).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>CRISTAL was conducted in intensive care units in Europe, North Africa and Canada.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Current analysis included all patients who had a pulmonary artery catheter in place at randomisation. 220 patients (117 received crystalloids vs 103 colloids) underwent pulmonary artery catheterisation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention<\/jats:title>\n                    <jats:p>Crystalloids versus colloids for fluid resuscitation in hypovolaemic shock.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measures<\/jats:title>\n                    <jats:p>Haemodynamic data were collected at the time of randomisation and subsequently on days 1, 2, 3, 4, 5, 6 and 7.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Median cumulative volume of fluid administered during the first 7 days was higher in the crystalloids group than in the colloids group (3500 (2000\u20136000) vs 2500 (1000\u20134000) mL, p=0.01). Patients in the colloids arm exhibited a lower heart rate over time compared with those allocated to the crystalloids arm (p=0.014). There was no significant difference in Cardiac Index (p=0.053), mean blood pressure (p=0.4), arterial lactates (p=0.9) or global Sequential Organ Failure Assessment score (p=0.3) over time between arms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>During acute severe hypovolaemic shock, patients monitored by a pulmonary artery catheter achieved broadly similar haemodynamic outcomes, using lower volumes of colloids than crystalloids. The heart rate was lower in the colloids arm.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2017-016736","type":"journal-article","created":{"date-parts":[[2017,10,7]],"date-time":"2017-10-07T20:10:20Z","timestamp":1507407020000},"page":"e016736","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":21,"title":["Haemodynamic response to crystalloids or colloids in shock: an exploratory subgroup analysis of a randomised controlled trial"],"prefix":"10.1136","volume":"7","clinical-trial-number":[{"clinical-trial-number":"nct00318942","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct00318942","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Nicholas","family":"Heming","sequence":"first","affiliation":[{"name":"General Intensive Care Unit, Raymond Poincar\u00e9 Hospital, Garches, France"},{"name":"U1173 Lab Inflammation& Infection, University of Versailles SQY-Paris Saclay - INSERM, Garches, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Souheil","family":"Elatrous","sequence":"additional","affiliation":[{"name":"service de r\u00e9animation, Centre Hospitalo-Universitaire Tahar Sfar, University of Monastir, Mahdia, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samir","family":"Jaber","sequence":"additional","affiliation":[{"name":"Saint Eloi University Hospital, Montpellier, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne Sylvie","family":"Dumenil","sequence":"additional","affiliation":[{"name":"Antoine B\u00e9cl\u00e8re Hospital, Clamart, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo\u00ebl","family":"Cousson","sequence":"additional","affiliation":[{"name":"Reims University Hospital, Robert Debr\u00e9 Hospital, Reims, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xavier","family":"Forceville","sequence":"additional","affiliation":[{"name":"General Hospital, Meaux, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoine","family":"Kimmoun","sequence":"additional","affiliation":[{"name":"Intensive Care Unit Brabois, Heart and Vessels Institute, Nancy University Hospital, Nancy, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean Louis","family":"Trouillet","sequence":"additional","affiliation":[{"name":"Piti\u00e9 Salp\u00eatri\u00e8re Hospital, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00e9r\u00f4me","family":"Fichet","sequence":"additional","affiliation":[{"name":"Centre Cardiologique du Nord, Saint-Denis, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadia","family":"Anguel","sequence":"additional","affiliation":[{"name":"Bic\u00eatre Hospital, Le Kremlin-Bic\u00eatre, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Darmon","sequence":"additional","affiliation":[{"name":"Saint Louis Hospital, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claude","family":"Martin","sequence":"additional","affiliation":[{"name":"AP-HM H\u00f4pital Nord, Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvie","family":"Chevret","sequence":"additional","affiliation":[{"name":"Biostatistic Team, Saint Louis Hospital, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Djillali","family":"Annane","sequence":"additional","affiliation":[{"name":"General Intensive Care Unit, Raymond Poincar\u00e9 Hospital, Garches, France"},{"name":"U1173 Lab Inflammation& Infection, University of Versailles SQY-Paris Saclay - INSERM, Garches, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2017,10,6]]},"reference":[{"key":"2025121400092545000_7.10.e016736.1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1208627"},{"key":"2025121400092545000_7.10.e016736.2","unstructured":"Guyton AC , Hall JE . 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