***TASK***
the task is to simplify the input abstract of a biomedical literature

***INPUT***
the input is the abstract of a biomedical literature

***OUTPUT***
the output is the simplified abstract for the input abstract of a biomedical literature

***DOCUMENTATION***

***EXAMPLES***

Input: We included four randomized trials involving 200 participants. Owing to small numbers of studies and participants, it was not possible to combine data for all outcomes. Two trials reported 28-day mortality, and one trial reported hospital mortality; in the third trial, the number of deaths stated did not match the quoted mortality rates. The pooled risk ratio (95% confidence interval) for 28-day mortality associated with HVHF was 0.89 (0.60 to 1.32, two trials, 146 participants, low-quality evidence). One study (137 participants, low-quality evidence) reported length of stay in the ICU. Two trials (170 participants, low-quality evidence) reported organ dysfunction, but we could not pool results owing to reporting differences. Three studies (189 participants, low-quality evidence) reported on haemodynamic changes, but we could not pool results owing to reporting differences. Investigators reported no adverse events. Overall, the included studies had low risk of bias. Investigators reported no adverse effects of HVHF (low-quality evidence). The results of this meta-analysis show that very few studies have been conducted to investigate the use of HVHF in critically ill patients with severe sepsis or septic shock (four studies, 201 participants, low-quality evidence). Researchers should consider additional randomized controlled trials that are large and multi-centred and have clinically relevant outcome measures. The cost-effectiveness of HVHF should also be studied..
Output:

This review is current until December 2015. We included four trials involving 205 participants. All four studies assessed effects of HVHF compared with the current standard haemofiltration and included participants with severe sepsis or septic shock who had been admitted to an ICU. Three of the four studies were very small (fewer than 20 participants enrolled in each study). The maximum time that participants were followed up after inclusion in any of the studies was 28 days. Two studies received financial support from pharmaceutical companies, and one study received support from a health research organization. Key results Outcome data were limited - two trials reported death rates at 28 days and one reported death rates in hospital; in the fourth study, the number of deaths stated did not match the quoted mortality rates. One study reported length of stay in the ICU, and one provided data on organ dysfunction. Investigators described no complications. No clear evidence showed any benefit of HVHF in critically ill patients with severe sepsis or septic shock. Quality of evidence Evidence is insufficient to support the routine use of high-volume haemofiltration in patients with severe sepsis or septic shock. Studies included in this review reported relatively small numbers of participants and measured different outcomes; therefore, we judged the quality of evidence with respect to the impact of HVHF as low. Larger trials, carried out at many centres, are required for full assessment of clinically relevant outcomes and for evaluation of cost versus benefit.