6/28/23, 12:22 AM CRISTAL Pathway Feedback Search Clinical Topics Home Studies CRISTAL CRISTAL Trial question What is the effect of fluid resuscitation with colloids on mortality in critically ill patients presenting with hypovolemic shock? Study design Multi-center Open label RCT Population Characteristics of study participants 38.0% female N = 2857 62.0% male 2857 patients (1075 female, 1782 male) Inclusion criteria: patients admitted to the ICU with hypovolemic shock Key exclusion criteria: receipt of fluid therapy in the ICU, anesthesia-related hypotension, advanced chronic liver disease, chronic HF, acute anaphylactic reaction, inherited coagulation disorders, pregnancy, dehydrated, or brain death or organ donor Interventions N=1414 fluid resuscitation with colloids (gelatins, dextrans, hydroxyethyl starches, or 4% or 20% of albumin) N=1443 fluid resuscitation with crystalloids (isotonic or hypertonic saline or Ringer lactate solution) Primary outcome Death at 28 days 27.0 % 27 25.4 20.3 % 13.5 % 6.8 % No significant difference 0.0 % https://web.pathway.md/studies/recywSdngWX4WnaqX 1/2 6/28/23, 12:22 AM CRISTAL Pathway Fluid resuscitation with colloids Fluid resuscitation with crystalloids No significant difference in death at 28 days (25.4% vs. 27%; RR 0.96, 96% CI 0.88 to 1.04) Secondary outcomes Significant decrease in death at 90 days (30.7% vs. 34.2%; RR 0.92, 95% CI 0.86 to 0.99) No significant difference in RRT (11% vs. 12.5%; RR 0.93, 95% CI 0.83 to 1.03) Conclusion In patients admitted to the ICU with hypovolemic shock, fluid resuscitation with colloids were not superior to fluid resuscitation with crystalloids with respect to death at 28 days. Reference Annane D, Siami S, Jaber S et al. Effects of fluid resuscitation with colloids vs crystalloids on mortality in critically ill patients presenting with hypovolemic shock: the CRISTAL randomized trial. JAMA. 2013 Nov 6;310(17):1809-17. Open reference URL https://web.pathway.md/studies/recywSdngWX4WnaqX 2/2