For decades, fluid administration has been considered a cornerstone of septic shock management. Yet increasing evidence suggested that excessive fluid accumulation may contribute to organ dysfunction, respiratory failure, and prolonged critical illness.
Previous studies raised concerns regarding liberal fluid strategies, but uncertainty remained regarding how aggressively fluids should be restricted after initial resuscitation.
The CLASSIC trial sought to answer this question. Published in 2022, CLASSIC randomized adult ICU patients with septic shock to either a restrictive fluid strategy or standard care following initial resuscitation.
Unlike early resuscitation trials, CLASSIC focused on patients who had already undergone initial stabilization and remained critically ill. The primary outcome was 90-day mortality.