We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Comment & Response |

Mortality in Patients With Hypovolemic Shock Treated With Colloids or Crystalloids

Rinaldo Bellomo, MD, FCICM1; Simon Finfer, MD, FCICM2; John Myburgh, PhD, FCICM2
[+] Author Affiliations
1Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Australia
2George Institute for Global Health, University of Sydney, Sydney, Australia
JAMA. 2014;311(10):1067-1068. doi:10.1001/jama.2014.833.
Text Size: A A A
Published online


To the Editor The CRISTAL trial1 requires scrutiny because its results contradict other high-quality evidence.2 The CRISTAL trial was stopped for futility based on no difference in 28-day mortality, but reported numerically lower mortality for the colloids group. However, eFigure 1 in the article suggests lower mortality in the crystalloids group when the trial was stopped. eFigure 2 shows a sudden increase in probability of death at 28 days in both groups; this indicates either censoring (suggesting the denominator for 90-day mortality was wrong) or an unexplained and puzzling cluster of deaths on day 28 resulting in the mortality difference at 90 days.


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview




March 12, 2014
Djillali Annane, MD, PhD; Sylvie Chevret, MD, PhD
1Raymond Poincaré Hospital, University of Versailles, Garches, France
2Saint Louis Hospital, Paris, France
JAMA. 2014;311(10):1069-1070. doi:10.1001/jama.2014.841.
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...