Non-invasive haemodynamic monitoring to individualise fluid resuscitation in adult diabetic ketoacidosis: A randomized controlled pilot trial

Figure 1 Pilot trial profile and participant flow. Consolidated Standards of Reporting Trials-style flow diagram indicating the screening of adults presenting with suspected diabetic ketoacidosis, eligibility assessment, randomisation to ultrasonic cardiac output monitor-guided or control fluid resuscitation, allocation, follow-up and inclusion in the primary and secondary analyses. Boxes indicate reasons for exclusion before randomisation. No participants withdrew after randomisation during the 14-day treatment and follow-up period.

Figure 2 Effects of ultrasonic cardiac output monitor-guided fluid resuscitation on net fluid balance, urine output, hospital stay, and complications. A: Net cumulative fluid replenishment over 72 hours in ultrasonic cardiac output monitor (USCOM)-guided and control groups, with error bands representing standard deviations; B: Urine output trajectories over the first 72 hours, with shaded areas indicating standard deviations; C: Kaplan-Meier curves illustrating time to hospital discharge, demonstrating earlier discharge trends in the USCOM-guided group; D: Incidence of key complications, indicating no signal of harm in major safety endpoints. Panels depict cumulative net fluid balance and urine output at 24 hours, 48 hours, and 72 hours, the total 72 hours net fluid balance, hospital length of stay, and the incidence of prespecified complications (hypoglycaemia, hypokalaemia, pulmonary oedema, acute kidney injury, and arrhythmia) in USCOM-guided and control groups. Bars indicate mean values, with error bars representing standard deviations. P values are from two-sided independent-samples t-tests for continuous outcomes and χ² or Fisher’s exact tests for categorical outcomes, consistent with the analyses reported in Tables 3, 4 and 6.