The association between early fluid strategy and prognosis of acute respiratory distress syndrome: A post hoc study of CHARDS

Author:

Chen Ziying12,Huang Xu2,Lu Haining3,Deng Wang4,Huang Linna2,Wu Dawei3,Wang Daoxin4,Zhan Qingyuan12ORCID,Wang Chen125

Affiliation:

1. Peking University China‐Japan Friendship School of Clinical Medicine Beijing China

2. Department of Pulmonary and Critical Care Medicine, China‐Japan Friendship Hospital, Center for Respiratory Diseases National Clinical Research Center for Respiratory Diseases Beijing China

3. Department of Critical Care Medicine Qilu Hospital of Shandong University (Qingdao) Qingdao China

4. Department of Respiratory and Critical Care Medicine The Second Affiliated Hospital of Chongqing Medical University Chongqing China

5. Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China

Abstract

AbstractWe aimed to assess general fluid management in China and evaluate the association between fluid balance and survival outcomes in acute respiratory distress syndrome (ARDS) patients. A retrospective, multicenter study including ARDS patients was conducted. We described the fluid management of ARDS patients in China. Furthermore, clinical characteristics and outcomes of patients subdivided by cumulative fluid balance were also analyzed. Multivariable logistic regression analysis was performed with hospital mortality as the outcome. From June 2016 to February 2018, 527 ARDS patients were included in our study. The mean cumulative fluid balance was 1669 (−1101 to 4351) mL in the first 7 day after intensive care unit (ICU) admission. Patients were divided into four groups based on cumulative fluid balance of the first 7 day after ICU admission: Group I (≤0 L), Group II (>0 L, ≤3 L), Group III (>3 L, ≤5 L), and Group IV (>5 L). Significantly lower hospital mortality was observed in patients with a lower cumulative fluid balance on day 7 of ICU admission (20.5% in Group I vs. 32.8% in Group II, 38.5% in Group III, and 50% in Group IV, p < 0.001). A lower fluid balance is associated with lower hospital mortality in patients with ARDS. However, a large‐scale and well‐designed randomized controlled trial is needed in the future.

Publisher

Wiley

Subject

Pulmonary and Respiratory Medicine

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