• Critical care clinics · Oct 2021

    Review

    Fluid Therapy and Acute Respiratory Distress Syndrome.

    • Jisoo Lee, Keith Corl, and Mitchell M Levy.
    • Division of Pulmonary, Critical Care & Sleep Medicine, Rhode Island Hospital, 593 Eddy Street, POB Suite 224, Room 222.1, Providence, RI 02903, USA. Electronic address: Jisoo_Lee@brown.edu.
    • Crit Care Clin. 2021 Oct 1; 37 (4): 867875867-875.

    AbstractThe optimal fluid management for acute respiratory distress syndrome (ARDS) remains unknown. Liberal fluid management may improve cardiac function and end-organ perfusion, but may lead to increased pulmonary edema and inhibit gas exchange. Trials suggest that conservative fluid management leads to better clinical outcomes, although prospective randomized, controlled trials have not demonstrated mortality benefit. Recent discoveries suggest there is large heterogeneity in ARDS, and varying phenotypes of ARDS respond differently to fluid treatments. Future advances in management will require real-time assignment of ARDS phenotypes, which may facilitate inclusion into clinical trials by ARDS phenotype and guide development of targeted therapies.Copyright © 2021 Elsevier Inc. All rights reserved.

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