Chen Ziying, Huang Xu, Lu Haining, Deng Wang, Huang Linna, Wu Dawei, Wang Daoxin, Zhan Qingyuan, Wang Chen
Peking University China-Japan Friendship School of Clinical Medicine Beijing China.
Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Center for Respiratory Diseases National Clinical Research Center for Respiratory Diseases Beijing China.
Pulm Circ. 2023 Jul 2;13(3):e12261. doi: 10.1002/pul2.12261. eCollection 2023 Jul.
We 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, < 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.
我们旨在评估中国的一般液体管理情况，并评估急性呼吸窘迫综合征（ARDS）患者的液体平衡与生存结局之间的关联。我们进行了一项纳入ARDS患者的回顾性多中心研究。我们描述了中国ARDS患者的液体管理情况。此外，还分析了根据累积液体平衡进行分组的患者的临床特征和结局。以医院死亡率为结局进行多变量逻辑回归分析。2016年6月至2018年2月，我们的研究纳入了527例ARDS患者。在重症监护病房（ICU）入院后的前7天，平均累积液体平衡为1669（-1101至4351）mL。根据ICU入院后前7天的累积液体平衡将患者分为四组：第一组（≤0 L），第二组（>0 L，≤3 L），第三组（>3 L，≤5 L）和第四组（>5 L）。在ICU入院第7天累积液体平衡较低的患者中观察到医院死亡率显著降低（第一组为20.5%，第二组为32.8%，第三组为38.5%，第四组为50%，P<0.001）。较低的液体平衡与ARDS患者较低的医院死亡率相关。然而，未来需要进行大规模且设计良好的随机对照试验。
