A perspective on the fluids and catheters treatment trial (FACTT). Fluid restriction is superior in acute lung injury and ARDS.
Restricting fluid intake and promoting fluid excretion (a "dry" or conservative strategy) is more effective than a "we or liberal strategy in patients with acute lung injury and acute respiratory distress syndrome. In a multicenter, randomized, prospective clinical comparison of the two strategies in 1000 patients, those in the conservative-strategy group experienced faster improvement in lung function and spent significantly fewer days on ventilation and in the intensive care unit (N Engl J Med 2006; 354:2564-2574). No significant differences were observed in the incidence of death by 60 days or of nonpulmonary organ failure at 28 days except for days of central nervous system failure, which were fewer in the conservative-strategy group.
Wiedemann
Herbert P
HP
Department of Pulmonary, Allergy, and Critical Care Medicine, Cleveland Clinic, OH 44195, USA. wiedemh@ccf.org
D000208:Acute Disease; D005260:Female; D005440:Fluid Therapy; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012121:Respiration, Artificial; D012128:Respiratory Distress Syndrome / Q000188:drug therapy / Q000628:therapy*; D012129:Respiratory Function Tests; D016896:Treatment Outcome; D014868:Water Deprivation