Fluid management using cardiometry versus simplified ‘Fluid and Catheter Treatment Trial’ protocol in acute respiratory distress syndrome
Abstract
Background & Objective: Fluid management is a complicated subject and an important part of medical care. Fluid balance has been shown to improve respiratory physiology in patients with acute respiratory distress syndrome (ARDS). We compared fluid management in ARDS guided by electrical cardiometry (EC) versus guided with conservative fluid protocol, simplified Fluid and Catheter Treatment Trial (‘FACTT Lite’).
Methodology: This prospective randomized study was conducted on 70 patients, who were 18 y or older and who fulfilled the Berlin definition of ARDS. Enrolled patients were randomly allocated into two equal groups; Group A: fluid management was guided by ‘FACTT Lite’ and Group B, in which fluid management was guided by EC.
Results: Mortality at 28th day was lower in Group B than in Group A; the hazardous ratio of mortality in Group A was 2.55 times than Group B. Duration of survival was higher in Group B than in Group A. Intensive care unit (ICU) stay and duration of mechanical ventilation (MV) were significantly lower in Group B than in Group A. Weaning was better in Group B than Group A. Lung Injury Score (LIS) was significantly decreased in Group B than Group A at 4, 5, 6, 7 and 14 days. Intravenous fluid intake and urine output were significantly decreased in Group B than Group A at all time measurements.
Conclusions: Electrical cardiometry was superior to ‘FACTT Lite’ in the fluid management in ARDS in terms of decreased 28-day mortality, Lung Injury Score, fluid intake, duration of mechanical ventilation and ICU stay.
Abbreviations: ARDS - acute respiratory distress syndrome; EC - electrical cardiometry; ‘FACTT Lite’- Simplified conservative fluid protocol, Fluid and Catheter Treatment Trial; MV - mechanical ventilation
Key words: Electrical Cardiometry; FACTT Lite; Fluid management; Mechanical ventilation; Acute Respiratory Distress Syndrome.
Citation: Shaheen MM, Elgebaly AS, Ghada Fouad Elbaradey GF, Elkeblawy AM. Fluid management using cardiometry versus simplified ‘Fluid and Catheter Treatment Trial’ protocol in acute respiratory distress syndrome. Anaesth. pain intensive care 2023;27(2):204−213.
Received: September 06, 202; Reviewed: July 18, 2022; Accepted: July 26, 2022
