Fluid balance and the adult respiratory distress syndrome

R. S. Simmons, G. G. Berdine, J. J. Seidenfeld, T. J. Prihoda, G. D. Harris, J. D. Smith, T. J. Gilbert, E. Mota, W. G. Johanson

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Abstract

This study examined the effect of fluid balance on survivals in ARDS. Of the 213 patients entered into a prospective data collection study, we evaluated 113 patients who met strict criteria for ARDS. Multiple variables were analyzed for as long as 14 days after intubation including cardiac output, pulmonary capillary wedge pressure, mean blood pressure, intake minus output (I-O), cumulative intake minus output (cum I-O), and change in weight (Δwt). We found significant differences in cum I-O and Δwt between survivors and nonsurvivors on almost every day. Survivors lost weight and had a significantly lower cum I-O compared with nonsurvivors. Logistic regression was used to determine if Δwt and cum I-O could predict survival. Patients who lost 3 kg or more weight had as much higher survival than did those who gained 3 kg or more weight (67 and 0%, respectively, on Day 14). Similar results were obtained using comparably low and high values for cum I-O. The logistic regression equations demonstrated that weight loss and low cumulative I-O correlated with improved survival. Although cause and effect relationships are difficult to determine from these types of analyses, they can be used to formulate prospective studies and predict survival in patients.

Original languageEnglish (US)
Pages (from-to)924-929
Number of pages6
JournalAmerican Review of Respiratory Disease
Volume135
Issue number4 I
DOIs
StatePublished - Jan 1 1987

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ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Simmons, R. S., Berdine, G. G., Seidenfeld, J. J., Prihoda, T. J., Harris, G. D., Smith, J. D., Gilbert, T. J., Mota, E., & Johanson, W. G. (1987). Fluid balance and the adult respiratory distress syndrome. American Review of Respiratory Disease, 135(4 I), 924-929. https://doi.org/10.1164/arrd.1987.135.4.924