The Clinical Value Of EVLW For ARDS Patients In Fluid Management

ObjectiveTo discuss the clinical value of extravascular lung water (EVLW) for acute respiratory distress syndrome (ARDS) patients in fluid-management by investigating the effect of two different fluid-management strategies on28days and60days survival rate, ICU days、mechanical ventilation days、acute lung injury score and oxygenation index to find the optimal fluid-management in ARDS patients.MethodsA total of27patients with acute respiratory distress syndrome (ARDS) in our ICU department from May2008to September2011met the inclusion criteria were selected as research objects. They were randomly assigned to restricted fluid management strategy group and liberal fluid management strategy group, acute lung injury score. Oxygenation index were measured per24h,the volume of24h fluid balance was recorded,28-day and60-day survival rates were as the primary end points, mechanical ventilation days and ICU days were as secondary end points.ResultsThere is no significant difference in28-day and60-day survival rate between two groups, however ICU days and mechanical ventilation days were much shorter in restricted fluid management strategy group than in liberal fluid management strategy group (P<0.05);acute lung injury score and oxygenation index both showed a significantly statistical difference during the treatment in and between groups (P<0.05)ConclusionAlthough there is no marked difference in survival rate between restricted fluid management strategy and liberal fluid management strategy for ARDS patients, the restricted fluid management strategy can greatly improve the acute lung injury score and oxygenation index, shorten the days of mechanical ventilation and ICU days. Restricted fluid management strategy for ARDS patients, especially with target of EVLW, is an effective approach to many corresponding benefits.