Conservative fluid management benefits black ARDS patients

Conservative fluid management benefits black ARDS patients

(HealthDay)—For patients with acute respiratory distress syndrome (ARDS), conservative fluid management is associated with reduced mortality for non-Hispanic black, but not white, patients, according to a study published online July 14 in the Annals of the American Thoracic Society.

Sarah E. Jolley, M.D., from Louisiana State University in New Orleans, and colleagues estimated long-term mortality by race in a post-hoc analysis of the Fluid and Catheter Treatment Trial (FACTT), including one-year follow-up, and the Economic Analysis of Pulmonary Artery Catheters study. A multi-state Markov model was fit to estimate one-year mortality for all non-Hispanic black and white FACTT subjects (217 and 641, respectively).

The researchers identified a significant interaction between race and fluid treatments (P = 0.012). Black subjects assigned to conservative fluids had lower one-year mortality (38 versus 54 percent for conservative and liberal, respectively; mean mortality difference, 16 percent; 95 percent confidence interval, 2 to 30 percent; P = 0.027). For white subjects, one-year mortality was 35 versus 30 percent for conservative versus liberal fluid management (mean mortality difference, −4.8 percent; 95 percent confidence interval, −13 to 3 percent; P = 0.23).

"In our cohort, conservative fluid management may have improved one-year for non-Hispanic black ARDS patients," the authors write. "However, we found no long-term benefit of conservative management in white subjects."

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