{"id":30500,"date":"2026-04-24T04:08:00","date_gmt":"2026-04-23T20:08:00","guid":{"rendered":"https:\/\/csccm.org.cn\/?p=30500"},"modified":"2026-04-24T05:40:58","modified_gmt":"2026-04-23T21:40:58","slug":"icu-management-practice-%e4%bf%9d%e6%8c%81ards%e6%82%a3%e8%80%85%e5%b9%b2%e7%87%a5","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=30500","title":{"rendered":"[ICU Management &#038; Practice]: \u4fdd\u6301ARDS\u60a3\u8005\u5e72\u71e5"},"content":{"rendered":"\n<h1 class=\"wp-block-heading\">Keeping the ARDS Patient Dry<\/h1>\n\n\n\n<ul>\n<li>In&nbsp;<a href=\"https:\/\/healthmanagement.org\/c\/icu\">ICU<\/a><\/li>\n\n\n\n<li>Thu, 19 Mar 2026<\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/res.cloudinary.com\/healthmanagement-org\/image\/upload\/f_auto\/q_90\/fl_lossy\/v1773920525\/cw\/00132270_cw_image_admin_55a83c03da97c8e45792a435203fc8c3.webp?_a=BAAABnBs\" alt=\"\"\/><\/figure>\n\n\n\n<p>Fluid management in acute respiratory distress syndrome (ARDS) remains a complex and evolving area, with no single \u2018optimal\u2019 strategy. Discussing this @ISICEM, Prof Daniel De Backer emphasised that while avoiding fluid overload is important, the key challenge is tailoring therapy to the individual patient rather than adhering to rigid \u2018dry\u2019 or \u2018wet\u2019 approaches.<\/p>\n\n\n\n<p>Historically, fluid management in ARDS has followed a shifting pendulum, moving from conservative to liberal strategies and back again. Much of the current understanding is informed by the landmark FACTT trial, which found no mortality benefit from a conservative (dry) strategy but did demonstrate faster weaning from mechanical ventilation, reinforcing the importance of limiting lung oedema. Observational data further support this, showing worse outcomes with higher extravascular lung water.<\/p>\n\n\n\n<p>However, clinical reality is more nuanced. ARDS often coexists with conditions such as sepsis and shock, where fluid resuscitation may be necessary to maintain tissue perfusion. In such cases, a strictly conservative strategy may be inappropriate. Adding to this complexity, research has identified distinct ARDS phenotypes with differing responses to fluid management, some benefiting from a dry approach, others from a more liberal one, though these phenotypes are not easily identifiable in routine practice.<\/p>\n\n\n\n<p>Given these challenges, Prof De Backer advocates for an individualised, physiology-driven approach. Fluid administration should only occur when there is a clear indication, such as impaired tissue perfusion, and clinicians should assess fluid responsiveness before giving volume. Equally important is ongoing reassessment to evaluate both the effectiveness and tolerance of fluids, avoiding unnecessary or excessive administration that could worsen pulmonary oedema.<\/p>\n\n\n\n<p>Monitoring plays a central role in this process, with tools such as echocardiography, clinical examination, and simple measures like capillary refill time helping guide decisions. The overarching aim is to strike the right balance, providing enough fluid to support perfusion without causing harm.<\/p>\n\n\n\n<p>Looking ahead, emerging technologies such as artificial intelligence may enhance clinicians\u2019 ability to personalise fluid therapy by identifying complex physiological patterns. For now, the key takeaway is clear: avoid fluid overload where possible, but prioritise careful, patient-specific decision-making over fixed protocols.<\/p>\n\n\n\n<p>Source: ISICEM<br \/>Image Credit: ISICEM<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Keeping the ARDS Patient Dry Fluid management in acute  [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[24,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/30500"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=30500"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/30500\/revisions"}],"predecessor-version":[{"id":30501,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/30500\/revisions\/30501"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=30500"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=30500"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=30500"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}