TY - JOUR T1 - Go Easy with the Fluids? Increased Mortality in Acute Respiratory Distress Syndrome with Hypervolemia JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.congress-2020.3442 VL - 56 IS - suppl 64 SP - 3442 AU - Kam S Ho AU - Paaras Kohli AU - Yasmin Herrera AU - Archana Pattupara AU - Joseph Poon AU - Shabnam Nasserifar AU - Andre Sotelo AU - Raymonde Jean Y1 - 2020/09/07 UR - http://erj.ersjournals.com/content/56/suppl_64/3442.abstract N2 - Introduction: Sepsis is a leading cause of acute respiratory distress syndrome (ARDS). The Surviving Sepsis guideline recommends the generous use of fluids, but hypervolemia is also associated with increased lung injury.Purpose: To determine the relationship between hypervolemia and mortality and health care resource utilization in patients admitted to the hospital in the US with ARDS on mechanical ventilation (MV).Method: A retrospective study was conducted using the AHRQ-HCUP National Readmission Database for the year 2014. Adults (≥ 18 years) with a principal diagnosis of ARDS on MV and a secondary diagnosis of hypervolemia were identified using ICD-9 codes as described in the literature. The primary outcome was in-hospital mortality. Secondary outcomes were length of hospital stay (LOS), and total hospitalization costs. Propensity score (PS) using the next neighbor method without replacement with 1:1 matching was utilized to adjust for confounders.Results: In total, 92,438 hospital admissions with a primary diagnosis of ARDS on MV were identified, of which 7.76% were hypervolemic. In-hospital morality (33.62%) was higher among the hypervolemic group in comparison to the euvolemic group (25.54%, p<0.001).The 30-day readmission rate among were similar between the two group (p=0.06). The most common reason for readmission was unspecified acute respiratory failure (9.7%). Hypervolemia was associated with longer LOS (p<0.003) and a higher total hospitalization cost (p<0.001).Conclusion: Excessive use of fluids during resuscitation for sepsis has an impact on lung and distal organ injury in ARDS.FootnotesCite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 3442.This abstract was presented at the 2020 ERS International Congress, in session “Respiratory viruses in the "pre COVID-19" era”.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only). ER -