Why is a conservative fluid status thought to be beneficial in ARDS?

  • ARDS characterised by alveolar oedema and flooding
    • Usually due to increased disruption of the alveolar-capillary membrane
  • Administration of fluid may result in:
    • Increased left atrial and pulmonary venous pressures
    • Increased alveolar oedema due to raised hydrostatic pressure
  • Optimal intravascular volume is that which maintains adequate tissue perfusion while minimizing alveolar flooding.