The ARDS Network’s Fluid and Catheter Treatment Trial (FACTT) found that a conservative fluid strategy increased ventilator-free days and reduced organ dysfunction, but it did not decrease mortality. However, a short-term follow-up study suggested that among black patients, there was a mortality benefit. In the September isue of the journal Annals of the American Thoracic Society, Sarah E. Jolley, MD, MSc, and colleagues report on a post-hoc analysis of 655 FACTT patients a year after enrollment in the study to determine if a mortality benefit in fact existed for these patients. They found that mortality was significantly lower for black patients receiving conservative fluid treatment compared to liberal fluid administration (38 percent vs. 54 percent).

Although the study had several limitations, including the fact that the original study was not powered to include longer-term follow-up, the authors conclude that their findings support the NIH’s call to test for gender, race, and ethnicity interactions and suggest “it would be prudent to avoid high fluids in our black patients.”

The article is titled, "Relationship between Race and the Effect of Fluids on Long-term Mortality after Acute Respiratory Distress Syndrome: Secondary Analysis of the NHLBI Fluid and Catheter Treatment Trial."