Objective: To evaluate the effect of conservative fluid management on the outcomes in patients with acute lung injury (ALI).
Methods: Randomized controlled trials (RCTs) and cohort trials on conservative fluid management from January 1, 1990 to May 20, 2010 were retrieved by electronic and manual searching. A meta-analysis of effect of conservative fluid management on the outcomes in ALI patients was conducted by the methods as recommended by the Cochrane Collaboration.
Results: Four RCTs involving 594 cases in conservative fluid management group and 584 in conventional fluid management group were included into the Meta-analysis. Compared with the conventional fluid management group, there was no beneficial effect of conservative fluid management strategy on mortality in ALI patients (P = 0.16). However, the duration of mechanical ventilation was shortened while the incidence of renal failure remained unchanged. Three retrospective cohort trials involving 296 cases in conservative fluid management group and 750 in conventional fluid management group were included into the meta-analysis. As compared with the conventional fluid management strategy, conservative fluid management strategy had improved the patient outcomes (P < 0.001).
Conclusion: No beneficial effect of conservative fluid management strategy on the mortality is observed in the ALI patients. And the ventilator-free durations become elongated. However, further trials of a larger sample size and a higher quality are warranted.