LAUSR

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 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 Conclusion: Excessive use of fluids during resuscitation for sepsis has an impact on lung and distal organ injury in ARDS.