Trial reportChest2016
B-Type Natriuretic Peptide, Aldosterone, and Fluid Management in ARDS.
Trial report in Chest, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
12 citing papers in PubMed, 20 citations in OpenAlex.
- Balanced Crystalloids versus Saline in the Intensive Care Unit. The SALT Randomized Trial.American journal of respiratory and critical care medicine · 2017Trial
- Right Atrial Dysfunction Is Prevalent in Pediatric Acute Respiratory Distress Syndrome and Reflects Pulmonary Hypertension and Right Ventricular Dysfunction.Critical care explorations · 2025Article
- Cardiac biomarkers in acute respiratory distress syndrome: a systematic review and meta-analysis.Journal of intensive care · 2021Article
- Fluids in ARDS: more pros than cons.Intensive care medicine experimental · 2020Review
- Fluid management in ARDS: an evaluation of current practice and the association between early diuretic use and hospital mortality.Journal of intensive care · 2020Article
- Centrality of G6PD in COVID-19: The Biochemical Rationale and Clinical Implications.Frontiers in medicine · 2020Article
- Positive Cumulative Fluid Balance Is Associated With Mortality in Pediatric Acute Respiratory Distress Syndrome in the Setting of Acute Kidney Injury.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2019Observational
- Fluid Management in Acute Respiratory Distress Syndrome.Seminars in respiratory and critical care medicine · 2019Review
- Progressive myocardial injury is associated with mortality in the acute respiratory distress syndrome.Journal of critical care · 2018Observational
- TACO and TRALI: biology, risk factors, and prevention strategies.Hematology. American Society of Hematology. Education Program · 2018Review
- Fluid resuscitation targeting sepsis-induced cardiovascular dysfunction: severity of disease as effect modifier.Journal of thoracic disease · 2017Article
- Differentiating pulmonary transfusion reactions using recipient and transfusion factors.Transfusion · 2017Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 1 institution in 1 country.
Funding
Abstract
backgroundConservative fluid management increases ventilator-free days without influencing overall mortality in acute respiratory distress syndrome. Plasma concentrations of B-type natriuretic peptide (a marker of ventricular filling) or aldosterone (a marker of effective circulating volume) may identify patients for whom fluid management impacts survival.
methodsThis was a retrospective analysis of the Fluid and Catheter Treatment Trial (FACTT), a randomized trial comparing conservative with liberal fluid management in acute respiratory distress syndrome. Using plasma collected at study enrollment, we measured B-type natriuretic peptide and aldosterone by immunoassay. Multivariable analyses examined the interaction between B-type natriuretic peptide or aldosterone concentration and fluid strategy with regard to 60-day in-hospital mortality.
resultsAmong 625 patients with adequate plasma, median B-type natriuretic peptide concentration was 825 pg/mL (interquartile range, 144-1,574 pg/mL), and median aldosterone was 2.49 ng/dL (interquartile range, 1.1-4.3 ng/dL). B-type natriuretic peptide did not predict overall mortality, correlate with fluid balance, or modify the effect of conservative vs liberal fluid management on outcomes. In contrast, among patients with lower aldosterone concentrations, conservative fluid management increased ventilator-free days (17.1 ± 9.8 vs 12.5 ± 10.3, P < .001) and decreased mortality (19% vs 30%, P = .03) (P value for interaction = .01).
conclusionsIn acute respiratory distress syndrome, B-type natriuretic peptide does not modify the effect of fluid management on outcomes. Lower initial aldosterone appears to identify patients for whom conservative fluid management may improve mortality.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.