Objective To investigate the clinical efficacy of different fluid management strategies on acute respiratory distress syndrome（ARDS）patients according to the results of pulse indicator continuous cardiac output（PiCCO）monitoring.Methods 68 cases of ARDS patients were randomly divided into an observation group and a control group（34cases in each group）and were taken respectively restrictive and non-restrictive fluid management measures with the application of PiCCO technology to record the amount of fluid intake and output

monitor oxygenation index（PaO

2

/FiO

2

）

blood lactate

central venous pressure（CVP）

femoral artery mean blood pressure（MAP）

cardiac function index（CFI）and extravascular lung water index（EVLWI）

record the time of ICU stay and mechanical ventilation

and track their 30-day survival of patients.ResultsIn the observation group

the net input volume of fluid on the second

third

fourth

fifth

sixth and seventh days was less than the control group

and the difference was statistically significant（P

<

0.01）;after 7-day treatment

PaO

2

/FiO

2

of patients in the observation group increased while their blood lactate

MAP and EVLWI declined

compared with before its treatment and the control group after treatment

the differences were statistically significant（P

<

0.05）;the time of ICU stay and duration of mechanical ventilation within 15 days in the observation group were respectively（11.93±3.04）days and（10.98±1.39）hours

while those of the control group were（16.59±3.83）days and（12.97±1.76）hours

and there were statistically significant differences between the two groups（P

<

0.05）;within 30 days

there were 5and 10 cases of death in the observation group and the control group

their cumulative survival rates were 85.3%（95% CI:73.34%

9

7.26%）and 70.6%（95% CI:55.31%

8

5.89%）

and the difference was not statistically significant（χ

2

=2.154

P=0.142）.Conclusion PiCCO can accurately monitor the changes of hemodynamics in patients with ARDS and according to PiCCO monitoring results

we may adopt different fluid management strategies on patients.Restrictive fluid management can help to improve patients′pulmonary function

shorten the use of mechanical ventilator and the time of ICU stay

but whether it can improve the recent survival rate in patients or not must be further explored.