What fluid strategy should I choose in patients with COVID-19 ARDS?

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In general, a conservative fluid regime is recommended in patients with SARS-CoV-2 pneumonia. Even though there is not much data on fluid therapy in patients with COVID-19, it is assumed that these patients responde similarly to other patients with ARDS.

In addition, it is assumed that up to 40% of all deaths in patients with COVID-19 may be attributed to cardiac failure alone or in combination with respiratory failure.

Gentle fluid administration could be considered in patients with evidence of hypo perfusion and a history suggestive of total body hypovolemia (e.g. prolonged nausea/vomiting or diarrhea).