In Reply Dr Pepper raises an interesting question related to the potential interaction between fluid balance and radiographic progression, mainly in patients with shock and severe sepsis. Unfortunately, we do not have data on fluid balance during the first 5 days after randomization.
Although we cannot specifically answer this question, our general practice was to keep patients in a negative or at least even fluid balance. Because the study was blinded and randomized, we do not think that changes in fluid balance accounted for differences in radiographic resolution.
Torres A. Treatment for Hospitalized Patients With Severe Community-Acquired Pneumonia—Reply. JAMA. 2015;313(21):2184-2185. doi:10.1001/jama.2015.4777