Use este identificador para citar ou linkar para este item: http://hdl.handle.net/11690/1894
Autor(es): Felice, Vinicius Brenner
Lisboa, Thiago Costa
Souza, Lucas Vieira de
Sell, Luana Canevese
Friedman, Gilberto
Título: Hemodynamically stable oliguric patients usually do not respond to fluid challenge
Palavras-chave: Oliguria;Fluid therapy;Acute kidney injury;Intensive care units
Data do documento: 2020
Editor: Associação de Medicina Intensiva Brasileira
Citação: FELICE, V. B. et al. Hemodynamically stable oliguric patients usually do not respond to fluid challenge. RBTI, v. 32, n. 4, p. 564-570, 2020. Disponível em: https://www.scielo.br/j/rbti/a/RtVq5VLyqbcnWzXGjVnPQTv/?lang=en. Acesso em: 23 jul. 2021.
Resumo: Objective: To evaluate renal responsiveness in oliguric critically ill patients after a fluid challenge. Methods: We conducted a prospective observational study in one university intensive care unit. Patients with urine output < 0.5mL/kg/h for 3 hours with a mean arterial pressure > 60mmHg received a fluid challenge. We examined renal fluid responsiveness (defined as urine output > 0.5mL/kg/h for 3 hours) after fluid challenge. Results: Forty-two patients (age 67 ± 13 years; APACHE II score 16 ± 6) were evaluated. Patient characteristics were similar between renal responders and renal nonresponders. Thirteen patients (31%) were renal responders. Hemodynamic or perfusion parameters were not different between those who did and those who did not increase urine output before the fluid challenge. The areas under the receiver operating characteristic curves were calculated for mean arterial pressure, heart rate, creatinine, urea, creatinine clearance, urea/creatinine ratio and lactate before the fluid challenge. None of these parameters were sensitive or specific enough to predict reversal of oliguria. Conclusion: After achieving hemodynamic stability, oliguric patients did not increase urine output after a fluid challenge. Systemic hemodynamic, perfusion or renal parameters were weak predictors of urine responsiveness. Our results suggest that volume replacement to correct oliguria in patients without obvious hypovolemia should be done with caution.
Aparece nas coleções:Artigo de Periódico (PPGSDH)

Arquivos associados a este item:
Arquivo Descrição TamanhoFormato 
Hemodynamically stable oliguric_RBTI.pdfOpen Access137.57 kBAdobe PDFVisualizar/Abrir


Os itens no repositório estão protegidos por copyright, com todos os direitos reservados, salvo quando é indicado o contrário.