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Hey everyone,
So what do you guys think about intraop oliguria/anuria? Does it matter? How do you manage it?
Had a spine case on an obese gentleman, prone position. He stopped making urine during the case, down to 5cc an hour for a couple hours. Tried fluid boluses to no avail. His BPs and lactate were stable the whole time. Flipped him supine at the end of the case and he started making urine again. Was I just treating a number with the fluid boluses?
From what I've read, intubation, positive pressure ventilation, surgery all cause increased release of ADH and urine output drops and doesn't correlate with intraop or postop renal function. What do you think? Do you guys try to trouble shoot oliguria? And with what: crystalloid, albumin, Lasix, mannitol? Does it differ whether you're doing an ex lap or big vascular case or spine or cardiac bypass case?
I feel like if BP is adequate and lactate stable and the patient is euvolemic, and it's not a mechanical issue with the foley, I shouldn't chase urine output, but wanted to get the opinion of the hive mind!
So what do you guys think about intraop oliguria/anuria? Does it matter? How do you manage it?
Had a spine case on an obese gentleman, prone position. He stopped making urine during the case, down to 5cc an hour for a couple hours. Tried fluid boluses to no avail. His BPs and lactate were stable the whole time. Flipped him supine at the end of the case and he started making urine again. Was I just treating a number with the fluid boluses?
From what I've read, intubation, positive pressure ventilation, surgery all cause increased release of ADH and urine output drops and doesn't correlate with intraop or postop renal function. What do you think? Do you guys try to trouble shoot oliguria? And with what: crystalloid, albumin, Lasix, mannitol? Does it differ whether you're doing an ex lap or big vascular case or spine or cardiac bypass case?
I feel like if BP is adequate and lactate stable and the patient is euvolemic, and it's not a mechanical issue with the foley, I shouldn't chase urine output, but wanted to get the opinion of the hive mind!