scholarly journals Urine Output Measurement by a Novel Electronic Urinometer is much more Accurate than by Conventional Urinometer

2020 ◽  
pp. 1-3
Author(s):  
David Rott ◽  
David Rott ◽  
Ilan Hay ◽  
Robert Klempfner
Keyword(s):  
Urine Output ◽  
Foley Catheter ◽  
Urine Volume ◽  
Kidney Injury ◽  
Average Deviation ◽  
Output Measurement ◽  
Icu Patients ◽  
Catheter Urine ◽  
Complex Surgery ◽  
The Eu

Introduction: Assessment of urine output in hospitalized patients or those undergoing complex surgery is essential for preventing Acute Kidney Injury and increased mortality. Currently, measurements of urine output are made by visually inspecting the volume of urine that accumulates in a bag attached to a catheter which resides in the bladder by way of a manual urinometer. Several electronic urinometers have been tested but have not been clinically proven or accepted. We report preliminary results of a novel Electronic Urinometer (EU) and compared its accuracy to a conventional Manual Urinometer (MU). Methods: The study included 22 consecutive ICU patients whose urine output was collected with a foley catheter. Urine output was measured for all patients by EU as well as by MU. Both measurements were compared to analysis of the volume in a Graduated Cylinder (GC). Results: The EU was highly accurate in measurement of both urine volume and urine flow with an average deviation from GC 4 ± 3.0% vs 17 ± 23% for the MU (P<0.01). Conclusion: This study showed that measuring urine output in ICU patients by an EU is more accurate than conventional MU.

Overestimation of Glomerular Filtration Rate Among Critically Ill Adults With Hospital-Acquired Oligoanuric Acute Kidney Injury

2014 ◽  
Vol 29 (2) ◽  
pp. 125-131 ◽  
Author(s):  
Erin N. Frazee ◽  
Heather A. Personett ◽  
Christina M. Wood-Wentz ◽  
Vitaly Herasevich ◽  
John C. Lieske ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Urine Output ◽  
Filtration Rate ◽  
Kidney Injury ◽  
Acute Kidney Injury Network ◽  
Estimation Methods ◽  
Icu Patients ◽  
Hospital Acquired

Background: Medication use in the intensive care unit (ICU) depends on creatinine-based glomerular filtration rate (GFR) estimates. Urine output deterioration may precede the creatinine rise resulting in delayed recognition of GFR reductions. Our objective was to quantify the disparity between estimated GFR (eGFR) and true GFR in ICU patients with hospital-acquired oligoanuric acute kidney injury (hAKI). Methods: This single-center cohort study examined adults who met the Acute Kidney Injury Network stage III urine output criterion ≥48 hours after ICU admission. True GFR was ≤15 mL/min/1.73 m2, and eGFR was described by 6 different creatinine-based equations. True GFR and eGFR were compared on the day of hAKI diagnosis and followed for 4 days using multivariable linear regression with generalized estimating equations, adjusting for day and method. Results: Of the 691 patients screened, we enrolled 61 patients. After adjustment for multiple comparisons and day, there were significant differences in eGFR between the estimation methods and true GFR ( P < .001). After day adjustment, eGFR overestimated true GFR by 17 to 50 mL/min/1.73 m2 and overestimation persisted through the fourth day of hAKI ( P ≤ .001). Conclusion: Creatinine-based equations overestimated GFR in ICU patients with hAKI. This study highlights a population at risk of medication misadventures in whom systems optimization should be considered.

scholarly journals Urine neutrophil gelatinase-associated lipocalin and urine output as predictors of the successful discontinuation of continuous renal replacement therapy in critically ill patients with acute kidney injury

2020 ◽  
Author(s):  
Josefine Thomsen ◽  
Ulrik Sprogøe ◽  
Palle Toft
Keyword(s):  
Acute Kidney Injury ◽  
Renal Function ◽  
Renal Replacement Therapy ◽  
Continuous Renal Replacement Therapy ◽  
Predictive Value ◽  
Urine Output ◽  
Kidney Injury ◽  
Icu Patients ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Neutrophil Gelatinase

Abstract Background: Continuous renal replacement therapy (CCRT) is a frequently used modality for the support of intensive care patients with acute kidney injury (AKI). Nevertheless, there are no objective criteria for the discontinuation of CRRT. The purpose of this study was to investigate whether urine neutrophil gelatinase-associated lipocalin (uNGAL) alone or in combination with urine output could be used as a diagnostic test for renal function recovery in ICU patients on CRRT.Methods: This was a single-centre prospective observational study including patients with acute kidney failure needing CRRT. Sixty-nine patients were enrolled, and 54 completed the study. Of the 54 patients, 22 recovered renal function (REC), defined as dialysis independency at 72 hours from discontinuation, while 32 patients did not (NREC). Urine NGAL was measured at 0, 6, 12, and 24 hours after CRRT discontinuation. The cumulated urine output was measured for 24 hours prior to discontinuation and at 6, 12, and 24 hours after discontinuation. Missing uNGAL values were calculated by interpolation. The Youden’s index was used to calculate cut-off values in order to define uNGAL and urine output single variable and 2-variable diagnostic tests with the optimum prediction of successful CRRT discontinuation. Results: Baseline characteristics at CRRT initiation were similar between groups. Compared to the NREC group, the REC group had significantly higher urine output (p<0.0001) and lower uNGAL (p<0.001) at all time points, except for uNGAL at 24 hours (p<0.24). The best uNGAL predictor for successful CRRT discontinuation was uNGAL at 6 hours after discontinuation (predictive value 80%). The best single predictor was cumulated urine output 24 hours before discontinuation (predictive value 85%). The combinations of uNGAL at 6 hours (cut-off 1650 µg/L) with cumulated urine output 24 hours prior to discontinuation (cut-off 210 ml) proved to be the superior tests (using either “or” or “and”), with predictive values of 93% (successful CRRT discontinuation) and 92% (dialysis dependency).Conclusions: With a predictive value of 93%, the combination of uNGAL at 6 hours after and the cumulated urine output 24 hours prior to CRRT cessation proved to be the best diagnostic test for successful CRRT discontinuation in ICU patients.Clinical trial registration: N/A

Urine Output during Cardiopulmonary Bypass Predicts Acute Kidney Injury after Coronary Artery Bypass Grafting

2016 ◽  
Vol 19 (6) ◽  
pp. 289 ◽  
Author(s):  
Mehmet Yilmaz ◽  
Rezan Aksoy ◽  
Vildan Kilic Yilmaz ◽  
Canan Balci ◽  
Cagri Duzyol ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Cardiopulmonary Bypass ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Urine Output ◽  
Artery Bypass ◽  
Kidney Injury ◽  
Urinary Output ◽  
Bypass Grafting

Objective: This study evaluated the relationship between the amount of urinary output during cardiopulmonary bypass and acute kidney injury in the postoperative period of coronary artery bypass grafting.Methods: Two hundred patients with normal preoperative serum creatinine levels, operated on with isolated CABG between 2012-2014 were investigated retrospectively. The RIFLE (Risk, injury, failure, loss of function, and end-stage renal disease) risk scores were calculated for each patient in the third postoperative day. Patients were distributed into two groups in relation to the presence of acute kidney injury or not and these two groups were compared.Results: The urinary output (mL/kg/hour) during cardiopulmonary bypass in the acute kidney injury negative group was significantly higher than in the acute kidney injury positive group (P = .022). In case of a urinary output value 3.70 and lower to predict acute kidney injury positivity, sensitivity was detected as 71.43%. Results of the analysis for urinary output predict positivity of acute kidney injury.Conclusion: We suggest that urine output during cardiopulmonary bypass is a significant criteria that could predict acute kidney injury following coronary artery bypass grafting with cardiopulmonary bypass. Attempts to increase the urine output during cardiopulmonary bypass could help to maintain the renal functions during and after surgery.

scholarly journals Perioperative acute kidney injury and urine output in lower limb arthroplasties

2021 ◽  
Author(s):  
Okke Nikkinen ◽  
Elias Jämsä ◽  
Toni Aaltonen ◽  
Seppo Alahuhta ◽  
Pasi Ohtonen ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Lower Limb ◽  
Urine Output ◽  
Kidney Injury

scholarly journals Short term versus conventional Catheterisation after Genital Prolapse Surgery

2013 ◽  
Vol 26 (2) ◽  
pp. 68-71 ◽  
Author(s):  
Khurshida Tahmin ◽  
Shamsun Nahar Begum
Keyword(s):  
Hospital Stay ◽  
Urine Volume ◽  
Genital Prolapse ◽  
Prolapse Surgery ◽  
Controlled Clinical Trial ◽  
Group I ◽  
Short Period ◽  
Group Ii ◽  
Catheter Urine ◽  
Randomised Controlled

This Randomised controlled clinical trial was undertaken to determine the suitable time of catheter removal after urogenital prolapse surgery in order to reduce the catheter related UTI and its long term sequel. Method: Total 80 patients undergoing vaginal hysterectomy with pelvic floor repair were enrolled and randomised into two equal groups by lottery method. Trans-urethral catheter was removed on 2nd & 5th post operative day in group I (n=40) and in group II (n=40) respectively. Post   voidal residual urine volume before operation and after removal of catheter was measured in   all patients by ultrasound scanning. Re-catheterisation was done for three more days if residual volume > 200ml after removal of catheter. Urine samples were taken before removal of catheter and send for routine microscopic examination and culture & sensitivity test to detect UTI.Results: Removal of catheter on 2nd post-operative day lead to significant reduction of rate of UTI. The rate of UTI following removal of catheter was 7.5% versus 42.5% in group I and in group II (p<0.001). But need for recatheterisation was significantly higher in group I (15%) than in group II (2.5%). The mean duration of catheterisation was 47.63 (±0.628) and 119.35 (±0.864) hours in group I and group II respectively. Majority of the patients in group I did not  require prolongation of catheterisation. Mean duration of hospital stay after operation was 5 days in group I and 7.95 days in group II (p<0.001). Conclusion: Short period catheterisation is associated with lower rate of UTI and shorter hospital stay. Disadvantages of prolonged catheterisation outweigh the advantages. Therefore removal of the catheter on the 2nd post-operative day after genital prolapse surgery is preferable than 5 days catheterization DOI: http://dx.doi.org/10.3329/bjog.v26i2.13782 Bangladesh J Obstet Gynaecol, 2011; Vol. 26(2) : 68-71

Utilization of Renal Ultrasound for Predicting Obstructive Uropathy in ICU Patients With Acute Kidney Injury

CHEST Journal ◽  
2014 ◽  
Vol 146 (4) ◽  
pp. 223A ◽  
Author(s):  
Syed Amin ◽  
Reejis Stephen ◽  
David Morris ◽  
David Kaufman
Keyword(s):  
Acute Kidney Injury ◽  
Obstructive Uropathy ◽  
Kidney Injury ◽  
Renal Ultrasound ◽  
Icu Patients

scholarly journals Risk factors and mortality in patients with sepsis, septic and non septic acute kidney injury in ICU

2019 ◽  
Vol 41 (4) ◽  
pp. 462-471 ◽  
Author(s):  
Kellen Hyde Elias Pinheiro ◽  
Franciana Aguiar Azêdo ◽  
Kelsy Catherina Nema Areco ◽  
Sandra Maria Rodrigues Laranja
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Kidney Disease ◽  
Kidney Injury ◽  
Mortality Rates ◽  
Icu Patients ◽  
Septic Acute Kidney Injury ◽  
Observational Cohort ◽  
Worse Prognosis

Abstract Acute kidney injury (AKI) has an incidence rate of 5-6% among intensive care unit (ICU) patients and sepsis is the most frequent etiology. Aims: To assess patients in the ICU that developed AKI, AKI on chronic kidney disease (CKD), and/or sepsis, and identify the risk factors and outcomes of these diseases. Methods: A prospective observational cohort quantitative study that included patients who stayed in the ICU > 48 hours and had not been on dialysis previously was carried out. Results: 302 patients were included and divided into: no sepsis and no AKI (nsnAKI), sepsis alone (S), septic AKI (sAKI), non-septic AKI (nsAKI), septic AKI on CKD (sAKI/CKD), and non-septic AKI on CKD (nsAKI/CKD). It was observed that 94% of the patients developed some degree of AKI. Kidney Disease Improving Global Outcomes (KDIGO) stage 3 was predominant in the septic groups (p = 0.018). Nephrologist follow-up in the non-septic patients was only 23% vs. 54% in the septic groups (p < 0.001). Dialysis was performed in 8% of the non-septic and 37% of the septic groups (p < 0.001). Mechanical ventilation (MV) requirement was higher in the septic groups (p < 0.001). Mortality was 38 and 39% in the sAKI and sAKI/CKD groups vs 16% and 0% in the nsAKI and nsAKI/CKD groups, respectively (p < 0.001). Conclusions: Patients with sAKI and sAKI/CKD had worse prognosis than those with nsAKI and nsAKI/CKD. The nephrologist was not contacted in a large number of AKI cases, except for KDIGO stage 3, which directly influenced mortality rates. The urine output was considerably impaired, ICU stay was longer, use of MV and mortality were higher when kidney injury was combined with sepsis.

scholarly journals Sepsis Associated Acute Kidney Injury

2021 ◽  
Author(s):  
Titik Setyawati ◽  
Ricky Aditya ◽  
Tinni Trihartini Maskoen
Keyword(s):  
Acute Kidney Injury ◽  
Serum Creatinine ◽  
Fluid Therapy ◽  
Urine Volume ◽  
Kidney Injury ◽  
Rapid Identification ◽  
Hospital Death ◽  
Cell Arrest ◽  
Sepsis And Septic Shock ◽  
Clinical Conditions

AKI is a syndrome consisting of several clinical conditions, due to sudden kidney dysfunction. Sepsis and septic shock are the causes of AKI and are known as Sepsis-Associated AKI (SA-AKI) and accounted for more than 50% of cases of AKI in the ICU, with poor prognosis. Acute Kidney Injury (AKI) is characterized by a sudden decline in kidney function for several hours/day, which results in the accumulation of creatinine, urea and other waste products. The most recent definition was formulated in the Kidney Disease consensus: Improving Global Outcome (KDIGO), published in 2012, where the AKI was established if the patient’s current clinical manifestation met several criteria: an increase in serum creatinine levels ≥0.3 mg/dL (26.5 μmol/L) within 48 hours, an increase in serum creatinine for at least 1.5 times the baseline value within the previous 7 days; or urine volume ≤ 0.5 ml/kg body weight for 6 hours. The AKI pathophysiology includes ischemic vasodilation, endothelial leakage, necrosis in nephrons and microtrombus in capillaries. The management of sepsis associated with AKI consisted of fluid therapy, vasopressors, antibiotics and nephrotoxic substances, Renal Replacement Therapy (RRT) and diuretics. In the analysis of the BEST Kidney trial subgroup, the likelihood of hospital death was 50% higher in AKI sepsis compared to non-sepsis AKI. Understanding of sepsis and endotoxins that can cause SA-AKI is not yet fully known. Some evidence suggests that renal microcirculation hypoperfusion, lack of energy for cells, mitochondrial dysfunction, endothelial injury and cycle cell arrest can cause SA-AKI. Rapid identification of SA-AKI events, antibiotics and appropriate fluid therapy are crucial in the management of SA-AKI.

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