BACKGROUND: Urine output (UO) is usually measured hourly in acutely ill patients. Devices capable of more continuous (minute by minute urine output, UOm) measurements have become available recently. This paper aims to (1) analyze the minute by minute variations of UO, (2) analyze the impact of sepsis on those variations and (3) test if UO measured over periods shorter than 60 min provides information not available in hourly measurements. METHODS: Fifteen male pigs were anesthetized, tracheostomized and mechanically ventilated. Sepsis was induced by the administration of live Escherichia coli. Three groups were studied: nonseptic (n = 7) and septic (n = 4), both receiving sodium chloride (NaCl) 0.9 % at 4 ml kg(-1) h(-1); and septic (n = 4) receiving NaCl 0.9 % at 17 ml kg(-1) h(-1). UOm was measured during 6 h. RESULTS: There was a significant variation of UOm over time, as assessed by the coefficient of variation of the root-mean-squared error (CV(RMSE)), which was significantly more pronounced under conditions of sepsis than under control conditions. A UO production pattern in sepsis was identified, characterized by low UO production compared to baseline levels for approximately 30 min, followed by high UO production for approximately 30 min after initiation of the septic challenge. This pattern was noticeable if UO was measured every 10 min but not over longer periods of time. CONCLUSIONS: UOm provides information not conveyed by hourly measurements, especially under the cardiovascular alterations associated to sepsis. This information could enable an early identification of sepsis.
BACKGROUND: Urine output (UO) is usually measured hourly in acutely ill patients. Devices capable of more continuous (minute by minute urine output, UOm) measurements have become available recently. This paper aims to (1) analyze the minute by minute variations of UO, (2) analyze the impact of sepsis on those variations and (3) test if UO measured over periods shorter than 60 min provides information not available in hourly measurements. METHODS: Fifteen male pigs were anesthetized, tracheostomized and mechanically ventilated. Sepsis was induced by the administration of live Escherichia coli. Three groups were studied: nonseptic (n = 7) and septic (n = 4), both receiving sodium chloride (NaCl) 0.9 % at 4 ml kg(-1) h(-1); and septic (n = 4) receiving NaCl 0.9 % at 17 ml kg(-1) h(-1). UOm was measured during 6 h. RESULTS: There was a significant variation of UOm over time, as assessed by the coefficient of variation of the root-mean-squared error (CV(RMSE)), which was significantly more pronounced under conditions of sepsis than under control conditions. A UO production pattern in sepsis was identified, characterized by low UO production compared to baseline levels for approximately 30 min, followed by high UO production for approximately 30 min after initiation of the septic challenge. This pattern was noticeable if UO was measured every 10 min but not over longer periods of time. CONCLUSIONS: UOm provides information not conveyed by hourly measurements, especially under the cardiovascular alterations associated to sepsis. This information could enable an early identification of sepsis.
Authors: Yoram Klein; Mor Grinstein; Stephen M Cohn; Jacob Silverman; Moti Klein; Hanoch Kashtan; Micha Y Shamir Journal: Anesth Analg Date: 2012-07-04 Impact factor: 5.108
Authors: Raúl Lombardi; Nicolás Nin; José A Lorente; Fernando Frutos-Vivar; Niall D Ferguson; Javier Hurtado; Carlos Apezteguia; Pablo Desmery; Konstantinos Raymondos; Vinko Tomicic; Nahit Cakar; Marco González; José Elizalde; Peter Nightingale; Fekri Abroug; Manuel Jibaja; Yaseen Arabi; Rui Moreno; Dimitros Matamis; Antonio Anzueto; Andrés Esteban Journal: Clin J Am Soc Nephrol Date: 2011-06-23 Impact factor: 8.237
Authors: Javier García-Septien; José A Lorente; Miguel A Delgado; Marta de Paula; Nicolás Nin; Amelia Moscoso; Alberto Sánchez-Ferrer; Francisco Perez-Vizcaino; Andrés Esteban Journal: Shock Date: 2010-09 Impact factor: 3.454
Authors: Henrik Gammelager; Christian Fynbo Christiansen; Martin Berg Johansen; Else Tønnesen; Bente Jespersen; Henrik Toft Sørensen Journal: Crit Care Date: 2012-07-12 Impact factor: 9.097
Authors: N Nin; J A Lorente; L Soto; F Ríos; J Hurtado; F Arancibia; S Ugarte; E Echevarría; P Cardinal; F Saldarini; H Bagnulo; I Cortés; G Bujedo; C Ortega; F Frutos; A Esteban Journal: Intensive Care Med Date: 2011-03-11 Impact factor: 17.440