Early recognition of renal insufficiency in post-anesthetic trauma victims
Shin, B.; Isenhower, N.N.; Mcaslan, T.C.; Mackenzie, C.F.; Helrich, M.
Anesthesiology 50(3): 262-265
1979
ISSN/ISBN: 0003-3022 PMID: 434521 Document Number: 140390
Acute renal failure continues to be a major complication following trauma. It has been reported that when postoperative free water clearance (CH2O) was close to or above zero, acute renal failure followed in 2-3 days. The study was based on CH2O measurements in a selected group of patients. Not all postoperative patients who have CH2O of more than -20 ml/h experience acute renal failure. Retrospectively the predictive value of CH2O in postoperative trauma victims was examined. CH2O alone should not be used for the prediction of acute renal failure. It is suggested that impending renal failure can be recognized early by monitoring both Cer and CH2O in the postoperative period. In management of patients who have a high risk of developing renal failure, Cer and CH2O should be included for routine clinical monitoring.