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Because there is increasing evidence of a detrimental effect of cumulative fluid balance [ 30- 32], a lower minimum urine output target may reduce fluid accumulation and its associated adverse outcomes.
She had a minimum urine output of 8 ml/hr for two hours during the period of DSS, but output improved thereafter, and she had no biochemical evidence of renal failure.
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This indicates the minimal urine output that can be expected.
The minimum hourly urine output rate used to define oliguria (< 0.5 ml/kg/hour) is based exclusively on clinical experience and animal models, not on clinical investigation.
In an open randomised controlled fashion, 59 fluid overloaded adult patients in two University hospital mixed intensive care units were randomised to a treatment algorithm using either continuous (n = 32 patients) or bolus (n = 27 patients) furosemide to achieve a minimum hourly urine output.
In order to excrete their normal solute load, the kidneys need a minimum water output of 850 millilitres as a vehicle; this volume is often called the minimum obligatory volume of urine.
Other renal safety parameters were minimum postoperative CrCl, incidence of oliguria (urine output <500 ml/day), and adverse events (AEs) related to the renal system until hospital discharge.
The median 6-hour urine output was 0.42 (0.27 to 0.64) ml/kg/hour (minimum 0, maximum 4.05 ml/kg/hour).
However, an analysis of urine output without factoring in body weight showed that a threshold of minimum 6-hourly urine output of 20 ml/hour, which is the equivalent of 0.3 ml/kg/hour in an average 70-kg person, best associated with mortality.
All adult patients who were admitted to intensive care units (ICUs) at our institution for a minimum of 6 continuous hours between January and March 2010 and had a urinary catheter for hourly urine output monitoring were eligible for this study.
The minimum urine volume for each collection duration was recorded and divided by the body weight and duration of collection to yield 1-hour to 12-hour urine outputs in millilitres per kilogram per hour.
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