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Diuresing Question

Posted

Specializes in Acute Medicine/ Palliative.

What are some causes post op for a pt diuresing 3700 cc dilute urine in 7 hrs? In was 2526cc. In for a LAR, and had a thyroid fxn test 1 week prior...any ideas?

Hx: HTN, arrythmia, ^ cholesterol, NIDDM

artial fib

TIA! B :)

:)

High diuresis usually seen in diabetes insipidous which is related to a variety of underlying disorders...brain injury, lung CA, dilantin therapy...the list goes on.

Would also look at their sodium and naturally their glucose.

In general i am trying to tell you there are many reasons and the info you provided isn't enough to make any type of intelligent guess.

Post operatively it may be fluid shift and the bodys response to volume expanders.

I have no idea what a LAR is...what does it stand for?

I also had the same question with a post-op ortho patient. He was 2 days post-op. Pt could not void after pulling foley. So we put another back in, put out 1400 cc. In the next 12 hours he put out 6000cc of yellow urine, not diluted at all. Vitals remained stable. When I called ortho resident (twice overnoc) he didn't seem at all concerned. AM sodium and potassium were fine, he was discharged that morning after the foley was again d/c'd and he voided on his own. I have yet to get an answer as to why this could occur.

Just a little more info on my pt. He had IVF d/c'd the day before and had only taken in about 15OO cc PO. Also no diabetes, had very little medical hx.

Thanks

Wow 7 liter diuresis 2 day post op is a lot. How much fluid did he get in the OR. If it was a long case and he got a lot it takes a bit of time for the body to equilabrate.

SmilingBluEyes

Has 20 years experience.

is he on any drugs that would enhance diuresis?

No meds that would cause diuresis. He was on very few medications. I don't remember exactly what he got in the OR but it was not anywhere compared to what he put out. I would not have been so concerned had it been over a longer period of time but over 15 hours I thought it was alot.

I don't know what a LAR is either so can't answer.

Greyseal, it is common in a post-op to 3rd space and then 48-72 hours later, the fluid shifts back and some is absorbed. The rest becomes urine. So a large diuresis can be expected. If the overall picture is normal that is. If the urine was very dilute and the lytes we of etc.., I would worry about ADH depletion(Diabetes Insipidus).

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