CHEST Guidelines-Intensive-Monitoring-of-Urine-Output-Is-Associated (1)

Intensive-Monitoring-of-Urine-Output-Is-Associated (1)

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The study explores the impact of intensive urine output (UO) monitoring on the detection and outcomes of acute kidney injury (AKI) in critically ill patients. UO is an essential vital sign in ICUs, but its monitoring practices vary. The study involved a retrospective analysis of 15,724 adult patients in ICUs from 2000 to 2008, focusing on those with and without AKI according to the intensity of UO monitoring. Intensive UO monitoring was defined as hourly recordings without gaps exceeding 3 hours in the first 48 hours after admission.<br /><br />Results indicated that intensive UO monitoring led to higher detection rates of AKI (OR, 1.22; P=.001) and was associated with better survival outcomes for patients with AKI after adjusting for age and illness severity. Patients with intensive monitoring also experienced less cumulative fluid volume and lower risk of fluid overload (2.98% vs 3.78%; P=.001).<br /><br />The study suggests that intensive UO monitoring not only improves AKI detection but also leads to better patient management, especially in terms of fluid administration, resulting in lower rates of fluid overload. Interestingly, the findings reveal that patients under intensive UO monitoring received less fluid but had higher urine output, showing possible implications for managing fluid balance in ICUs. Additionally, intensive monitoring correlated with fewer instances of vasopressor use, further highlighting the stability it provides in patient care management.<br /><br />Conclusively, the study emphasizes the benefits of intensive UO monitoring in enhancing AKI detection and patient outcomes through better fluid management, informing clinical decisions and policies on UO monitoring frequency. The results underscore the role of intensive monitoring as potentially critical for improving AKI outcomes, warranting its integration into ICU practices, particularly for patients at high risk of AKI or fluid overload.

Keywords

urine output monitoring

acute kidney injury

intensive care units

fluid management

patient outcomes

critical care

fluid overload

vasopressor use

retrospective analysis

clinical practices