The relationship between intraoperative oliguria and acute kidney injury

Abstract

Evidence of opioidinduced hyperalgesia in clinical populations after chronic opioid exposure: a systematic review and metaanalysis. Br J Anaesth 2019; 122: e114e26 17. Connolly C, Buggy DJ. Opioids and metastasis: does the choice of the anestheticeanalgesic technique influence outcome after cancer surgery? Curr Opin Anaesthesiol 2016; 29: 468e74 18. Oh TK, Song I-A, Lee JH, et al. Preadmission chronic opioid usage and its association with 90-day mortality after intensive care unit admission in critically ill patients. Br J Anaesth 2019; 122: e189e97 19. Beloeil H, Albaladejo P, Sion A, et al. Multicentre, prospective, double-blind, randomised controlled clinical trial comparing different non-opioid analgesic combinations with morphine for postoperative analgesia: the OCTOPUS study.

Meaning and Management of Perioperative Oliguria

“…12 In the Restrictive versus Liberal Fluid Therapy for Major Abdominal Surgery (RELIEF) trial, intraoperative oliguria (urine output less than 0.5 ml · kg −1 · h −1 for 1 h or more) was associated with postoperative AKI (risk ratio, 1.38; 95% CI, 1.14 to 1.44; P < 0.001). 1 However, the positive predictive value of intraoperative oliguria was low (25.5%), and 74% of the patients with postoperative AKI did not present intraoperative oliguria. 1 Another single-center retrospective study including 165 patients undergoing elective abdominal surgery showed no association between intraoperative oliguria (urine output less than 0.5 ml · kg −1 · h −1 for 1 h or more) and postoperative AKI ( P = 0.772).…”

“…Low urine output and oliguria meeting criteria for acute kidney injury (AKI) have been associated with complications including increased length of hospital stay, costs, and mortality. 1,2…”

“…Low urine output and oliguria meeting criteria for acute kidney injury (AKI) have been associated with complications including increased length of hospital stay, costs, and mortality. 1,2 The scope of this review is to discuss the determinants and consequences of perioperative oliguria and guide physicians' decision-making from the operating room to the intensive care unit (ICU) or the ward on how to manage oliguria in surgical patients. We will discuss the factors regulating urine output, propose a pragmatic approach to oliguria management during and after surgery, and describe how a search for perioperative complications (e.g., sepsis, bleeding, pulmonary embolism, tamponade) should be considered a priority when facing a patient with persistent postoperative oliguria.…”

“…We will discuss the factors regulating urine output, propose a pragmatic approach to oliguria management during and after surgery, and describe how a search for perioperative complications (e.g., sepsis, bleeding, pulmonary embolism, tamponade) should be considered a priority when facing a patient with persistent postoperative oliguria. [1][2][3][4][5][6][7]…”

Hemodinamia y Anestesia

“…La liberación de ADH puede ser generada por distintos estímulos extrarrenales como la nocicepción o el tipo de cirugía en sí. Por sí misma, posee un bajo valor predictivo positivo para la injuria renal aguda [20].…”