Renal monitoring

We monitor diuresis as a basic physiological indicator in all children in intensive care. In critical situations, accurate hourly collection and balance is required. This new the insertion of a permanent urinary catheter.

In case of absolute or relative hypovolemia the organism compensates for insufficient effective circulating volume mmj. vasoconstriction of the splanchnic and this leads to a decrease in diuresis. The kidneys thus represent a "mirror" of tissue perfusion. Polyuria is found in some types of acute renal failure and in chronic renal failure. Polyuria is an important indicator of a number of syndromes in CNS affections - diabetes insipidus or cerebral salt wasting syndrom.

Reference/pathology values

 * normal diuresis: > 1 ml/kg/hours
 * oliguria: 0,5–1 ml/kg/hours
 * anuria: < 0,5 ml/kg/hours
 * polyuria: long-term increase in diuresis > 4 ml/kg/hours in infants and > 3 ml/kg/hours in children older than 1 year.

Urine ion waste
The laboratory indicates the amount of urine in ml collected in X hours and the numerical value of the waste in mmol/l. he goal is to list the waste in the value of mmol/kg/24 hours.

Urine amount 403 ml, collected in 14 hours., U–Na+ 120 mmol/l, child's weight 12,0 kg.
 * Example:
 * 120 x 0,403 = 48,36 mmol (corresponds to U–Na+ waste in volume of 403 ml)
 * 48,36 / 14 = 3,45 mmol (corresponds to U–Na+ waste in 1 hour.)
 * 3,45 x 24 = 82,9 mmol (corresponds to U–Na+ waste in 24 hours)
 * 82,9 / 12 = 6,9 mmol (corresponds to U–Na+ waste/kg/24 hours.)

Waste U–Na+ in urine in mmol/kg/day is 6,9 mmol.

Related articles

 * Hypovolemic shock (pediatrics)
 * Cardiopulmonary monitoring
 * Monitoring in neurointensive care

Source
HAVRÁNEK, Jiří: Ostatní monitoring.