How is urinary output monitored in sepsis/septic shock?

Updated: Oct 07, 2020
  • Author: Andre Kalil, MD, MPH; Chief Editor: Michael R Pinsky, MD, CM, Dr(HC), FCCP, FAPS, MCCM  more...
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Answer

UOP should also be monitored as a measure of dehydration. UOP lower than 30-50 mL/h should prompt further fluid resuscitation or other measures to increase cardiac output in a non–fluid-responsive patient. Important to note, during fluid resuscitation for sepsis, increased intra-abdominal fluid accumulation and ileus often occur and can induce increases in intra-abdominal pressure. If intra-abdominal pressure is greater than 12 mm Hg, intra-abdominal hypertension exists. Since renal perfusion pressure can be approximated as mean arterial pressure minus CVP or intra-abdominal pressure (whichever is higher), low UOP may reflect low renal perfusion pressure. In general, targeting a renal perfusion pressure of 70-75 mm Hg sustains adequate renal blood flow in sepsis unless preexisting hypertension is present, in which case targeting a higher renal perfusion pressure of 80-85 mm Hg is indicated. [81]


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