title: Spontaneous diuresis and negative fluid balance predicting recovery and survival in patients with trauma-hemorragic shock.
abstract: Most patients with trauma-hemorragic shock, prior to ICU admission, have been resuscitated and stabilized in the emergency room (ER) and/or operation room (OR). Many of them suffer from systemic edema. This extra-vascular fluid is caused by massive infusion of fluid and blood for the maintenance of blood pressure. During the recovery stage, the patients exhibit spontaneous diuresis followed by negative fluid balance. Urine volumes of some patients are more than 10000 ml/d. Do we need to maintain a balance between daily input and output of water at this situation? There are many references in the medical literature and textbooks about fluid resuscitation and the principles in maintaining the balance between input and output of water, but rarely about when and how to restrict it, that is, when and how to permit a negative balance. In this retrospective review, we examined the resuscitation records of 205 patients with systemic edema after trauma-hemorragic shock.
authors.affiliation: ICU, Affiliated Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou 310016, China. goudoy123@msn.com
authors.forename: Dong-yuan
authors.initials: DY
authors.lastname: Gou
authors.forename: Ya-fang
authors.initials: YF
authors.lastname: Zhu
authors.forename: Yan
authors.initials: Y
authors.lastname: Jin
authors.forename: Li-ying
authors.initials: LY
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D002648:Child; D003422:Critical Care / Q000379:methods; D004231:Diuresis / Q000502:physiology; D005260:Female; D005440:Fluid Therapy / Q000379:methods; D006801:Humans; D015601:Injury Severity Score; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy; D011237:Predictive Value of Tests; D011336:Probability; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012771:Shock, Hemorrhagic / Q000175:diagnosis* / Q000401:mortality* / Q000628:therapy; D015996:Survival Rate; D014882:Water-Electrolyte Balance