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Thu Dec 21 15:09:19 GMT 2006

In a message dated 12/21/2006 6:27:07 AM Central Standard Time,  
tch at sun.ac.za writes:

We use a  simple "loss per day plus 500ml" regime, which is replaced as the 
urine is  lost - i.e. continually. U&e based additives to the .45% saline as  
required (Ca++ / K+ / Phosphate)

The polyuric phase usually only lasts  around three days and then the kidneys 
"relearn" how to concentrate the urine  and everything goes back to normal.

The KISS principle I  suppose!

Very interesting....much easier, I'm not surprised that's enough to  keep the 
tubules open in the face of significant myoglobinuria. I do agree about  the 
72 hour span of the polyuric phase, but my experience was that we 'chased'  
the output too much replacing output 'one for one.' We had some patients  that 
would hit 500 ml or more an hour *after* the first 3 liters were removed,  and 
continue that for as long as we tried to keep up the full amount.  Admittedly, 
this was 20 years ago and I realize that the plural of 'anecdote' is  NOT 
'data.'

ck
Charles S. Krin, DO FAAFP

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