RT Book, Section
A1 Davenport, Andrew
A2 Lee, Kiwon
SR Print(0)
ID 1101645475
T1 Renal Replacement Therapies
T2 The NeuroICU Book
YR 2012
FD 2012
PB McGraw-Hill Education
PP New York, NY
SN 9780071636353
LK neurology.mhmedical.com/content.aspx?aid=1101645475
RD 2024/04/19
AB A  26-year-old  woman  was  admitted  following  a  horse-riding  accident.  She  had  fractured  her  femur  and  suffered  an  intracranial  hemorrhage.  Postoperatively  she  required  ventilation  and  then  developed  a  respiratory  tract  infection,  and  on  the  third  day  of  admission,  her  urine  output  had  fallen  to  0.5  mL/kg  per  hour,  and  her  serum  creatinine  had  risen  from  0.5  mg/dL  on  admission  to  1.24  mg/dL.  At  this  stage  her  intracranial  pressure  (ICP),  measured  with  an  intraventricular  catheter,  remained  elevated  at  35  mm  Hg,  with  a  mean  arterial  blood  pressure  of  90  mm  Hg.  In  view  of  the  increase  in  creatinine  and  fall  in  urine  output,  a  fluid  challenge  was  given  to  try  to  prevent  progression  of  acute  kidney  injury  (AKI),  to  exclude  a  volume-responsive  reversible  cause  of  AKI  (see  Chapter  41).  However,  by  the  following  day  her  urine  output  had  fallen  to  0.3  mL/kg  per  hour  and  her  serum  creatinine  increased  to  2.0  mg/dL.