RENAL PROBLEMS AND CRITICAL CARE

An 82 year old female undergoes elective surgery for an infra-renal abdominal aortic aneurysm (AAA). The operation takes 31/2 hours. Urinary output during this period was 29ml. On return to the ICU, the patient’s urinary output over the first hour is 15ml. She is treated with 1 liter of hydroxyethyl starch (Hextend), and output increases to 45ml per hour for the next hour, and gradually trails off. Her post operative creatinine is 1.5, up from 0.8.

How would you approach this patient?

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