oliguria in major burns
Last reviewed 01/2018
Oliguria in major burns usually is due to inadequate fluid resucitation. It is more likely in the following groups:
- inhalation damage to lung
- electrocution
- delay before resuscitation
- children
- dehydrated individuals, e.g. excess alcohol consumption
Oliguria should prompt a fluid challenge:
- supplementary bolus of 5-10 mls / kg, or
- increase the next hour's estimated volume by 50%
However, caution must be exercised in the following groups with reduced ability to compensate for fluid shifts:
- children
- elderly patients
- patients with cardiac compromise
Invasive monitoring of cardiac preload and afterload may be warranted in the setting of the HDU/ITU.
Generally, diuretics should not be used in response to oliguria in the patient with a major burn injury. An exception to this rule may be haemochromogenuria under the guidance of the burns unit or a renal physician.
Whenever a fluid challenge is given, the patient must be reassessed a short time later to determine their response.