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Poll: For the first 6hr following surgical repair of a leaking abdominal aortic aneurysm in a 70yo man oli

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Thread: q303

  1. #1
    Anonymous is offline Unregistered Guest
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    q303

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    For the first 6hr following surgical repair of a leaking abdominal aortic aneurysm in a 70yo man oliguria(total urinary output of 25cc since the operation)has become a concern.what’s the most appropriate diagnostic test for this pt?
    a:abdominal US
    b:renal scan
    c:left heart preload pressures
    d:urinay Na concentration
    e:Cr clearance
    f:abdominal CT

  2. #2
    saghar is offline Junior Member
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    Ans

    d:urinay Na concentration
    If it's low < 10-20 meq---> dehydration----> give him fluid
    if it's high > 40 meq----> renal failure----> fluid restriction
    One of the post op comlication of surgical repair of AAA is renal failure.

  3. #3
    Anonymous is offline Unregistered Guest
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    The answer is......

    c:left heart preload pressures

    The most likely coz of oliguria observed in this pt is hypovolemia.pts who had a leaking aneurysm&then a long,usually difficult operation with large surgical fields that collect third-space fluids may be intravascularly depleted despite large volumes of IV fluid&blood replacement.
    Volume status would be best assessed by floating a Swan-Ganz catheter to measure the preload pressures in the LA,titrate the CO by providing as much fluid as necessary to keep the wedge pressures near 15mmHg.

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