Oliguria in major burns usually is due to inadequate fluid resucitation. It is more likely in the following groups:
Oliguria should prompt a fluid challenge:
However, caution must be exercised in the following groups with reduced ability to compensate for fluid shifts:
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.
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