Sepsis-Associated AKI – Bellomo Kidney – Implications for Management
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Jon-Emile S. Kenny [@heart_lung] “Rather than love, than money, than fame, give me truth.” -Thoreau The Case A 56 year old man with non-ischemic cardiomyopathy [LVEF 40% and mitral regurgitation] is admitted with severe sepsis due to appendicitis. One month prior to admission, his outpatient cardiologist saw him and noted a dry weight of 88 kg. On admission to the ICU, the patient’s weight is 90 kg. He is with acute kidney injury with a very elevated BUN-to-Creatinine ratio, oliguria and mild hypotension. His ACE-inhibitor is held and his serum chemistry is interpreted as ‘pre-renal azotemia’ so he is given 3 litres of lactated ringers in addition to broad spectrum antimicrobials. 48 hours later, he is greatly improved with normalization of his renal function. His weight on transfer to the floor is 96 kg and he is dyspneic.
Sepsis-Associated AKI – Bellomo Kidney – Implications for Management
Sepsis-Associated AKI – Bellomo Kidney …
Sepsis-Associated AKI – Bellomo Kidney – Implications for Management
Jon-Emile S. Kenny [@heart_lung] “Rather than love, than money, than fame, give me truth.” -Thoreau The Case A 56 year old man with non-ischemic cardiomyopathy [LVEF 40% and mitral regurgitation] is admitted with severe sepsis due to appendicitis. One month prior to admission, his outpatient cardiologist saw him and noted a dry weight of 88 kg. On admission to the ICU, the patient’s weight is 90 kg. He is with acute kidney injury with a very elevated BUN-to-Creatinine ratio, oliguria and mild hypotension. His ACE-inhibitor is held and his serum chemistry is interpreted as ‘pre-renal azotemia’ so he is given 3 litres of lactated ringers in addition to broad spectrum antimicrobials. 48 hours later, he is greatly improved with normalization of his renal function. His weight on transfer to the floor is 96 kg and he is dyspneic.