Automated versus manual urine output monitoring in the intensive care unit

Abstract Acute kidney injury (AKI) is defined by changes in serum creatinine and urine output (UO). Significant limitations exist regarding accurate ascertainment of urine output even within the intensive care unit. We sought to evaluate an automated urine output collections system and compare it to...

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Autores principales:	Joni Minor, Ali Smith, Frederic Deutsch, John A. Kellum
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/5a9d8a7f031146edb64981b602d09570
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spelling	oai:doaj.org-article:5a9d8a7f031146edb64981b602d095702021-12-02T16:38:24ZAutomated versus manual urine output monitoring in the intensive care unit10.1038/s41598-021-97026-82045-2322https://doaj.org/article/5a9d8a7f031146edb64981b602d095702021-08-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-97026-8https://doaj.org/toc/2045-2322Abstract Acute kidney injury (AKI) is defined by changes in serum creatinine and urine output (UO). Significant limitations exist regarding accurate ascertainment of urine output even within the intensive care unit. We sought to evaluate an automated urine output collections system and compare it to nursing measurements. We prospectively collected urine output using an electronic urine monitoring system and compared it to charted hourly UO in 44 patients after cardiac surgery at a single university hospital ICU. We calculated UO and oliguria rates and compared them to data from the sensor and from nursing charting. A total of 187 hourly UO measurements were obtained and on average, UO was reported 47 min late, with a median of 18 min, and a maximum of almost 6 h. Patients had a mean hourly UO of 76.3 ml over the observation period. Compared to manual measurements by study personnel, nurses significantly overestimated hourly UO by 19.9 ml (95% CI: 10.3; 29.5; p = < 0.001). By contrast, the mean difference between the UO measured with the sensor and by study personnel was 2.29 ml (95% CI: − 6.7; 11.3), p = 0.61. Electronic UO monitoring is significantly more accurate than nurse-performed manual measurements in actual intensive care patients. Furthermore, timely ascertainment of UO is difficult to achieve with manual technique, resulting in important delays in detecting oliguria perhaps leading to missed cases of AKI.Joni MinorAli SmithFrederic DeutschJohn A. KellumNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-5 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Joni Minor Ali Smith Frederic Deutsch John A. Kellum Automated versus manual urine output monitoring in the intensive care unit
description	Abstract Acute kidney injury (AKI) is defined by changes in serum creatinine and urine output (UO). Significant limitations exist regarding accurate ascertainment of urine output even within the intensive care unit. We sought to evaluate an automated urine output collections system and compare it to nursing measurements. We prospectively collected urine output using an electronic urine monitoring system and compared it to charted hourly UO in 44 patients after cardiac surgery at a single university hospital ICU. We calculated UO and oliguria rates and compared them to data from the sensor and from nursing charting. A total of 187 hourly UO measurements were obtained and on average, UO was reported 47 min late, with a median of 18 min, and a maximum of almost 6 h. Patients had a mean hourly UO of 76.3 ml over the observation period. Compared to manual measurements by study personnel, nurses significantly overestimated hourly UO by 19.9 ml (95% CI: 10.3; 29.5; p = < 0.001). By contrast, the mean difference between the UO measured with the sensor and by study personnel was 2.29 ml (95% CI: − 6.7; 11.3), p = 0.61. Electronic UO monitoring is significantly more accurate than nurse-performed manual measurements in actual intensive care patients. Furthermore, timely ascertainment of UO is difficult to achieve with manual technique, resulting in important delays in detecting oliguria perhaps leading to missed cases of AKI.
format	article
author	Joni Minor Ali Smith Frederic Deutsch John A. Kellum
author_facet	Joni Minor Ali Smith Frederic Deutsch John A. Kellum
author_sort	Joni Minor
title	Automated versus manual urine output monitoring in the intensive care unit
title_short	Automated versus manual urine output monitoring in the intensive care unit
title_full	Automated versus manual urine output monitoring in the intensive care unit
title_fullStr	Automated versus manual urine output monitoring in the intensive care unit
title_full_unstemmed	Automated versus manual urine output monitoring in the intensive care unit
title_sort	automated versus manual urine output monitoring in the intensive care unit
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/5a9d8a7f031146edb64981b602d09570
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Automated versus manual urine output monitoring in the intensive care unit

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