Oliguria

After these reports there were many attempts to administer hemoglobin solutions to humans. Many of these patients did well, but others demonstrated hypertension, bradycardia, oliguria, and even anaphylaxis. These untoward effects were not correlated with specific biochemical properties of the solutions themselves. 

Renal—hematuria, cystitis, elevated blood urea nitrogen, polyuria, dysuria, oliguria, and acute renal failure in those with impaired renal function... 

The onset of symptoms of barbiturate toxicity may not occur until several hours after the drug is administered. Symptoms of acute toxicity include CNSand respiratory depression, constriction or paralytic dilation of the pupils tachycardia, hypotension, lowered body temperature, oliguria, circulatory collapse, and coma. The nurse should report any symptoms of toxicity to the primary health care provider immediately. 

Warning sgns of a fluid and electrolyte imbalance include dry mouth, thirst, weakness lethargy, drowsiness restlessness muscle pains or cramps confuson, gastrointestinal disturbances hypotenson, oliguria, tachycardia, and seizures... 

Nausea, diarrhea, stomatitis, hypotension, anorexia, bone marrow depression, pulmonary congestion, dyspnea, oliguria Dysuria, urinary frequency, cystitis, hematuria, urinary incontinence... 

Fever, hot dry skin, dry sticky mucous membranes, rough dry tongue, edema, weight gain, intense thirst, excitement, restlessness, agitation, oliguria or anuria... 

Potassium is contraindicated in patients who are at risk for experiencing hyperkalemia, such as those with renal failure, oliguria, or azotemia (file presence of nitrogen-containing compounds in the blood), anuria, severe hemolytic reactions, untreated Addison s disease (see Chap. 50), acute dehydration, heat cramps, and any form of hyperkalemia Potassium is used cautiously in patients with renal impairment or adrenal insufficiency, heart disease, metabolic acidosis, or prolonged or severe diarrhea. Concurrent use of potassium with... 

Sepsis The systemic inflammatory response syndrome and documented infection (culture or Gram stain of blood, sputum, urine, or normally sterile body fluid positive for pathogenic microorganisms Severe sepsis Sepsis associated with organ dysfunction, hypoperfusion, or hypotension (systolic blood pressure less than 90 mm Hg). Hypoperfusion and perfusion abnormalities may include, but are not limited to, lactic acidosis, oliguria, or acute alteration in mental status. 

Oliguria often follows hypotension because of decreased perfusion. Metabolic acidosis ensues because of diminished clearance by the kidneys and liver of lactic acid. 

Normal saline or dopamine at renal perfusion dose of 2 mcg/kg per minute for oliguria monitor for electrolyte abnormalities and replace as indicated. 

Patients may develop edema, fluid overload, and oliguria that may progress to anuria with acute renal failure. 

Oliguria Reduced urine output usually defined as less than 400 mL in 24 hours or less than 0.5 mL/kg/hour. 

Case reports are available regarding lethal effects of acute exposure to arsine (Pinto et al. 1950 Morse and Setterlind 1950 Hesdorffer et al. 1986). However, no definitive quantitative exposure data accompany these reports. Signs and symptoms varied depending on the exposure situation but usually included abdominal and muscle pain, nausea and diarrhea, hematuria, and oliguria. Delayed lethality, common in arsine poisoning, varied considerably. 

Levinsky et al. (1970) reported on three men exposed to an unknown concentration of arsine for an estimated, 2, 3, and 15 min. Signs and symptoms of exposure (malaise, headache, abdominal pain, chills, nausea, vomiting, oliguria/ anuria, hematuria, bronze skin color) developed within 1-2 h. All three individuals required extensive medical intervention to save their lives. Clinical findings were indicative of massive hemolysis and repeated blood exchange transfusions were necessary for the survival of these individuals. 

Shock refers to conditions manifested by hemodynamic alterations (e.g., hypotension, tachycardia, low cardiac output [CO], and oliguria) caused by intravascular volume deficit (hypovolemic shock), myocardial pump failure (cardiogenic shock), or peripheral vasodilation (septic, anaphylactic, or neurogenic shock). The underlying problem in these situations is inadequate tissue perfusion resulting from circulatory failure. 

Hypotension, tachycardia, tachypnea, confusion, and oliguria are common symptoms. Myocardial and cerebral ischemia, pulmonary edema (cardiogenic shock), and multisystem organ failure often follow. Significant hypotension (systolic blood pressure [SBP] less than 90mmHg) with reflex sinus tachycardia (greater than 120 beats/min) and increased... 

Kidneys are exquisitely sensitive to changes in perfusion pressures. Moderate alterations can lead to significant changes in glomerular filtration rate. Oliguria, progressing to anuria, occurs because of vasoconstriction of afferent arterioles. 

Symptoms of PE include dyspnea, tachypnea, pleuritic chest pain, tachycardia, palpitations, cough, diaphoresis, and hemoptysis. Cardiovascular collapse, characterized by cyanosis, shock, and oliguria, is an ominous sign. 

Sepsis associated with organ dysfunction, hypoperfusion, or hypotension. Hypoperfusion and perfusion abnormalities may include, but are not limited to, lactic acidosis, oliguria, or acute alteration in mental status. 

Progression of uncontrolled sepsis leads to evidence of organ dysfunction, which may include oliguria, hemodynamic instability with hypotension or shock, lactic acidosis, hyperglycemia or hypoglycemia, possibly leukopenia, disseminated intravascular coagulation, thrombocytopenia, acute respiratory distress syndrome, GI hemorrhage, or coma. 

Monitoring changes in UOP can help diagnose the cause of ARF. Acute anuria (less than 50 mL urine/day) is secondary to complete urinary obstruction or a catastrophic event (e.g., shock). Oliguria (400 to 500 mL urine/day) suggests prerenal azotemia. Nonoliguric renal failure (more... 

Renal Effects. The information regarding renal effects following dermal exposure to cyanide in humans is limited to one case report. Transitory oliguria (scanty urination) was observed in a patient who accidentally fell into a cistern containing 1,000 gallons of hot copper cyanide and remained there for 3 minutes before being rescued (Dodds and McKnight 1985). 

Kidney Failure The inability of a kidney to excrete metabolites at normal plasma levels under conditions of normal loading, or the inability to retain electrolytes under conditions of normal intake. In the acute form (kidney failure, acute), it is marked by uremia and usually by oliguria or anuria, with hyperkalemia and pulmonary edema. The chronic form (kidney failure, chronic) is irreversible and requires hemodialysis. [NIH]... 

Kidney Failure, Acute A clinical syndrome characterized by a sudden decrease in glomerular filtration rate, often to values of less than 1 to 2 ml per minute. It is usually associated with oliguria (urine volumes of less than 400 ml per day) and is always associated with biochemical consequences of the reduction in glomerular filtration rate such as a rise in blood urea nitrogen (BUN) and serum creatinine concentrations. [NIH]... 

Oliguria Clinical manifestation of the urinary system consisting of a decrease in the amount of urine secreted. [NIH]... 

Renal Effects. The patient described by Letz et al. (1984) (see Section 2.2.3.1) who lived for 64 hours after exposure to toxic levels of 1,2-dibromoethane had acute renal failure as evidenced by severe oliguria 24 hours after exposure and abnormal clinical chemistry values (blood urea nitrogen, creatinine, and serum uric acid). Severe metabolic acidosis was present despite two hemodialysis procedures. 

Paxillus syndrome is a food allergy, not a true poisoning. As a consequence, some who eat the mushrooms will not develop symptoms. Symptoms may include colic, vomiting, diarrhea, oliguria or anuria, kidney pain, hemoglobinuria, and renal failure. A hemagglutination test has been used for confirmation (Bresinsky and Besl, 1990). 

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