Urine Output Based Fluid Management in the Critically Ill: assessing hypovolemia and preventing hypervolemia

Intravenous fluids have become commonplace in medical care, and are used to hydrate patients who are either not allowed or temporarily unable to eat, restore or maintain intravascular volume, or as a dilutive agent for intravenous medication. In the critically ill, there appears to be a mismatch between intravenous fluid administration and fluid loss via urine output, which leads to fluid overload and related adverse events. The main aim of this thesis is to investigate whether additional fluid administration aimed at improving urine output has the desired effect, whether this effect can be predicted, and whether this effect impacts patients’ outcome.