Early detection of oliguric events in critically ill patients in the ICU with a novel continuous urine flow measurement device: results of an initial validation study

Objectives: Urine output is used to evaluate fluid status and is an important marker for acute kidney injury (AKI). Our primary aim was to validate a new automatic urine output monitoring device by comparison to the current practice – the standard urometer. Methods: We conducted a prospective observ...

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Bibliographic Details
Published in:Journal of clinical monitoring and computing 2023-10, Vol.37 (5), p.1341-1349
Main Authors: Fishman, Guy, Ram, Eilon, Gorfil, Dan, Kassif, Yigal, David, Rachel, Hershko, Tzlil, Malbrain, Manu L.N.G., Singer, Pierre, Sessler, Daniel I.
Format: Article
Language:English
Subjects:
Anesthesiology
Assessments
Bias
Cameras
Critical Care Medicine
Flow measurement
Health Sciences
Intensive
Measuring instruments
Medicine
Medicine & Public Health
Nurses
Nursing
Oliguria
Original Research
Patients
Statistics for Life Sciences
Urine
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Summary:Objectives: Urine output is used to evaluate fluid status and is an important marker for acute kidney injury (AKI). Our primary aim was to validate a new automatic urine output monitoring device by comparison to the current practice – the standard urometer. Methods: We conducted a prospective observational study in three ICUs. Urine flow measurements by Serenno Medical Automatic urine output measuring device (Serenno Medical, Yokneam, Israel) were compared to standard urometer readings taken automatically at 5-minutes intervals by a camera, and to hourly urometer readings by the nurses, both over 1 to 7 days. Our primary outcome was the difference between urine flow assessed by the Serenno device and reference camera-derived measurements (Camera). Our secondary outcome was the difference between urine flow assessed by the Serenno device and hourly nursing assessments (Nurse), and detection of oliguria. Results: Thirty-seven patients completed the study, with 1,306 h of recording and a median of 25 measurement hours per patient. Bland and Altman analysis comparing the study device to camera measurements demonstrated good agreement, with a bias of -0.4 ml/h and 95% confidence intervals ranging from − 28 to 27ml/h. Concordance was 92%. The correlation between Camera and hourly nursing assessment of urine output was distinctly worse with a bias of 7.2 ml and limits of agreement extending from − 75 to + 107 ml. Severe oliguria (urine output 
ISSN:1387-1307
1573-2614
DOI:10.1007/s10877-023-00991-w