Inaccuracy of Urine Output Measurements due to Urinary Retention in Catheterized Patients in the Burn ICU

• Published in: Journal of burn care & research 2017-01, Vol.38 (1), p.e409-e417
• Main Authors: Kramer, George C, Luxon, Evan, Wolf, Jordan, Burnett, Daniel R, Nanduri, Devyani, Friedman, Bruce C
• Format: Article
• Language: English
• Subjects: Adult; Burn Units; Burns - complications; Burns - therapy; Case-Control Studies; False Positive Reactions; Female; Humans; Male; Middle Aged; Oliguria - diagnosis; Oliguria - etiology; Reproducibility of Results; Urinary Catheterization - adverse effects; Urinary Catheterization - instrumentation; Urinary Retention - diagnosis; Urinary Retention - etiology; Urine
• ISSN: 1559-047X; 1559-0488
• DOI: 10.1097/BCR.0000000000000405

Electronic urinary output monitors, intended to provide urine output information to guide fluid therapy during burn resuscitation, can be inaccurate because of airlocks causing urine retention in the drainage tube and bladder. In this study, the authors explore the effects of airlock formation on urine output measured using an electronic urinary output monitor connected to either a standard commercial drainage tubing system or a drainage tubing system with an automated airlock clearing mechanism. In a multicenter study in the burn intensive care unit, urine output was compared between 10 control patients with a standard commercial drainage tubing system and 10 test patients with a novel automated airlock clearing drainage tubing system. The comparison was focused on identifying the number and magnitude of surges in urinary output because of airlocks and associated periods of false oliguria. In the control group, 5 of 10 (50%) patients had drainage line flow impediments from 8 airlocks. In addition, control patients experienced six associated periods of false oliguria. Airlock surge volumes ranged from 50 to 329 ml, and false oliguria duration ranged from 39.4 to 185.2 minutes. In the test group, 0 of 10 (0%) patients had drainage line impediments from airlocks (P < .01), and hence, there were no periods of false oliguria. Airlocks and associated periods of false oliguria occur with standard commercial drainage tubing and are eliminated using an automated airlock clearing drainage tube. Electronic urinary output monitoring with self-clearing drainage has the potential to improve tracking of real-time urine output and decrease caregiver workload.