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If a patient is extubated and experiences loss of kidney function, is this from fluid overload?
If you want to know the answer to that, stay tuned!
My name is Patrik Hutzel from intensivecarehotline.com and I have another quick tip for families in intensive care.
So today, I have this question from Lina, who says, “Hi Patrik, if a patient is extubated and experiences loss of kidney function, is it from fluid overload?” Let’s dive into the answer to that question.
First of all, let’s clarify some terminology. Extubation means the removal of the breathing tube for a patient in intensive care, so that’s what extubation means. Someone has been weaned off the ventilator successfully, and now they’re ready to have the breathing tube taken out.
Now, loss of kidney function following extubation can potentially be related to fluid overload, but it’s not the only possible cause. After extubation, patients are at risk of various complications, including fluid imbalance, which can occur for several reasons.
Fluid overload. If the patient was on mechanical ventilation for an extended period, they might have received significant intravenous fluids, leading to fluid retention. This could result in kidney dysfunction, especially if the kidneys are unable to excrete the excess fluid due to underlying renal issues.
Next, pre-renal causes. Reduced renal perfusions due to hypotension or poor cardiac output after extubation can also impact kidney function.
Next, renal injury. Other causes, such as acute kidney injury (AKI) from ischemia, sepsis, or nephrotoxic medications, may also contribute to the loss of kidney function.
Lastly, electrolyte disturbances. Abnormalities in electrolytes or acid-base balance can impact renal function as well.
In any case, careful monitoring of fluid balance and kidney function, especially creatinine, urea, BUN, urine output, and overall clinical status is crucial and absolutely critical in such cases.
The biggest cause that I have seen, after having worked in critical care nursing for 25 years, that patients going into acute kidney failure is really sepsis, hypotension, and mismanagement of fluid balances, but also electrolyte disturbances, and also rhabdomyolysis, which I haven’t mentioned yet, which is in patients who have multiple trauma. The body is breaking down the muscle tissue, and then it’s released into the body, and that can clog, basically, the kidneys as well.
But the procedure, extubation as such, is very unlikely to cause kidney failure, it’s more what’s leading into it. When you look at the research, I don’t have the numbers right here, but there’s a reasonably high number of patients in intensive care that go into kidney failure for the reasons that I mentioned. Those patients may not necessarily be intubated. It all comes down to, once again, what happens in intensive care. Often patients are septic, that can cause kidney failure. Patients might be hypotensive for significant periods of time, and that causes a lack of organ perfusion, including lack of kidney perfusion, and that can cause kidney failure, sometimes temporarily, sometimes permanently. You have to discuss that, obviously, with the intensive care team if that’s the situation with your critically ill loved one.
I hope that answers your question.
Like I mentioned, I have worked in critical care nursing for 25 years in three different countries where I worked as a nurse manager for over 5 years in intensive care. I’ve been consulting and advocating for families in intensive care since 2013 here at intensivecarehotline.com. I can very confidently say that we have saved many lives with our consulting and advocacy. You can verify that on our testimonial section at intensivecarehotline.com. You can also verify it on our podcast section at intensivecarehotline.com where we’ve done client interviews who can verify that we have saved their loved ones’ lives.
That’s why we have helped hundreds and hundreds of members and clients over the years, and we can help you as well very fast. You would be surprised how fast we can help you when you have a loved one critically ill in intensive care because the biggest challenge for families in intensive care is that they don’t know what they don’t know. They don’t know what to look for. They don’t know what questions to ask. They don’t know their rights and they don’t know how to manage doctors and nurses in intensive care. That is exactly what you’re up against if you’re watching this.
That’s also why I do one-on-one consulting and advocacy over the phone, Zoom, Skype, WhatsApp, whichever medium works best for you. I talk to you and your families directly. I handhold you through this once in a lifetime situation that you simply cannot afford to get wrong. I also talk to doctors and nurses directly, with you or on your behalf. When I talk to doctors and nurses directly, I ask all the questions that you haven’t even considered asking but must be asked when you have a loved one critically ill in intensive care.
I also represent you in family meetings with intensive care teams.
We also do medical record reviews in real-time so that you can get a second opinion in real-time. We also do medical record reviews after intensive care if you have unanswered questions, if you need closure, or if you are suspecting medical negligence.
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Thank you so much for watching.
This is Patrik Hutzel from intensivecarehotline.com and I will talk to you in a few days.
Take care for now.
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