Hi Kristeen, what do you tend to do when a pt presents with fluid overload and there’s no past renal baseline for comparison, and their renal function is deteriorating with diuresis but they still appear clinically overloaded? Is there a percentage of say 30% increase in creatinine that would be acceptable for a ‘new renal baseline’ when we accept the increase in renal biomarkers? Thanks so much for your videos!
This is a great question. It depends on the unique case but aiming for 0.5-1kg negative balance usually causes only a mild change in gfr due to diuresis, whereas if the gfr jump is large it might be that the diuresis was too much in a 24 hour period. So that’s the first thing. The other thing is that usually the gfr if it drops a little during diuresis, it stabilises out, and it shouldn’t keep going off, that would definitely make me cut back. And of course all of the Aki work up still applies to these patients, wouldn’t just put it down to diuresis if gfr changes significantly. Percentage values are hard to give here, I think patterns and context and the whole picture need to be considered with diuretic effect in the differential alongside other things to be safe. I hope that helps :) and thank you so much again for a great question!
ooo can you tell me more about the audio experience? What's happening for you? When you say left, volume low? Or buzzy? I got a new lapel mic and on a learning curve with tech as always :) Thank you so much for any constructive feedback so i can make things pop in future. Also thank you so much for stopping by!
@@kristeenbarker when you listen with earphones or headphones, your voice sounds its coming more from the left, and less so/muffled on the right. It might be fixed by positioning your mic differently, or doing some post-processing wizardry.
I am doing BPT and this is the best explanation I had so far for this topic ! thank you so much
Thank you so much for taking the time to say hello! I’m so glad it was helpful. And I hope all the studies are going well. 😊
Thank you so much !
Awesome. So easy to follow. Thank you for your numerous excellent videos.
Yay! So glad it helped and thanks so much for saying hello. U da best!
Awesome explanation! I will be using this at work! Thank you :)
Yass!!! Love it! So excited it was helpful :)
Hi Kristeen, what do you tend to do when a pt presents with fluid overload and there’s no past renal baseline for comparison, and their renal function is deteriorating with diuresis but they still appear clinically overloaded?
Is there a percentage of say 30% increase in creatinine that would be acceptable for a ‘new renal baseline’ when we accept the increase in renal biomarkers?
Thanks so much for your videos!
This is a great question. It depends on the unique case but aiming for 0.5-1kg negative balance usually causes only a mild change in gfr due to diuresis, whereas if the gfr jump is large it might be that the diuresis was too much in a 24 hour period. So that’s the first thing. The other thing is that usually the gfr if it drops a little during diuresis, it stabilises out, and it shouldn’t keep going off, that would definitely make me cut back. And of course all of the Aki work up still applies to these patients, wouldn’t just put it down to diuresis if gfr changes significantly. Percentage values are hard to give here, I think patterns and context and the whole picture need to be considered with diuretic effect in the differential alongside other things to be safe. I hope that helps :) and thank you so much again for a great question!
@@kristeenbarker thank you again!!
US IVC - can it be helpful in those situation when JVP elevation not ovbvious
Oooo thats a great thought - yes if within your power to check central vein pressures/volume - you are winning! Great idea!
Audio is a little bit to the left, but thanks for the helpful video.
ooo can you tell me more about the audio experience? What's happening for you? When you say left, volume low? Or buzzy? I got a new lapel mic and on a learning curve with tech as always :) Thank you so much for any constructive feedback so i can make things pop in future. Also thank you so much for stopping by!
@@kristeenbarker when you listen with earphones or headphones, your voice sounds its coming more from the left, and less so/muffled on the right. It might be fixed by positioning your mic differently, or doing some post-processing wizardry.