Simplified conservative fluid management protocol (Fluid and Catheter Treatment Trial Lite)
| Central venous pressure, mm Hg (recommended) | Pulmonary artery occlusion pressure, mm Hg (optional) | Mean arterial pressure ≥ and off vasopressors ≥ 12 hour | |
|---|---|---|---|
| Urine output < 0.5 mL/kg/hr | Urine output ≥ 0.5 mL/kg/hr | ||
| > 8 | > 12 | Furosemidea; reassess in 1 hour | Furosemidea; reassess in 4 hours |
| 4–8 | 8–12 | Give fluid bolus; reassess in 1 hour | Furosemidea; reassess in 4 hours |
| < 4 | < 8 | Give fluid bolus; reassess in 1 hour | No intervention; reassess in 4 hours |
↵a Recommended furosemide dosing: begin with 20-mg bolus or 3-mg/hour infusion or last known effective dose. Double each subsequent dose until goal achieved (oliguria reversal or intravascular pressure target) or a maximum infusion rate of 24 mg/hour or a 160-mg bolus is reached. Do not exceed 620 mg/day. Also, if patient has heart failure, consider treatment with dobutamine.
From reference 8.