Impact of a urinary dynamics monitoring device on fluid resuscitation outcomes in severe burn patients in a general ward

SU Yu-juan; PAN Sun-feng; FAN Yu

doi:10.13820/j.cnki.gdyx.20243181

Abstract：Objective To compare the accuracy of hourly urine output monitoring using manual versus device-based methods with a urinary dynamics monitoring device and to evaluate its impact on fluid resuscitation outcomes in se-vere burn patients in a general ward setting.Methods Seventy severe burn patients admitted to the Department of Burn and Plastic Surgery,Jiaxing Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medicine University,be-tween March 2021 and December 2023 were sequentially numbered and divided into two groups:a manual monitoring group(manual group,n=35;odd-numbered cases)and a device monitoring group(device group,n=35;even-num-bered cases).Urine output was monitored hourly for 48 hours.In the manual group,a nurse recorded urine volume from a disposable precision drainage bag by visual inspection each hour,while in the device group,a urinary dynamics monito-ring device automatically recorded hourly urine output.Based on these measurements,fluid infusion rates were adjusted to maintain a target urine output of 1-1.5 mL/h per kilogram body weight.The two groups were compared regarding meas-urement punctuality,time required per measurement,24-and 48-hour hematocrit,residual base,C-reactive protein,renal function parameters,and the incidence of complications within 48 hours.Results Over the 48-hour period,the manual group achieved on-time measurements 59 times(3.51％),whereas the device group maintained 100％on-time measurements(P＜0.01).The manual group required an average of(125.32±38.63)seconds per measurement com-pared to(3.32±0.28)seconds in the device group(P＜0.01).At both 24 and 48 hours,the device group showed sig-nificantly improved hematocrit,residual base,and C-reactive protein levels compared to the manual group(P＜0.01).Although blood urea nitrogen and creatinine levels did not differ significantly at 24 hours(P＞0.05),they were signifi-cantly lower in the device group at 48 hours(P＜0.05).Additionally,no complications were observed in the device group within 48 hours,while 4 complications occurred in the manual group(P＞0.05).Conclusion The urinary dy-namics monitoring device offers superior punctuality and efficiency in hourly urine output measurements compared to manu-al monitoring.This precision not only reduces nursing workload but also enables optimal adjustment of fluid infusion rates,thereby enhancing the effectiveness of fluid resuscitation in severe burn patients in a general ward.