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Oliguria in major burns

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Oliguria in major burns usually is due to inadequate fluid resucitation. It is more likely in the following groups:

  • inhalation damage to lung
  • electrocution
  • delay before resuscitation
  • children
  • dehydrated individuals, e.g. excess alcohol consumption

Oliguria should prompt a fluid challenge:

  • supplementary bolus of 5-10 mls / kg, or
  • increase the next hour's estimated volume by 50%

However, caution must be exercised in the following groups with reduced ability to compensate for fluid shifts:

  • children
  • elderly patients
  • patients with cardiac compromise

Invasive monitoring of cardiac preload and afterload may be warranted in the setting of the HDU/ITU.

Generally, diuretics should not be used in response to oliguria in the patient with a major burn injury. An exception to this rule may be haemochromogenuria under the guidance of the burns unit or a renal physician.

Whenever a fluid challenge is given, the patient must be reassessed a short time later to determine their response.

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