Clinical Pearl

The volume-overloaded post-op patient has copious output from the indwelling (JP) drains…and everybody is eager to get fluid off ASAP. Should diuretics be used? Unfortunately, removing many liters from abdominal drains and concomitant use of diuretics can be harsh on the kidneys. Since a healthy peritoneum can remove roughly 900 ml of fluid daily, it’s safe to remove the drains when they are putting out 1 liter per day. That’s the most appropriate time to start diuretics.

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