[Aggressive volume therapy for prevention of acute renal failure in multiple trauma patients]

Immediate fluid resuscitation is of the utmost importance for patients with multiple trauma. Evaluation of this form of treatment for the prevention of acute renal failure was the purpose of this study. Of 262 patients with multiple trauma, 112 were in shock on admission. The patients were treated with large volumes of Ringer's lactate and sodium bicarbonate until urine production was 60-100 ml/h. Hemoglobin and electrolytes were substituted according to the laboratory findings. There were 32 patients who developed renal complications, such as bacteriuria (13), hematuria (7), reduction of renal function (3), and acute renal failure (9). The renal failure did not develop during the first 24-48 h but during treatment in the intensive care unit, mostly in the course of multiple organ failure. Death supervened in 35 of the 262 patients (13.5%). Thus, immediate rapid fluid replacement with large volumes of crystalloid solutions can prevent acute renal failure.