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JAMA Diagnostic Test Interpretation
December 11, 2018

Serum Creatinine in the Critically Ill Patient With Sepsis

Author Affiliations
  • 1AP-HP, GH Saint Louis-Lariboisière, Department of Anesthesiology and Critical Care and Burn Unit, Paris, France
  • 2University Paris Diderot, Université Sorbonne Paris Cité, France
  • 3UMR INSERM 942, Institut National de la Santé et de la Recherche Médicale (INSERM), Paris, France,
  • 4F-CRIN, INICRCT Network, Paris, France
  • 5Center for Critical Care Nephrology, Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
JAMA. 2018;320(22):2369-2370. doi:10.1001/jama.2018.16627

A 73-year-old man underwent esophageal resection for cancer. He had a history of hypertension that was treated with an angiotensin receptor blocker. Preoperative estimated glomerular filtration rate (GFR) was 98 mL/min/1.73 m2. On the second postoperative day, body temperature was 38.6°C. Chest x-ray revealed bilateral lung consolidations consistent with pneumonia. Blood pressure decreased from 145/72 mm Hg to 96/53 mm Hg with a heart rate of 105/min. The patient was admitted to the intensive care unit (ICU) with acute respiratory failure and was placed on mechanical ventilation. In the ICU, urine output was 50 mL over 3 hours. On day 3, he received 4.5 L of Ringer lactate over 12 hours. Laboratory values are shown in the Table.

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