case_images: PMC10165981_01
case_images: Daily and accumulated evolution of hydric balance and radiological findings at the time the patient was intubated and extubated
case_images: AIT-53-43909-g001.jpg
case_images: PMC10165981_01_AIT-53-43909-g001.jpg
case_images: F1
case_images: The clinical picture was progressively aggravated by respiratory insufficiency due to acute pulmonary oedema, and invasive mechanical ventilation was required a few hours later (Figure 1). The administration of the first bolus of 20% mannitol (100 mL) was followed by an increase in urine output (1 mL kg-1 h-1), allowing for a negative fluid balance to be achieved that day (-2000 mL) (Figure 1). X-ray findings and ventilatory requirements also improved, making weaning from mechanical ventilation possible (Figure 1).
case_images: Time evolution of diuresis, administered diuretics, and results of the studies of the glomerular and tubular function
case_images: AIT-53-43909-g002.jpg
case_images: PMC10165981_01_AIT-53-43909-g002.jpg
case_images: F2
case_images: Creatinine clearance showed mild renal insufficiency (CrCl: 74 mL min-1); the fractional excretion of sodium was very low in spite of the natriuretic treatment with furosemide (FeNa: 0.4 %); and free water clearance was negative (ClH2O: -0.6 mL min-1), indicating water reabsorption (Figure 2). Results for both glomerular (CrCl: 73 mL min-1) and tubular (FeNa: 0.4%) functions remained stable but, interestingly, free water clearance had turned positive (ClH2O: +0.4 mL min-1) (Figure 2).