2 min Evaluation – Urimeter – 10 seconds to reach a conclusion
The quick explanation :
Situation : urine = (translucent) red.
Background : hemoglobinuria. (I had originally identified this erroneously as methemoglobinemia – mea culpa),
Action : requires alkalinization of urine to avoid acute renal failure.
Recommendation : increase pH~7.50 (increase minute volume).
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The “long winded” explanation :
S-B-A-R format reporting – quick reporting format for handoff from one healthcare professional to another.
A lot of this presentation is conjecture … but time and experience has proven correct 99 out of 100 times.
Translucent red urine – the hemoglobin have been “beaten up” / ” chewed up” by some unknown process’ (the usual offending agent is heart surgery,
general surgery or rhabdomylosis.
RBCs (=bags of hemoglobin) have lost their membrane integrity and free floating hemoglobin
is now coursing thru the cardiovascular system.
As the hemoglobin pass thru the renal vascular anatomic structures, the hemoglobin molecularly binds with the distal convoluted tubule
(DCT) structures and causes acute renal failure (ARF-k).
The transient solution is to alkalinize the urine.
Alkalinization of urine will create an environment non-conducive to precipitation of free hemoglobin on renal DCT sub-structures. (further reading >> pH and molecular structure / shaping).
The free-floating hemoglobin tends to bind poorly to DCT structures in an alkalemic environment.
Transient solution is to increase the minute volume to target a pH~7.50.
