Figure 8
Case B: Cr unchanged . Plasma creatinine changes (a) and fluid input/urine output and plasma volume (b) are shown. Fluids alone (no change in glomerular filtration rate (GFR) and no reduction in creatinine production) suggest that a decrease in plasma creatinine should have been observed (grey line). If there had been a reduction in creatinine production (Figure 4), the decrease would have been greater (dotted line). A model including a reduction in creatinine, fluids in and out, and a reduction of 40% in GFR increasing to 90% at about 24 hours best fits the measured creatinine. The patient became anuric despite multiple boluses and died at 53 hours. Crunchanged, group of patients in whom plasma creatinine increased no more than 20% or decreased no more than 10% at 24 hours after cardiac arrest.