What is the recommended urine output in patients with DKA or HHS to ensure adequate tissue perfusion?

In the management of patients with diabetic ketoacidosis (DKA) or hyperglycemic hyperosmolar state (HHS), it is crucial to ensure adequate tissue perfusion and renal function. The recommended urine output of 1 to 3 mL/kg/h reflects a balance that indicates sufficient kidney perfusion and function. This range helps to ensure that the kidneys are effectively clearing waste products and maintaining fluid and electrolyte balance, which is essential in the context of these conditions where dehydration and electrolyte imbalances are common.

Maintaining urine output within this range is indicative of adequate renal perfusion and function, supporting the idea that blood flow to the kidneys is sufficient to filter blood and produce urine. In the context of DKA and HHS, where patients often present with a high degree of dehydration, monitoring urine output is a critical vital sign.

A urine output less than this range might suggest inadequate perfusion and risk for acute kidney injury, while output significantly above this range could indicate other issues such as osmotic diuresis or fluid overload, which are not typically desirable in the acute management of these patients. Therefore, targeting a urine output of 1 to 3 mL/kg/h is aligned with best practice guidelines for ensuring adequate tissue perfusion