Early Diuresis Following Colorectal Surgery

Exclusion Criteria

• •Surgeries involving intraoperative radiation
• •Ileostomy closures, when performed as the only surgical intervention
• •Surgeries involving multiple disciplines (e.g., colorectal plus general surgery, colorectal plus gynecology surgery) except for colorectal surgeries plus ureteral stent placements.
• •Chronic loop diuretic therapy (i.e., bumetanide, torsemide, furosemide, ethacrynic acid) including as needed administration of such therapy
• •Patients receiving dialysis
• •Creatinine clearance, calculated by the Cockcroft-Gault equation, less than 30 mL/min.
• •Inpatient prior to surgery
• •Allergy to furosemide
• •Allergy to sulfa drugs if the allergy involves anaphylactic reaction
• •Lack of serum creatinine concentration within 3 months preceding the surgery AND diagnosis of chronic kidney disease
• •Patient's weight on postoperative day (POD) #1 and POD #2 is less than preoperative weight.
• •Blood pressure criteria: systolic blood pressure criteria less than 90 mmHg or greater than 30 mmHg below baseline on POD #1 and/or POD #2 immediately prior to administration of study drug.
• •Complications within 48 hours of surgery
• •Abscess (infected fluid collection, treated with CT drainage)
• •Leak (defined by CT drainage or reoperation)
• •Wound infection (treated with either antibiotics and/or open packing)
• •Bowel obstruction (treated with reoperation)
• •Reoperation
• •Hemorrhage
• •Weight change since admission on POD #1: \> 5 kg
• •Acute kidney injury on POD #1 and POD#2 defined as serum creatinine (SCr) increase ≥ 0.3 mg/dL or increase to ≥ 150% to 200% (1.5- to 2-fold) from baseline