Table 1.

A mnemonic “CAN-U-P-LOTS” summarizing evidence-based potentially-better-practices that may be used in clinical practice to treat patients with fluid overload

CAN-U-P-LOTS Mnemonic
Cause	Determine underlying etiology   - Abdominal compartment syndrome   - Cardiac (congenital heart disease, patent ductus arteriosus, heart failure)   - Congenital anomalies of kidney and urinary tract (CAKUT)   - Dehydration   - Hypoalbuminemia   - Hyperuricemia   - Shock (sepsis, necrotizing enterocolitis, or hypoxic ischemic injury)
Albumin	Treat with 20–25% albumin:   - 2 g/kg/dose over 4 h if albumin < 2.0 mg/dL   - 1 g/kg/dose over 4 h if 2.0 to < 2.5 mg/dL
Nephrotoxicity	Assess medications   - Avoid or switch to less nephrotoxic medications   - Follow levels closely if nephrotoxic medications needed
Ultrafiltration	Kidney support therapy via peritoneal or extracorporeal approach
Perfusion	Determine and treat cause of shock   - Adrenal   - Cardiac   - Hypovolemia   - Neurologic   - Sepsis   - Titrate mean arterial pressure (MAP) goals to achieve urine output
Lasix stress test	Furosemide stress test to assess kidney response
Output	Assess urine output trends Place foley catheter Consider bladder obstruction
Total fluid intake	Determine dry weight for dosing and calculating fluid balance Set fluid goals Concentrate all medications and nutrition Maintain adequate nutrition and intravascular volume
Steroids	Add stress dose hydrocortisone for refractory hypotension