Runge Sørensen Charlotte, Madsen Jens Kristian, Schmidt Frank, Sloth Erik
Anæstesi/intensiv Afdeling I, Aarhus Universitetshospital, Skejby, Brendstrupgårdsvej 100, Aarhus.
Ugeskr Laeger. 2012 Oct 22;174(43):2617-20.
In many intensive care units, loop diuretics are used more or less routinely to achieve a urinary output above 1 ml/kg/h in critically ill patients. We do not in the literature find any basis of this strategy. In contrast, this practice may cause a risk of circulatory instability in the critically ill patient due to large diuresis and volume depletion. There is no evidence so far that the use of loop diuretics has a renal protective effect or any other beneficial impact on the renal function. The use of loop diuretics in oliguric critically ill patients may be harmful. Consequently an individual assessment is required.
在许多重症监护病房,或多或少常规使用袢利尿剂,以使重症患者尿量达到每千克体重每小时1毫升以上。我们在文献中未找到该策略的任何依据。相反,这种做法可能因大量利尿和容量耗竭而导致重症患者出现循环不稳定的风险。目前尚无证据表明使用袢利尿剂具有肾脏保护作用或对肾功能有任何其他有益影响。在少尿的重症患者中使用袢利尿剂可能有害。因此,需要进行个体化评估。