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持续静脉输注呋塞米对急性肾损伤预后的影响。

Effect of continuous furosemide infusion on outcome of acute kidney injury.

作者信息

Ni Jie, Jiang Hui, Wang Fang, Zhang Long, Sha Dujuan, Wang Jun

机构信息

Jie Ni, Department of Emergency, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Gulou District, Nanjing 210000, Nanjing Province, P. R. China.

Hui Jiang, Department of Neurology, Jiangsu Province Hospital of Traditional Chinese Medicine, Affiliated Hospital of Nanjing University of Traditional Chinese Medicine, Nanjing 210000, China.

出版信息

Pak J Med Sci. 2019;35(3):754-757. doi: 10.12669/pjms.35.3.1012.

Abstract

OBJECTIVE

To evaluate the clinical effects of continuous intravenous infusion with high-dose furosemide on early acute kidney injury (AKI) complicated with acute lung edema.

METHODS

Ninety patients who had been treated by furosemide at routine dose for 12 hour but with unsatisfactory outcomes were selected and subjected to continuous intravenous infusion with high-dose furosemide. The dose was adjusted according to hourly urine output. Serum levels of urea nitrogen, creatinine and potassium, pH, oxygenation index and mechanical ventilation time before and 6, 12, 24, 48 and 72 hour after treatment were compared.

RESULTS

The urine outputs before and 6, 12, 24, 48 and 72 hour after treatment were (10.71 ± 1.81), (164.52 ± 21.42), (189.71 ± 29.61), (181.33 ± 23.52), (176.82 ± 24.80) and (164.52 ± 18.91) ml/h respectively. Compared with data before treatment, the serum levels of urea nitrogen, creatinine and potassium significantly decreased while pH and oxygenation index significantly increased after six hour of treatment (P<0.05). After treatment, the kidney functions of 80 patients (88.9%) were completely recovered, without obvious adverse reactions.

CONCLUSION

For patients with early AKI complicated with acute pulmonary edema who cannot be cured by diuretic agent at routine dose, high-dose furosemide increases urine output and improves success rate.

摘要

目的

评估大剂量呋塞米持续静脉输注对早期急性肾损伤(AKI)合并急性肺水肿的临床疗效。

方法

选取90例常规剂量呋塞米治疗12小时效果不佳的患者,给予大剂量呋塞米持续静脉输注。根据每小时尿量调整剂量。比较治疗前及治疗后6、12、24、48和72小时的血清尿素氮、肌酐、钾水平、pH值、氧合指数及机械通气时间。

结果

治疗前及治疗后6、12、24、48和72小时的尿量分别为(10.71±1.81)、(164.52±21.42)、(189.71±29.61)、(181.33±23.52)、(176.82±24.80)和(164.52±18.91)ml/h。与治疗前数据相比,治疗6小时后血清尿素氮、肌酐和钾水平显著降低,而pH值和氧合指数显著升高(P<0.05)。治疗后,80例患者(88.9%)肾功能完全恢复,无明显不良反应。

结论

对于常规剂量利尿剂治疗无效的早期AKI合并急性肺水肿患者,大剂量呋塞米可增加尿量并提高成功率。

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