Department of Critical Care Medicine, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China.
Zhanjiang Key Laboratory of Organ Injury and Protection and Translational Medicine, Guangdong, China.
Ren Fail. 2023 Dec;45(1):2185084. doi: 10.1080/0886022X.2023.2185084.
To investigate the effects of low-dose furosemide and aminophylline on the renal function in patients with septic shock.
A total of 109 eligible septic shock patients in the intensive care unit were randomly divided into a control group ( = 55) and an intervention group ( = 54). The control group received normal saline, and the intervention group received low-dose furosemide (0.048 mg/kg.h) with aminophylline (0.3 mg/kg.h). The primary outcomes included the levels of serum creatinine (Scr), creatinine clearance rate (Ccr), blood urea nitrogen (BUN), glomerular filtration rate (GFR), and urine output on admission and on days 3, 7 and 14. The secondary outcomes were the sequential organ failure assessment (SOFA) scores, continuous renal replacement therapy (CRRT) time and intensive care unit (ICU) mortality, hospital mortality and 28-day mortality. There were no significant differences in the levels of Scr, Ccr, BUN, or GFR between the two groups, while the urine output was higher in the intervention group on days 3, 7, and 14. Compared with the control group, the SOFA scores, ICU mortality, hospital mortality and 28-day mortality were significantly lower in the intervention group on days 3, 7, and 14, the CRRT time was shorter, and the cumulative fluid balance was lower on days 3 and 7 in the intervention group.
Although low-dose furosemide and aminophylline have fewer protective effects on the renal function in septic shock patients, they could reduce the CRRT time and improve the prognosis.
研究小剂量呋塞米和氨茶碱对感染性休克患者肾功能的影响。
共有 109 名符合条件的重症监护病房感染性休克患者被随机分为对照组(n=55)和干预组(n=54)。对照组给予生理盐水,干预组给予小剂量呋塞米(0.048mg/kg.h)联合氨茶碱(0.3mg/kg.h)。主要结局包括入院时和第 3、7、14 天的血清肌酐(Scr)、肌酐清除率(Ccr)、血尿素氮(BUN)、肾小球滤过率(GFR)和尿量。次要结局为序贯器官衰竭评估(SOFA)评分、连续肾脏替代治疗(CRRT)时间、重症监护病房(ICU)死亡率、医院死亡率和 28 天死亡率。两组 Scr、Ccr、BUN 或 GFR 水平无显著差异,而干预组第 3、7、14 天尿量较高。与对照组相比,干预组第 3、7、14 天 SOFA 评分、ICU 死亡率、医院死亡率和 28 天死亡率均显著降低,CRRT 时间缩短,第 3、7 天累积液体平衡降低。
虽然小剂量呋塞米和氨茶碱对感染性休克患者的肾功能保护作用较小,但可缩短 CRRT 时间,改善预后。