速食治疗急性病患者急性肾衰竭后的肾脏恢复不能改善肾脏恢复:一项双重盲随机对照试验。
摘要来源:
crit Care Care Med。 2009年2月; 37(2):533-8。 PMID: 19114909 Zandberg,Joke de Ruiter,Rik t Gerritsen,Peter H M Egbers,W Peter Kingma,MichaëlAKuiper
文章隶属关系:重症监护局,Onze lieve lieve vrouwe vrouwe vrouwe vrouwe casthuis,netherlands。 To study the potential beneficial role of furosemide in resolving renal failure after hemofiltration in mechanically ventilated critically ill patients.
DESIGN: Single-center randomized, double blind, placebo-对照研究。
设置: 在教学医院中的13张床混合重症监护室(ICU)。
包括。
干预: 连续静脉血液过滤结束后,收集了前4小时的尿液,以测量肌酐清除率。随后通过连续输注将患者随机分配为速尿(0.5 mg/kg/hr)或安慰剂。 To prevent hypovolemia, the rate of fluid infusion was adapted every hour and was set as the urinary production of the previous hour.
MEASUREMENTS AND MAIN RESULTS: End points were renal recovery (creatinine clearance more than 30 mL/min or stable serum creatinine without renal replacement therapy) in the ICU and in the医院。包括72例患者,71例有资格进行分析。与35例接受安慰剂治疗的患者(中位数为247 ml/hr(IQR] 774 mL/hr)相比,经安慰剂治疗的患者与117 mL/hr(IQR 158 mL/hr),尿液(P = 0.003)和更大的iim exritiaian Excriteion(Mediaian Excretiian Excretiian exretiian exretiian exriian exriian exriian exriian exretiian exretiian 73),经安慰剂治疗的患者(中位数为247 mL/hr)和117 mL/hr(IQR)(iqr] 774 mL/hr)(vs.1174 mL/hr)(v),36例速尿治疗患者的尿量显着增加。 37(IQR 48)mmol/l,p = 0.001)。在速尿组25患者中,在安慰剂组中,第27例患者在ICU出院时恢复了肾功能(p = 0.46)。 Two patients of the furosemide group needed long-term dialysis dependency (p = 0.23).
CONCLUSION: Furosemide by continuous infusion in the recovery phase of hemofiltration-dependent acute kidney failure did increase urinary volume and sodium excretion but did not lead to a shorter duration of renal failure或更频繁的肾脏恢复。