Effect of Furosemide on Urinary Oxygenation in Patients with Septic Shock.

Osawa, Eduardo Atsushi; Cutuli, Salvatore Lucio; Bitker, Laurent; Canet, Emmanuel; Cioccari, Luca; Iguchi, Naoya; Lankadeva, Yugeesh R; Eastwood, Glenn M; Evans, Roger G; May, Clive N; Bellomo, Rinaldo (2019). Effect of Furosemide on Urinary Oxygenation in Patients with Septic Shock. (In Press). Blood purification, pp. 1-10. Karger 10.1159/000501512

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BACKGROUND Renal medullary hypoxia precedes the development of acute kidney injury in experimental sepsis and can now be assessed by continuous measurement of urinary oxygen tension (PuO2). OBJECTIVES We aimed to test if PuO2 measurements in patients with septic shock would be similar to those shown in experimental sepsis and would detect changes induced by the administration of furosemide. METHOD Pilot prospective observational cohort study in a tertiary intensive care unit (ICU). Seven adult patients with septic shock admitted to ICU had PuO2 measurements recorded minutely. There were 29 episodes of intravenous furosemide (20 mg n = 19; 40 mg n = 10). RESULTS The median pre-furosemide PuO2 was low at 21.2 mm Hg (interquartile range [IQR] 17.73-24.86) and increased to 26 mm Hg (IQR 20.27-29.95) at 20 min (p < 0.01), to 27.5 mm Hg (IQR 24.06-33.18) at 40 min (p < 0.01) and to 28.5 mm Hg (IQR 22.65-31.03) at 60 min (p < 0.01). The increase in PuO2 was greater in episodes with a diuretic response >2 mL/kg/h than during episodes without such a response (p < 0.01). CONCLUSIONS PuO2 measurements in patients are reflective of the low values reported in experimental models of sepsis. PuO2 values increased following furosemide administration with a response independently associated with greater diuresis.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic of Intensive Care

UniBE Contributor:

Cioccari, Luca

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0253-5068

Publisher:

Karger

Language:

English

Submitter:

Mirella Aeberhard

Date Deposited:

22 Aug 2019 10:33

Last Modified:

23 Aug 2019 01:32

Publisher DOI:

10.1159/000501512

PubMed ID:

31336370

Uncontrolled Keywords:

Furosemide Medullary oxygenation Sepsis Septic shock Urinary output Urinary oxygenation

URI:

https://boris.unibe.ch/id/eprint/132185

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