呋塞米激发试验对感染性休克早期急性肾损伤患者预后的预测价值

doi:103969/jissn1002-1949201712003

Chinese Journal of Critical Care Medicine

2017, Vol. 37

Issue (12): 1083-1086 DOI: 103969/jissn1002-1949201712003

The prediction value of the furosemide stress test in the severity of early acute kidney injury complicated by septic shock

Zhao Dan, Liang Feng-ming, Dong Liang, Hui Jiao-jie

Wuxi People′s Hospital Affiliated to Nanjing Medical University

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Abstract Objective：To investigate the prediction value of the furosemide stress test in the severity of early acute kidney injury (AKI) complicated by septic shock. Methods：From February 2014 through December 2016, a total of 72 eligible patients who admitted to ICU and EICU in our hospital were enrolled in this prospective study. They were received a furosemide stress test (FST) (one-time dose of 1.0 or 1.5 mg/kg intravenous furosemide depending on prior furosemide-exposure) after adequate fluid resuscitation. The urine output following FST in each of the first 6 hours were recorded. The test was followed up for 28 days. According to stage 3 of AKI criteria, patients were divided into the progressor group and non-progressor group. The receiver operating characteristic curves were used to evaluate the prediction value of the furosemide stress test in the severity of acute kidney injury. Results：Subjects with progressive AKI had significantly lower urine output following FST in each of the first 6 hours (P＜0.05). The area under the receiver operator characteristic curves for the total urine output over the first 2 hours following FST to predict progression to stage 3 of AKI was 0.914 (95% CI 0.824～0.967), the sensitivity was 86.8% and specificity was 88.2% with a cutoff value of 170 mL. Age, APACHEⅡ score, blood lactate and urine output following FST in first 2 hours are the high risk factors affecting the prognosis (P＜0.05). Conclusion：The urine output following FST within the first 2 hours has a predictive value for in the severity of subjects with early AKI complicated by sepsis shock. Age, APACHEⅡ score, blood lactate and urine output following FST in first 2 hours are the high risk factors affecting the prognosis.

Corresponding Authors: Liang Feng-ming, E-mail:liangnanyi@sina.com

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http://www.cnemergency.org.cn/EN/103969/jissn1002-1949201712003 OR http://www.cnemergency.org.cn/EN/Y2017/V37/I12/1083

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