Prophylactic low dose furosemide infusion effect on cardiac surgery patients with renal dysfunction: A randomized controlled trial

Prieta Adriane, Jefferson Hidayat, Adhrie Sugiarto, April Retno Susilo

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: Preoperative renal dysfunction in-creases the risk of postoperative renal failure and mortality in cardiac surgery patients. Stud-ies investigating the protective effect of furo-semide in cardiac surgery were mostly conducted in patients with normal renal function. This study aimed to evaluate the effect of prophylactic low-dose furosemide in cardiac surgery patients with mild to moderate renal dys-function. Design: Double-blind randomized controlled trial. Setting: This study was conducted at a cardiovascular surgery center. Patients and participants: Eighty-seven patients of elective cardiac surgery with mild to moderate renal dysfunction (estimated glomerular filtration rate [eGFR] 30-89 ml/min/1.73 m2). Interventions: Prophylactic furosemide infusion (2 mg/h) or 0.9% NaCl infusion (2 ml/h) was ad-ministered and continued for a total of 12 hours. Measurement and results: We examined blood samples at 12, 24, 48, and 120 hours after infusion started to measure the change in eGFR. A decrease in eGFR ³20% was considered a worsening of renal function, while ³20% increase in eGFR was recovering of renal function. We compared the requirement for therapeutic furo-semide infusion and renal replacement therapy in both groups. The incidence of decreasing eGFR at the 12th, 24th, and 48th-hour was higher in the control compared to the furosemide group. Increasing eGFR at the 120th-hour was the same in both groups. Subjects in the furosemide group re-quired less administration of therapeutic furo-semide infusion than the control group. Renal replacement therapy was needed more in the furo-semide group than in the control group. Conclusions: Low-dose furosemide infusion can reduce the incidence of worsening renal function, and the need for therapeutic furosemide infu-sion, but does not prevent the usage of renal replacement therapy.

Original languageEnglish
Pages (from-to)253-262
Number of pages10
JournalCritical Care and Shock
Volume25
Issue number5
Publication statusPublished - Oct 2022

Keywords

  • cardiac surgery
  • Furosemide
  • glomerular filtration rate
  • renal dysfunction

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