Dopamine dose and renal damage

Abstract

haemodynamic and renal parameters in patients with septic shock requiring treatment with noradrenaline. Intensive Care Med 1998; 24: 564–68. 3 Galley HF. Renal-dose dopamine: will the message now get through?. Lancet 2000; 356: 2112–13. 4 Martin C, Viviand X, Leone M, Thirion X. Effect of norepinephrine on the outcome of septic shock. Crit Care Med 2000; 28: 2758–65. 5 Task Force of the American College of Critical Care Medicine, Society of Critical Care Medicine. Practice parameters for hemodynamic support of sepsis in adult patients in sepsis. Crit Care Med 1999; 27: 639–60. were differences in urine flow between study groups. Had criteria for the use of diuretics other than dopamine been established? Given that there is no proven benefit of loop diuretics in septic patients, administration should have been prohibited in the protocol. Some patients require more than 4 h fluid resuscitation and finally improve their urine output and renal function and never need a diuretic intervention or renal replacement therapy. 40–50% of our oliguric patients had a baseline creatinine clearance higher than 60 mL/min and were not included. On the other end of the spectrum of clinical severity, experience also shows that in some patients the septic shock state may be refractory to fluid resuscitation and vasopressors. Were these two types of patients included? If not, how many patients were excluded or not randomised for haemodynamic reasons? Had hemodynamic inclusion criteria been established?