Intraoperative Dobutamine Plus Norepinephrine to Prevent Postoperative Acute Kidney Injury in Septic Shock: A Randomized Clinical Trial.

Intraoperative dobutamine combined with norepinephrine reduces postoperative AKI in septic shock patients compared to norepinephrine alone, with a risk ratio of 0.64.

• Why it matters: Postoperative AKI is a common complication in septic shock patients undergoing surgery, and current guidelines lack strong evidence for intraoperative dobutamine's effectiveness, creating a gap in optimal management strategies.
• What they did: A randomized, open-label trial involving 584 adults across 39 Chinese hospitals compared intraoperative dobutamine plus norepinephrine versus norepinephrine alone, measuring AKI within 7 days post-surgery.
• The result: The combination therapy decreased the incidence of AKI (22.8% vs 34.7%), lowered Stage 2 and 3 AKI rates, and improved early postoperative SOFA scores and urine output, though it increased tachycardia frequency.