Intraoperative Dobutamine Plus Norepinephrine to Prevent Postoperative Acute Kidney Injury in Septic Shock: A Randomized Clinical Trial
Primary result · New-onset AKI or worsening of preoperative AKI (KDIGO criteria)Result — go to the resultAdjusted risk ratio (ARR) 0.64 95% CI 0.49–0.83Authors' conclusion
Among adult patients with septic shock undergoing surgical source control, intraoperative dobutamine combined with norepinephrine reduced the incidence of new-onset or worsening AKI within 7 postoperative days compared with norepinephrine.
Study context
- Population
- Adults with septic shock who were undergoing surgical source control
- Participants
- 584 patients
- Comparison
- Dobutamine plus norepinephrine vs norepinephrine alone
- Dobutamine plus norepinephrinen = 290
- Norepinephrine alonen = 294reference
- Primary endpoint
- New-onset acute kidney injury (AKI) or worsening of preoperative AKI (KDIGO criteria)
- Follow-up
- Within 7 days after surgery
Methodological details39 tertiary hospitals in China
- 39 tertiary hospitals in China
Primary result
As reported in the abstract
Adjusted risk ratio (ARR)
0.64
95% CI 0.49–0.83
Events by treatment group
Dobutamine plus norepinephrine vs norepinephrine alone
adjusted risk ratio (ARR) 0.64 (95% CI 0.49–0.83)
Secondary outcomes
| Outcome | Adjusted difference (lower with dobutamine plus norepinephrine) (95% CI) | |
|---|---|---|
| SOFA score · postoperative day 1 | −0.53 (−0.98 to −0.07) | |
| −1−0.500.5Difference (linear scale) |
| Outcome | Adjusted difference (higher with dobutamine plus norepinephrine) (mL/kg/h) (95% CI) | |
|---|---|---|
| Urine output · 1 hour post intervention | 0.55 (0.03–1.07) | |
| −0.500.511.5Difference, mL/kg/h (linear scale) |
| Outcome | Dobutamine plus norepinephrine | Norepinephrine alone | ARR (95% CI) | |
|---|---|---|---|---|
| Stage 2 AKI | 4.8% | 9.9% | 0.48 (0.26–0.88) | |
| Stage 3 AKI | 7.9% | 13.6% | 0.56 (0.35–0.91) | |
| 0.20.5125Adjusted relative risk (log scale) |
Secondary outcomes (11)
- No significant differences in 9 of the 11 secondary outcomes
Safety
Tachycardia (heart rate >100/min)
- Occurred more frequently with dobutamine and norepinephrine than norepinephrine alone
Original publication
Intraoperative Dobutamine Plus Norepinephrine to Prevent Postoperative Acute Kidney Injury in Septic Shock: A Randomized Clinical Trial. JAMA. Published 14 October 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →