常記溪亭日暮，沉醉不知?dú)w路。
公眾號(hào)：小小醫(yī)生之有趣的醫(yī)學(xué)
白蛋白+利尿劑，理論上，白蛋白把組織的水分“拉出來”，利尿劑把多余的水份排出去，效果棒棒噠！
實(shí)際上，效果并不理想。
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感覺真好 
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Background: Some physicians co-administer albumin with loop diuretics to overcome diuretic resistance in critically ill hypoalbuminemia patients, though previous studies have reported conflicting results on this matter.
研究背景：一些醫(yī)生喜歡使用白蛋白+袢利尿劑治療危重病人的利尿劑抵抗，雖然之前很多的研究結(jié)果是矛盾的（一些研究有效，一些研究無效）。
Objective: The effects of adding albumin to furosemide to enhance its efficacy in critically ill hypoalbuminemia patients are evaluated.
研究目的：評(píng)價(jià)在速尿中加入白蛋白對(duì)危重低蛋白血癥患者的療效。
Methods: This was a non-blinded randomized trial. 49 adult critically ill patients with hypoalbuminemia and generalized edema who received randomly furosemide and furosemide/albumin complex were enrolled. The patients' urine was collected at intervals of 2, 4, 6 and 8 h after initiation of the furosemide treatment, and the urine output and urinary excretion of furosemide and sodium were measured. The urinary excretion of furosemide was considered an indicator of drug efficacy.
方法：這是一項(xiàng)非盲隨機(jī)試驗(yàn)。49名患有低白蛋白血癥和全身水腫的成年危重患者隨機(jī)分成2組：對(duì)照組單獨(dú)使用速尿，研究組速尿+白蛋白治療。在開始速尿治療后，每隔2、4、6和8小時(shí)收集患者的尿液，并測(cè)量尿量以及速尿和鈉的排泄量。尿中呋塞米的排泄被認(rèn)為是藥物療效的一個(gè)指標(biāo)。
Results: The amount of sodium and furosemide excreted in urine showed no significant differences between the two groups; however, the mean of the urinary excretion of furosemide in the first 2 h after drug infusion was significantly higher (p = 0.03) in the furosemide/albumin group. No significant correlation between APACHE II scores and serum albumin levels and the urinary excretion of furosemide was seen.
結(jié)果：兩組尿鈉和速尿排泄量無顯著性差異；然而，在給藥后的前2小時(shí)內(nèi)，速尿+白蛋白組的尿量的平均值顯著高于單獨(dú)使用速尿組（p=0.03）。APACHEⅡ評(píng)分與血清白蛋白水平及尿呋塞米排泄量之間無顯著相關(guān)性。
Conclusion: The results indicated that there is not statistically significant differences between groups with furosemide alone and combined with albumin in urinary furosemide excretion. It seems that adding albumin for furosemide pharmacotherapy regime is not recommended as an intervention to increase furosemide efficacy in critically ill hypoalbuminemia patients.
結(jié)論：結(jié)果表明，單獨(dú)使用呋塞米組和聯(lián)合使用白蛋白組的尿呋塞米排泄量無統(tǒng)計(jì)學(xué)差異。似乎不建議在呋塞米藥物治療方案中添加白蛋白作為干預(yù)措施，以提高重癥低蛋白血癥患者的呋塞米療效。
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給藥后的前2小時(shí)內(nèi)，速尿+白蛋白組的尿量的平均值顯著高于單獨(dú)使用速尿組（p=0.03）。
4、6和8小時(shí)收集患者的尿液，就差不多了，沒有明顯的差別。
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Mahmoodpoor A, Zahedi S, Pourakbar A, et al. Efficacy of furosemide-albumin compared with furosemide in critically ill hypoalbuminemia patients admitted to intensive care unit: a prospective randomized clinical trial. Daru. 2020;28(1):263-269. doi:10.1007/s40199-020-00339-8
05 雜志
Daru
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別人什么都可以研究，研究了就發(fā)SCI。關(guān)于臨床問題，我們是什么都不能研究！
09 學(xué)習(xí)視頻
10
呼吸重癥：呼吸機(jī)參數(shù)設(shè)置指南（入門版），附視頻
楊柳岸，曉風(fēng)殘?jiān)隆?/span>
視頻
這孩子怎么不按套路出牌？
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陳翔六點(diǎn)半：你就說，這是不是排隊(duì)時(shí)的你
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