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

Intraoperative dobutamine (up to 5 µg/kg/min) plus norepinephrine reduced postoperative acute kidney injury within 7 days in adults with septic shock undergoing surgical source control: AKI occurred in 22.8% (66/290) with the combination vs 34.7% (102/294) with norepinephrine alone (adjusted risk ratio 0.64 [95% CI, 0.49-0.83]). Stage 2 and 3 AKI were also lower, though tachycardia was more frequent. The trial, conducted in 39 tertiary hospitals in China, provides randomized evidence for a guideline recommendation previously based on very low-certainty evidence.