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A simple adjustment to drugs given during operations for septic shock could prevent thousands of patients from suffering kidney damage, according to the results of a major trial now published in JAMA. Scientists from the University of Southampton working with experts from Zhejiang University School of Medicine in China discovered that combining the medications dobutamine and norepinephrine during surgery can significantly lower the risk of acute kidney injury.

Septic shock has a global death rate as high as 50% and is often triggered by an extreme immune response to an infection. Although emergency surgery usually clears the underlying infection, inflammation and surgical trauma can cause kidney injury among patients.

Dr. Nazrul Islam from Southampton, a senior co-corresponding author, said that standard medical care during septic shock surgery is to use blood pressure drugs that can accidentally starve the kidneys of vital blood. "Our trial discovered that adding these two heart medications during the operation safely boosts blood flow. It also significantly cuts the risk of severe kidney damage, offering a safer way to protect vulnerable patients during high-risk surgery."

As part of the trial, experts tracked 584 adult patients undergoing surgery across 39 hospitals in China. Half received an infusion of dobutamine, a heart medication that improves blood flow, alongside norepinephrine, while the other group received norepinephrine alone.

Primary corresponding author Dr. Xiangming Fang, from the Zhejiang University School of Medicine, said, "Our research is timely as the International Guidelines for Management of Sepsis and Septic Shock recently said there was insufficient data to make a recommendation for the use of dobutamine.

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