Use of fenoldopam to increase urine output in a patient with renal insufficiency secondary to septic shock: A case report

Objective: We describe the use of fenoldopam to increase urine output in a pediatric patient with sepsis, heart failure, oliguria, and volume overload. Design: Case report. Setting. A tertiary pediatric intensive care unit. Patient A 17-year-old male who was being treated for acute lymphoblastic leukemia and was admitted from outside the hospital to the pediatric intensive care unit, in septic shock, after a course of chemotherapy. Interventions., A continuous fenoldopam infusion of 0.03 mu g/kg/min was added to a regimen of multiple inotropic and vasopressor agents and a furosemide continuous infusion. Measurements and Main Results., Urine output increased 586% 12 hrs after starting the fenoldopam infusion and 775% from baseline 24 hrs after starting the infusion. Diuretics were decreased while maintaining adequate urine output. No hypotension was noted. Conclusions. Fenoldopam increased urine output in a pediatric patient who was in septic shock and oliguria. The mechanism for this effect is unclear, and further trials are necessary to determine the role of fenoldopam in this patient population.