Angiotensin ii therapy in refractory septic shock: which patient can benefit most? A narrative review.
Angiotensin II
Refractory shock
Septic shock
Vasopressors
Journal
Journal of anesthesia, analgesia and critical care
ISSN: 2731-3786
Titre abrégé: J Anesth Analg Crit Care
Pays: England
ID NLM: 9918591885906676
Informations de publication
Date de publication:
21 Feb 2024
21 Feb 2024
Historique:
received:
08
12
2023
accepted:
12
02
2024
medline:
22
2
2024
pubmed:
22
2
2024
entrez:
21
2
2024
Statut:
epublish
Résumé
Patients with septic shock who experience refractory hypotension despite adequate fluid resuscitation and high-dose noradrenaline have high mortality rates. To improve outcomes, evidence-based guidelines recommend starting a second vasopressor, such as vasopressin, if noradrenaline doses exceed 0.5 µg/kg/min. Recently, promising results have been observed in treating refractory hypotension with angiotensin II, which has been shown to increase mean arterial pressure and has been associated with improved outcomes. This narrative review aims to provide an overview of the pathophysiology of the renin-angiotensin system and the role of endogenous angiotensin II in vasodilatory shock with a focus on how angiotensin II treatment impacts clinical outcomes and on identifying the population that may benefit most from its use.
Identifiants
pubmed: 38383521
doi: 10.1186/s44158-024-00150-w
pii: 10.1186/s44158-024-00150-w
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
13Informations de copyright
© 2024. The Author(s).
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