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Author Notes:
Correspondence: Laurence W Busse, Department of Critical Care, Emory St Joseph’s Hospital, 5665 Peachtree Dunwoody Rd, Atlanta, GA 30342, USA, Tel +1 678 843 7273, Email laurence.w.busse@emory.edu
LWB reports receiving consulting fees from La Jolla Pharmaceutical Company.
The authors report no other conflicts of interest in this work.
Subjects:
Keywords:
- Science & Technology
- Life Sciences & Biomedicine
- Health Care Sciences & Services
- catecholamine resistance
- refractory shock
- ACUTE KIDNEY INJURY
- DOSE VASOPRESSOR THERAPY
- INTENSIVE-CARE-UNIT
- ACUTE-RENAL-FAILURE
- RESPIRATORY-DISTRESS-SYNDROME
- CONVERTING-ENZYME-INHIBITORS
- CONGESTIVE-HEART-FAILURE
- REFRACTORY SEPTIC SHOCK
- BLOOD-PRESSURE
- ARGININE-VASOPRESSIN
Angiotensin II : a new therapeutic option for vasodilatory shock
Abstract:
Angiotensin II (Ang II), part of the renin-angiotensin-aldosterone system (RAS), is a potent vasoconstrictor and has been recently approved for use by the US Food and Drug Administration in high-output shock. Though not a new drug, the recently published Angiotensin II for the Treatment of High Output Shock (ATHOS-3) trial, as well as a number of retrospective analyses have sparked renewed interest in the use of Ang II, which may have a role in treating refractory shock. We describe refractory shock, the unique mechanism of action of Ang II, RAS dysregulation in shock, and the evidence supporting the use of Ang II to restore blood pressure. Evidence suggests that Ang II may preferentially be of benefit in acute kidney injury and acute respiratory distress syndrome, where the RAS is known to be disrupted. Additionally, there may be a role for Ang II in cardiogenic shock, angiotensin converting enzyme inhibitor overdose, cardiac arrest, liver failure, and in settings of extracorporeal circulation.
Copyright information:
© 2018 Bussard and Busse. This work is published and licensed by Dove Medical Press Limited
This is an Open Access work distributed under the terms of the Creative Commons Attribution-Noncommercial 3.0 Unported License (http://creativecommons.org/licenses/by-nc/3.0/).
