Angiotensin II for the Treatment of Vasodilatory Shock
| Autor: | Raphael Favory, Rakshit Panwar, Lakhmir S. Chawla, Balasubramanian Venkatesh, Kealy R. Ham, Laurence W. Busse, Johanna Hästbacka, Rinaldo Bellomo, David W. Boldt, Richard G. Wunderink, B. Taylor Thompson, Stefan N. Chock, Michelle N. Gong, James A. Tumlin, Stew Kroll, Jeffrey B. Jensen, Marlies Ostermann, Laith Altaweel, Shane W. English, Ashish Khanna, Adam M. Deane, Paul J Young, Timothy E Albertson, Michael T. McCurdy, Harold M. Szerlip, Caleb Mackey, George F. Tidmarsh, Xueyuan S. Wang, Kenneth Krell, Raghavan Murugan |
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| Přispěvatelé: | Clinicum, Anestesiologian yksikkö, Department of Diagnostics and Therapeutics, HUS Perioperative, Intensive Care and Pain Medicine |
| Rok vydání: | 2017 |
| Předmět: |
Male
Mean arterial pressure Organ Dysfunction Scores Blood Pressure 030204 cardiovascular system & hematology Placebo Norepinephrine (medication) 03 medical and health sciences 0302 clinical medicine Catecholamines Double-Blind Method NORADRENALINE MANAGEMENT medicine Humans Vasoconstrictor Agents REFRACTORY SEPTIC SHOCK Aged business.industry Septic shock Angiotensin II 030208 emergency & critical care medicine Shock General Medicine Middle Aged medicine.disease 3. Good health SEVERE SEPSIS Blood pressure Distributive shock 3121 General medicine internal medicine and other clinical medicine Anesthesia Shock (circulatory) SURVIVAL TRIAL Drug Therapy Combination Female medicine.symptom Hypotension business SYSTEM medicine.drug |
| Zdroj: | NEW ENGLAND JOURNAL OF MEDICINE |
| ISSN: | 1533-4406 |
| Popis: | BACKGROUND Vasodilatory shock that does not respond to high-dose vasopressors is associated with high mortality. We investigated the effectiveness of angiotensin II for the treatment of patients with this condition. METHODS We randomly assigned patients with vasodilatory shock who were receiving more than 0.2 mu g of norepinephrine per kilogram of body weight per minute or the equivalent dose of another vasopressor to receive infusions of either angiotensin II or placebo. The primary end point was a response with respect to mean arterial pressure at hour 3 after the start of infusion, with response defined as an increase from baseline of at least 10 mm Hg or an increase to at least 75 mm Hg, without an increase in the dose of background vasopressors. RESULTS A total of 344 patients were assigned to one of the two regimens; 321 received a study intervention (163 received angiotensin II, and 158 received placebo) and were included in the analysis. The primary end point was reached by more patients in the angiotensin II group (114 of 163 patients, 69.9%) than in the placebo group (37 of 158 patients, 23.4%) (odds ratio, 7.95; 95% confidence interval [CI], 4.76 to 13.3; P |
| Databáze: | OpenAIRE |
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