A Retrospective Review of Angiotensin II Use in Adult Patients With Refractory Distributive Shock
| Autor: | Camille R. Petri, Adrian Wong, Afrah Alkazemi, Todd Sarge, I. Mary Eche, Michael N. Cocchi |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Hemodynamics Critical Care and Intensive Care Medicine 03 medical and health sciences Catecholamines 0302 clinical medicine Refractory medicine Humans Vasoconstrictor Agents Adverse effect Retrospective Studies Retrospective review Adult patients Septic shock business.industry Angiotensin II Shock 030208 emergency & critical care medicine respiratory system medicine.disease Distributive shock 030228 respiratory system Anesthesia business |
| Zdroj: | Journal of Intensive Care Medicine. 35:1490-1496 |
| ISSN: | 1525-1489 0885-0666 |
| Popis: | Purpose: Catecholamines are first-line vasopressors for hemodynamic support in distributive shock but are associated with adverse effects, which may be mitigated with noncatecholamine vasopressors. Angiotensin II (ATII) is a noncatecholamine vasopressor recently approved for the management of distributive shock, but limited data support its clinical utility. The purpose of this study was to describe our institution’s usage of ATII including patient outcomes (eg, response to therapy, safety profile). Materials and Methods: Patients who received ATII at our institution were included. Patient demographics, degree of concordance with institutional ATII use guidelines, safety profile of ATII, and response to therapy (1 and 3 hours after ATII initiation) were collected. Results: A total of 16 patients received ATII for distributive shock. The median Sequential Organ Failure Assessment score at the time of ATII initiation was 16.5 (interquartile range: 15.8-20.0). Fourteen (87.5%) patients met institutional guidelines for ATII use; 10 (62.5%) and 8 (50.0%) patients met our definition for response at 1 and 3 hours, respectively. No patients developed thrombotic or infectious complications after receiving ATII. Conclusions: In this cohort, ATII appears to be well tolerated in patients with a high predicted mortality. Future studies evaluating the clinical efficacy of ATII are needed to determine its role in the management of distributive shock. |
| Databáze: | OpenAIRE |
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