Angiotensin II in Vasodilatory Shock

Brett J Wakefield; Laurence W Busse; Ashish K Khanna

doi:10.1016/j.ccc.2018.11.003

Angiotensin II in Vasodilatory Shock

Crit Care Clin. 2019 Apr;35(2):229-245. doi: 10.1016/j.ccc.2018.11.003. Epub 2019 Jan 23.

Authors

Brett J Wakefield¹, Laurence W Busse², Ashish K Khanna³

Affiliations

¹ Department of General Anesthesiology, Anesthesiology Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA; Department of Anesthesiology, Division of Critical Care Medicine, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8054, St Louis, MO 63110, USA.
² Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, Emory University School of Medicine, Emory St. Joseph's Hospital, 5665 Peachtree Dunwoody Road, Atlanta, GA 30342, USA.
³ Department of General Anesthesiology, Anesthesiology Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA; Center for Critical Care, Department of Outcomes Research, Cleveland Clinic, 9500 Euclid Avenue - G58, Cleveland, OH 44195, USA; Department of Anesthesiology, Wake Forest University School of Medicine, Winston-Salem, NC, USA. Electronic address: ashish@or.org.

PMID: 30784606
DOI: 10.1016/j.ccc.2018.11.003

Abstract

The Angiotensin II for the Treatment of Vasodilatory Shock (ATHOS-3) trial demonstrated the vasopressor effects and catecholamine-sparing properties of angiotensin II. As a result, the Food and Drug Administration has approved angiotensin II for the treatment of vasodilatory shock. This review details the goals of treatment of vasodilatory shock in addition to the history, current use, and recent research regarding the use of angiotensin II. An illustrative case of the use of angiotensin II is also incorporated for understanding the clinical utility of the drug.

Keywords: Angiotensin II; Blood pressure; Septic shock; Vasodilatory shock; Vasopressor.

Publication types

Case Reports
Review

MeSH terms

Adult
Aged
Aged, 80 and over
Angiotensin II / therapeutic use*
Female
Humans
Male
Middle Aged
Shock / diagnosis*
Shock / drug therapy*
Treatment Outcome
Vasoconstrictor Agents / therapeutic use*
Vasodilation / drug effects*

Substances

Vasoconstrictor Agents
Angiotensin II