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Angiotensin II, septic shock

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https://www.readbyqxmd.com/read/30407370/plasma-renin-concentration-is-associated-with-hemodynamic-deficiency-and-adverse-renal-outcome-in-septic-shock
#1
Maxime Nguyen, Damien Denimal, Auguste Dargent, Pierre-Grégoire Guinot, Laurence Duvillard, Jean-Pierre Quenot, Bélaïd Bouhemad
BACKGROUND: In septic shock, both systemic vasodilatation and glomerular arteriole dilatation are responsible for the drop in glomerular filtration observed in early acute kidney injury. Angiotensin II has been showed to act on both mechanisms. Our objective was to evaluate the impact of renin angiotensin system activation, on hemodynamic deficiency and renal outcome in patient with septic shock and to assess whether urinary sodium could be a reliable test for high plasma renin concentration screening...
November 6, 2018: Shock
https://www.readbyqxmd.com/read/30144016/fda-approval-of-angiotensin-ii-for-the-treatment-of-hypotension-in-adults-with-distributive-shock
#2
Fortunato Senatore, Gowraganahalli Jagadeesh, Martin Rose, Venkateswaran C Pillai, Sudharshan Hariharan, Ququan Liu, McDowell Tzu-Yun, Mohan K Sapru, Mary Ross Southworth, Norman Stockbridge
Distributive shock is a subset of shock marked by decreased systemic vascular resistance, organ hypoperfusion and altered oxygen extraction. Despite the use of intravenous fluids and either higher dose of catecholamines or other additional exogenous vasopressors to maintain blood pressure in the target range, the rate of mortality remains higher in patients with septic shock. Therefore, there is clearly an unmet need for additional safe and effective treatments. The use of angiotensin II to raise the mean arterial pressure (MAP) could provide additional therapy and the opportunity to evaluate a catecholamine-sparing effect by decreasing the dose of concomitant catecholamines while maintaining a target MAP...
August 25, 2018: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
https://www.readbyqxmd.com/read/29979224/microrna-155-amplifies-nitric-oxide-cgmp-signaling-and-impairs-vascular-angiotensin-ii-reactivity-in-septic-shock
#3
Francisco Vasques-Nóvoa, Tiago L Laundos, Rui J Cerqueira, Catarina Quina-Rodrigues, Ricardo Soares-Dos-Reis, Fabiana Baganha, Sara Ribeiro, Luís Mendonça, Francisco Gonçalves, Carlos Reguenga, Wouter Verhesen, Fátima Carneiro, José Artur Paiva, Blanche Schroen, Paulo Castro-Chaves, Perpétua Pinto-do-Ó, Diana S Nascimento, Stephane Heymans, Adelino F Leite-Moreira, Roberto Roncon-Albuquerque
OBJECTIVES: Septic shock is a life-threatening clinical situation associated with acute myocardial and vascular dysfunction, whose pathophysiology is still poorly understood. Herein, we investigated microRNA-155-dependent mechanisms of myocardial and vascular dysfunction in septic shock. DESIGN: Prospective, randomized controlled experimental murine study and clinical cohort analysis. SETTING: University research laboratory and ICU at a tertiary-care center...
September 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29908046/sepsis-induced-acute-kidney-injury-a-disease-of-the-microcirculation
#4
REVIEW
Shuai Ma, Roger G Evans, Naoya Iguchi, Marianne Tare, Helena C Parkington, Rinaldo Bellomo, Clive N May, Yugeesh R Lankadeva
AKI is a common complication of sepsis and is significantly associated with mortality. Sepsis accounts for more than 50% of the cases of AKI, with a mortality rate of up to 40%. The pathogenesis of septic AKI is complex, but there is emerging evidence that, at least in the first 48 hours, the defects may be functional rather than structural in nature. For example, septic AKI is associated with an absence of histopathological changes, but with microvascular abnormalities and tubular stress. In this context, renal medullary hypoxia due to redistribution of intra-renal perfusion is emerging as a critical mediator of septic AKI...
June 16, 2018: Microcirculation: the Official Journal of the Microcirculatory Society, Inc
https://www.readbyqxmd.com/read/29877879/vasodilatory-shock-in-the-icu-and-the-role-of-angiotensin-ii
#5
Brett J Wakefield, Gretchen L Sacha, Ashish K Khanna
PURPOSE OF REVIEW: There are limited vasoactive options to utilize for patients presenting with vasodilatory shock. This review discusses vasoactive agents in vasodilatory, specifically, septic shock and focuses on angiotensin II as a novel, noncatecholamine agent and describes its efficacy, safety, and role in the armamentarium of vasoactive agents utilized in this patient population. RECENT FINDINGS: The Angiotensin II for the Treatment of High-Output Shock 3 study evaluated angiotensin II use in patients with high-output, vasodilatory shock and demonstrated reduced background catecholamine doses and improved ability to achieve blood pressure goals associated with the use of angiotensin II...
August 2018: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29688923/when-all-else-fails-novel-use-of-angiotensin-ii-for-vasodilatory-shock-a-case-report
#6
Jonathan H Chow, Samuel M Galvagno, Kenichi A Tanaka, Michael A Mazzeffi, Zackary Chancer, Reney Henderson, Michael T McCurdy
Angiotensin (AT) II is an endogenous hormone that acts on venous and arterial smooth muscle to cause vasoconstriction. Recent trials have sparked great interest in its ability to be used as a vasopressor for catecholamine-refractory hypotension. Herein, we describe the successful use of AT II in a patient with a colonic perforation with septic shock refractory to conventional treatment. After AT II initiation, there was an immediate reduction in catecholamine requirement, and the patient survived.
October 1, 2018: A&A practice
https://www.readbyqxmd.com/read/29582666/a-blast-from-the-past-revival-of-angiotensin-ii-for-vasodilatory-shock
#7
Brittany D Bissell, Kelsey Browder, Matt McKenzie, Alexander H Flannery
OBJECTIVE: To review and summarize data on angiotensin II (AT-II), approved by the Food and Drug Administration (FDA) in December 2017 to increase blood pressure in adults with septic or other distributive shock. DATA SOURCES: A PubMed/MEDLINE search was conducted using the following terms: (angiotensin ii OR angiotensin 2) AND (shock) from 1966 to February 2018. STUDY SELECTION AND DATA EXTRACTION: A total of 691 citations were reviewed with only relevant clinical data extracted...
September 2018: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/29496373/major-publications-in-the-critical-care-pharmacotherapy-literature-january-december-2017
#8
REVIEW
Drayton A Hammond, Laura Baumgartner, Craig Cooper, Elisabeth Donahey, Serena A Harris, Jessica M Mercer, Mandy Morris, Mona K Patel, Angela M Plewa-Rusiecki, Alia A Poore, Ryan Szaniawski, Deanna Horner
PURPOSE: To summarize selected meta-analyses and trials related to critical care pharmacotherapy published in 2017. The Critical Care Pharmacotherapy Literature Update (CCPLU) Group screened 32 journals monthly for impactful articles and reviewed 115 during 2017. Two meta-analyses and eight original research trials were reviewed here from those included in the monthly CCPLU. Meta-analyses on early, goal-directed therapy for septic shock and statin therapy for acute respiratory distress syndrome were summarized...
June 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29491694/pharmaceutical-approval-update
#9
Michele B Kaufman
Zoster vaccine recombinant, adjuvanted (Shingrix) for the prevention of shingles in adults; angiotensin II injection (Giapreza) to increase blood pressure in adults with septic or other distributive shock; and glycopyrrolate inhalation solution (Lonhala Magnair) for the maintenance treatment of chronic obstructive pulmonary disease.
March 2018: P & T: a Peer-reviewed Journal for Formulary Management
https://www.readbyqxmd.com/read/29486781/vasoplegia-treatments-the-past-the-present-and-the-future
#10
REVIEW
Bruno Levy, Caroline Fritz, Elsa Tahon, Audrey Jacquot, Thomas Auchet, Antoine Kimmoun
Vasoplegia is a ubiquitous phenomenon in all advanced shock states, including septic, cardiogenic, hemorrhagic, and anaphylactic shock. Its pathophysiology is complex, involving various mechanisms in vascular smooth muscle cells such as G protein-coupled receptor desensitization (adrenoceptors, vasopressin 1 receptors, angiotensin type 1 receptors), alteration of second messenger pathways, critical illness-related corticosteroid insufficiency, and increased production of nitric oxide. This review, based on a critical appraisal of the literature, discusses the main current treatments and future approaches...
February 27, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29282149/the-effect-of-angiotensin-ii-on-blood-pressure-in-patients-with-circulatory-shock-a-structured-review-of-the-literature
#11
REVIEW
Laurence W Busse, Michael T McCurdy, Osman Ali, Anna Hall, Huaizhen Chen, Marlies Ostermann
BACKGROUND: Circulatory shock is a common syndrome with a high mortality and limited therapeutic options. Despite its discovery and use in clinical and experimental settings more than a half-century ago, angiotensin II (Ang II) has only been recently evaluated as a vasopressor in distributive shock. We examined existing literature for associations between Ang II and the resolution of circulatory shock. METHODS: We searched PubMed, MEDLINE, Ovid, and Embase to identify all English literature accounts of intravenous Ang II in humans for the treatment of shock (systolic blood pressure [SBP] ≤ 90 mmHg or a mean arterial pressure [MAP] ≤ 65 mmHg), and hand-searched the references of extracted papers for further studies meeting inclusion criteria...
December 28, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28215124/the-athos-3-trial-angiotensin-ii-and-the-three-musketeers
#12
EDITORIAL
Rinaldo Bellomo, Andrew Hilton
No abstract text is available yet for this article.
March 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/27879559/angiotensin-ii-in-refractory-septic-shock
#13
REVIEW
Elio Antonucci, Patrick J Gleeson, Filippo Annoni, Sara Agosta, Sergio Orlando, Fabio Silvio Taccone, Dimitrios Velissaris, Sabino Scolletta
Refractory septic shock is defined as persistently low mean arterial blood pressure despite volume resuscitation and titrated vasopressors/inotropes in patients with a proven or suspected infection and concomitant organ dysfunction. Its management typically requires high doses of catecholamines, which can induce significant adverse effects such as ischemia and arrhythmias. Angiotensin II (Ang II), a key product of the renin-angiotensin-aldosterone system, is a vasopressor agent that could be used in conjunction with other vasopressors to stabilize critically ill patients during refractory septic shock, and reduce catecholamine requirements...
May 2017: Shock
https://www.readbyqxmd.com/read/27398737/potentially-inadvertent-immunomodulation-norepinephrine-use-in-sepsis
#14
Roeland F Stolk, Tom van der Poll, Derek C Angus, Johannes G van der Hoeven, Peter Pickkers, Matthijs Kox
Septic shock is a major cause of death worldwide and a considerable healthcare burden in the twenty-first century. Attention has shifted from damaging effects of the proinflammatory response to the detrimental role of antiinflammation, a phenomenon known as sepsis-induced immunoparalysis. Sepsis-induced immunoparalysis may render patients vulnerable to secondary infections and is associated with impaired outcome. The immunoparalysis hypothesis compels us to reevaluate the current management of septic shock and to assess whether we are inadvertently compromising or altering the host immune response...
September 1, 2016: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/26297976/matrix-metalloproteinase-inhibitors-prevent-sepsis-induced-refractoriness-to-vasoconstrictors-in-the-cecal-ligation-and-puncture-model-in-rats
#15
Priscila de Souza, Richard Schulz, José Eduardo da Silva-Santos
Previous studies have shown that the loss of contractility in aortas from lipopolysaccharide (LPS)-treated rats is related to intracellular activation of matrix metalloproteinase (MMPs). However, the role of MMPs in the vascular refractoriness to vasoconstrictors has not been investigated in a model of polymicrobial sepsis. We evaluated the effects of the oral administration of the MMP inhibitors doxycycline or ONO-4817 in the in vitro vascular reactivity of aortic rings from rats subjected to the cecal ligation and puncture (CLP) model of sepsis...
October 15, 2015: European Journal of Pharmacology
https://www.readbyqxmd.com/read/26221342/effects-of-angiotensin-ii-type-1-receptor-antagonist-on-rats-with-septic-shock
#16
Jianrong Guo, Wei Guo, Xiaoju Jin, Yang Liu, Lei Zhang, Jianping Zhang
AIMS: To investigate the effects of angiotensin II type 1 receptor (AT1R) antagonist, losartan, on rats with septic shock induced by endotoxin. METHODS: Thirty male SD rats were randomly divided into 3 groups (10 for each group): rats were injected with normal saline in C group, lipopolysaccharide (LPS) of 12 mg kg(-1) intravenously in LPS group, and losartan of 50 mg kg(-1) intraperitoneally followed by LPS of 12 mg kg(-1) intravenously in LOS group. The plasma concentrations of nitric oxide (NO), malondialdehyde (MDA), IL-1β and TNF-α were measured 6 h after LPS administration...
2015: International Journal of Clinical and Experimental Medicine
https://www.readbyqxmd.com/read/26079239/reverse-physiology-applying-an-antihypertensive-drug-to-increase-arterial-blood-pressure-in-septic-shock
#17
EDITORIAL
Ilse Gradwohl-Matis, Martin W Dünser
No abstract text is available yet for this article.
July 2015: Critical Care Medicine
https://www.readbyqxmd.com/read/25886853/angiotensin-ii-in-septic-shock
#18
REVIEW
Thiago D Corrêa, Jukka Takala, Stephan M Jakob
This article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency Medicine 2015 and co-published as a series in Critical Care. Other articles in the series can be found online at http://ccforum.com/series/annualupdate2015. Further information about the Annual Update in Intensive Care and Emergency Medicine is available from http://www.springer.com/series/8901.
March 16, 2015: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/25860204/clonidine-restores-pressor-responsiveness-to-phenylephrine-and-angiotensin-ii-in-ovine-sepsis
#19
Yugeesh R Lankadeva, Lindsea C Booth, Junko Kosaka, Roger G Evans, Luc Quintin, Rinaldo Bellomo, Clive N May
OBJECTIVES: In sepsis, prolonged, sympathetic overstimulation may lead to vasopressor-refractory hypotension. We therefore examined the effects of the α2-adrenergic agonist clonidine on mean arterial pressure, renal sympathetic nerve activity, and pressor responsiveness to phenylephrine and angiotensin II during hypotensive sepsis in conscious sheep. DESIGN: Interventional study. SETTING: Research institute. SUBJECTS: Twelve adult Merino ewes (n = 6 per group)...
July 2015: Critical Care Medicine
https://www.readbyqxmd.com/read/25777894/angiotensin-ii-in-septic-shock
#20
Thiago D Corrêa, Jukka Takala, Stephan M Jakob
This article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency Medicine 2015 and co-published as a series in Critical Care. Other articles in the series can be found online at http://ccforum.com/series/annualupdate2015 . Further information about the Annual Update in Intensive Care and Emergency Medicine is available from http://www.springer.com/series/8901 .
December 2015: Critical Care: the Official Journal of the Critical Care Forum
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