Angiotensin II Treatment Examined in Vasodilatory Shock

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Angiotensin II effective for vasodilatory shock in patients not responding to conventional vasopressors
Angiotensin II effective for vasodilatory shock in patients not responding to conventional vasopressors

HealthDay News — For patients with vasodilatory shock that does not respond to high-dose vasopressors, angiotensin II increases blood pressure, according to a study published online May 21 in the New England Journal of Medicine. The research was published to coincide with the annual meeting of the American Thoracic Society, held from May 19 to 24 in Washington, DC.

Ashish Khanna, MD, from the Cleveland Clinic, and colleagues randomized patients with vasodilatory shock receiving more than 0.2 µg of norepinephrine/kg body weight/minute or equivalent dose of another vasopressor to receive angiotensin II or placebo infusions. Data were included for 321 patients (163 randomized to angiotensin II and 158 to placebo).

The researchers found that the primary end point of a response with respect to mean arterial pressure at hour 3 after the start of infusion was reached by 69.9% of patients in the angiotensin II group and by 23.4% in the placebo group (odds ratio, 7.95). The mean improvement in the cardiovascular Sequential Organ Failure Assessment score was significantly greater in the angiotensin II group than in the placebo group at 48 hours (−1.75 versus −1.28). Serious adverse events were reported in 60.7 and 67.1% of patients in the angiotensin II and placebo groups.

"Angiotensin II effectively increased blood pressure in patients with vasodilatory shock that did not respond to high doses of conventional vasopressors," the authors write.

The study was funded by La Jolla Pharmaceutical Company, the manufacturer of the angiotensin II used in the study.

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