2026-04-14T07:04:00Zhttps://recercat.cat/oai/request

oai:recercat.cat:11351/111202025-10-24T10:33:53Zcom_2072_378070com_2072_378040col_2072_378092

Angiotensin ii therapy in refractory septic shock: which patient can benefit most? A narrative review Coloretti, Irene Genovese, Andrea Teixeira, Pedro J. Cherian, Anusha LANDONI, Giovanni Ferrer, Ricard Institut Català de la Salut [Coloretti I, Genovese A] Anesthesia and Intensive Care Medicine, Policlinico Di Modena, University of Modena and Reggio Emilia, Italy. [Teixeira JP] Divisions of Nephrology and Pulmonary, Critical Care, and Sleep Medicine, University of New Mexico School of Medicine, Albuquerque, NM, USA. [Cherian A] Anesthesiology and Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Dhanvantri Nagar, Pondicherry, India. [Ferrer R] Servei de Medicina Intensiva, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Landoni G] Anesthesia and Intensive Care, IRCCS San Rafaele Scientifc Institute, Milan, Italy Vall d'Hebron Barcelona Hospital Campus Xoc sèptic - Tractament Hipotensió arterial DISEASES::Bacterial Infections and Mycoses::Infection::Sepsis::Shock, Septic Other subheadings::Other subheadings::Other subheadings::/drug therapy DISEASES::Cardiovascular Diseases::Vascular Diseases::Hypotension ENFERMEDADES::infecciones bacterianas y micosis::infección::sepsis::choque séptico Otros calificadores::Otros calificadores::Otros calificadores::/farmacoterapia ENFERMEDADES::enfermedades cardiovasculares::enfermedades vasculares::hipotensión Angiotensina II; Shock sèptic; Vasopressors Angiotensin II; Septic shock; Vasopressors Angiotensina II; Shock séptico; Vasopresores Patients with septic shock who experience refractory hypotension despite adequate fluid resuscitation and high-dose noradrenaline have high mortality rates. To improve outcomes, evidence-based guidelines recommend starting a second vasopressor, such as vasopressin, if noradrenaline doses exceed 0.5 µg/kg/min. Recently, promising results have been observed in treating refractory hypotension with angiotensin II, which has been shown to increase mean arterial pressure and has been associated with improved outcomes. This narrative review aims to provide an overview of the pathophysiology of the renin-angiotensin system and the role of endogenous angiotensin II in vasodilatory shock with a focus on how angiotensin II treatment impacts clinical outcomes and on identifying the population that may benefit most from its use. 2024-02-26T12:42:51Z 2024-02-26T12:42:51Z 2024-02-21 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Coloretti I, Genovese A, Teixeira JP, Cherian A, Ferrer R, Landoni G, et al. Angiotensin ii therapy in refractory septic shock: which patient can benefit most? A narrative review. J Anesth Analg Crit Care. 2024 Feb 21;4:13. 2731-3786 https://hdl.handle.net/11351/11120 10.1186/s44158-024-00150-w 38383521 http://hdl.handle.net/11351/11120 eng Journal of Anesthesia, Analgesia and Critical Care;4 https://doi.org/10.1186/s44158-024-00150-w Attribution 4.0 International http://creativecommons.org/licenses/by/4.0/ info:eu-repo/semantics/openAccess application/pdf BMC Scientia