Real-world Experience of Angiotensin II and Renin Usage in Patients With Distributive Shock:A Single-center Descriptive Study.

IF 2.1 4区 医学 Q2 ANESTHESIOLOGY
Andreja Möller Petrun, Mario Gorenjak, Franc Svenšek, Nives Matković Lonzarić, Alenka Strdin Košir, Maja Cvikl Knehtl, Evgenija Homšak, Žiga Kalamar, Giovanni Landoni, Andrej Markota
{"title":"Real-world Experience of Angiotensin II and Renin Usage in Patients With Distributive Shock:A Single-center Descriptive Study.","authors":"Andreja Möller Petrun, Mario Gorenjak, Franc Svenšek, Nives Matković Lonzarić, Alenka Strdin Košir, Maja Cvikl Knehtl, Evgenija Homšak, Žiga Kalamar, Giovanni Landoni, Andrej Markota","doi":"10.1053/j.jvca.2025.08.044","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To evaluate real-life use of angiotensin II, a novel vasopressor, and renin, which can be used as a marker of endogenous angiotensin II deficiency and disease severity.</p><p><strong>Design: </strong>A retrospective observational single-center cohort study.</p><p><strong>Setting: </strong>Four intensive care units in one university hospital.</p><p><strong>Participants: </strong>Adult patients with distributive shock, no limitations of active care, and with ongoing use of vasoconstrictors (norepinephrine base ≥0.3 mcg/kg/min plus vasopressin), who were admitted between August 2022 and August 2023.</p><p><strong>Interventions: </strong>None.</p><p><strong>Measurements and main results: </strong>Septic shock (38/42, 90.5%) and post-cardiopulmonary bypass vasoplegia (4/42, 9.5%) were the causes of distributive shock. After the initiation of angiotensin II, a decrease in the norepinephrine base dose at 4, 24, and 48 hours (0.40 ± 0.25 mcg/kg/min, 0.21 ± 0.11 mcg/kg/min, and 0.13 ± 0.06 mcg/kg/min, respectively), and a decrease in vasopressin dose were observed. Renin concentration decreased after initiation of angiotensin II from 376.90 ± 168.50 mU/L to 188.24 ± 167.47 mU/L (p < 0.01). Control renin was lower in survivors to hospital discharge compared with nonsurvivors (78.06 ± 121.14 mU/L in survivors, v 259.07 ± 163.4 mU/L in nonsurvivors, p < 0.01).</p><p><strong>Conclusions: </strong>Angiotensin II can be used to decrease the doses of non-angiotensin II vasopressors, and renin concentration may potentially aid in the prognostication of patients with distributive shock.</p>","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":" ","pages":""},"PeriodicalIF":2.1000,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of cardiothoracic and vascular anesthesia","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1053/j.jvca.2025.08.044","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Objective: To evaluate real-life use of angiotensin II, a novel vasopressor, and renin, which can be used as a marker of endogenous angiotensin II deficiency and disease severity.

Design: A retrospective observational single-center cohort study.

Setting: Four intensive care units in one university hospital.

Participants: Adult patients with distributive shock, no limitations of active care, and with ongoing use of vasoconstrictors (norepinephrine base ≥0.3 mcg/kg/min plus vasopressin), who were admitted between August 2022 and August 2023.

Interventions: None.

Measurements and main results: Septic shock (38/42, 90.5%) and post-cardiopulmonary bypass vasoplegia (4/42, 9.5%) were the causes of distributive shock. After the initiation of angiotensin II, a decrease in the norepinephrine base dose at 4, 24, and 48 hours (0.40 ± 0.25 mcg/kg/min, 0.21 ± 0.11 mcg/kg/min, and 0.13 ± 0.06 mcg/kg/min, respectively), and a decrease in vasopressin dose were observed. Renin concentration decreased after initiation of angiotensin II from 376.90 ± 168.50 mU/L to 188.24 ± 167.47 mU/L (p < 0.01). Control renin was lower in survivors to hospital discharge compared with nonsurvivors (78.06 ± 121.14 mU/L in survivors, v 259.07 ± 163.4 mU/L in nonsurvivors, p < 0.01).

Conclusions: Angiotensin II can be used to decrease the doses of non-angiotensin II vasopressors, and renin concentration may potentially aid in the prognostication of patients with distributive shock.

分布性休克患者血管紧张素和肾素使用的真实世界经验:一项单中心描述性研究。
目的:评价血管紧张素II(一种新型血管加压素)和肾素在现实生活中的使用情况,肾素可作为内源性血管紧张素II缺乏和疾病严重程度的标志。设计:回顾性观察性单中心队列研究。环境:一所大学医院的四个重症监护室。参与者:在2022年8月至2023年8月期间入院的患有分散性休克、没有积极护理限制、持续使用血管收缩剂(去甲肾上腺素基数≥0.3 mcg/kg/min +加压素)的成年患者。干预措施:没有。测量结果及主要结果:感染性休克(38/42,90.5%)和体外循环后血管截瘫(4/42,9.5%)是分配性休克的原因。血管紧张素II启动后,去甲肾上腺素基础剂量在4、24和48小时分别下降(0.40±0.25 mcg/kg/min、0.21±0.11 mcg/kg/min和0.13±0.06 mcg/kg/min),抗利尿激素剂量下降。肾素浓度由376.90±168.50 mU/L降至188.24±167.47 mU/L (p < 0.01)。对照肾素在幸存者出院时低于非幸存者(幸存者78.06±121.14 mU/L,非幸存者259.07±163.4 mU/L, p < 0.01)。结论:血管紧张素II可用于减少非血管紧张素II血管加压药物的剂量,肾素浓度可能有助于预测分布性休克患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
4.80
自引率
17.90%
发文量
606
审稿时长
37 days
期刊介绍: The Journal of Cardiothoracic and Vascular Anesthesia is primarily aimed at anesthesiologists who deal with patients undergoing cardiac, thoracic or vascular surgical procedures. JCVA features a multidisciplinary approach, with contributions from cardiac, vascular and thoracic surgeons, cardiologists, and other related specialists. Emphasis is placed on rapid publication of clinically relevant material.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信