How Effective is Angiotensin II in Decreasing Mortality of Vasodilatory Shock? A Systematic Review
Bambang Pujo Semedi,1,2 Nancy Margarita Rehatta,2 Soetjipto Soetjipto,3 Jusak Nugraha,4 Muhammad H Mahyuddin,5 Jannatin N Arnindita,5 Nabilah A P Wairooy5 1Doctoral Program of Medical Science, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, 60132, Indonesia; 2Department of Anesthesi...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2023-01-01
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| Series: | Open Access Emergency Medicine |
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| Online Access: | https://www.dovepress.com/how-effective-is-angiotensin-ii-in-decreasing-mortality-of-vasodilator-peer-reviewed-fulltext-article-OAEM |
| _version_ | 1797955560122875904 |
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| author | Semedi BP Rehatta NM Soetjipto S Nugraha J Mahyuddin MH Arnindita JN Wairooy NAP |
| author_facet | Semedi BP Rehatta NM Soetjipto S Nugraha J Mahyuddin MH Arnindita JN Wairooy NAP |
| author_sort | Semedi BP |
| collection | DOAJ |
| description | Bambang Pujo Semedi,1,2 Nancy Margarita Rehatta,2 Soetjipto Soetjipto,3 Jusak Nugraha,4 Muhammad H Mahyuddin,5 Jannatin N Arnindita,5 Nabilah A P Wairooy5 1Doctoral Program of Medical Science, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, 60132, Indonesia; 2Department of Anesthesiology and Reanimation, Medical Faculty of Medicine, Universitas Airlangga—Dr Soetomo General Hospital, Surabaya, East Java, 60132, Indonesia; 3Department of Medical Biochemistry, Medical Faculty of Universitas Airlangga, Surabaya, East Java, 60132, Indonesia; 4Department of Clinical Pathology, Medical Faculty of Universitas Airlangga, Surabaya, East Java, 60132, Indonesia; 5Medical Faculty Universitas Airlangga, Surabaya, East Java, 60132, IndonesiaCorrespondence: Nancy Margarita Rehatta, Email margaritarehatta@gmail.comBackground: Patients with severe vasodilation accompanied by refractory hypotension despite high doses of vasopressors were associated with a high mortality rate. The Ang-2 for the Treatment of High-Output Shock (ATHOS) 3 trial demonstrated that angiotensin 2 (Ang-2) could effectively increase MAP and blood pressure in vasodilatory shock patients. This systematic review aims to summarize the impact of Ang-2 for the treatment of vasodilatory shock on clinical outcomes, including length of stay, MAP level (before and after), and mortality also Ang-2 dose needed.Methods: A systematic search in PubMed, Sage, ScienceDirect, Scopus and Gray literature was conducted to obtain studies about the use of Ang-2 in vasodilatory shock patients.Results: In all of the studies that we obtained, there were different results regarding mortality in patients with vasodilatory shock with Ang-2. Mortality was significantly lower when Ang-2 was administered to patients with elevated renin. The initial dose of Ang-2 can be started at 10– 20 ng/kg/min, but there is no agreement on the maximum dose. Ang-2 may be considered a third-line vasopressor if the targeted MAP has not been achieved after administration of norepinephrine > 200 ng/kg/min for more than 6 hours. Although not statistically significant, the use of Ang-2 can reduce the length of stay in the ICU and in the hospital when compared to patients without Ang-2 therapy, in addition to reducing the dose of vasopressor.Conclusion: Overall, the use of Ang-2 has potential to be a regimen for patients with vasodilatory shock. Further study is needed to obtain more data.Keywords: angiotensin II, vasodilatory shock, vasopressor, mortality |
| first_indexed | 2024-04-10T23:35:06Z |
| format | Article |
| id | doaj.art-7e96667157c64f7b9f587c6ff930299b |
| institution | Directory Open Access Journal |
| issn | 1179-1500 |
| language | English |
| last_indexed | 2024-04-10T23:35:06Z |
| publishDate | 2023-01-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Open Access Emergency Medicine |
| spelling | doaj.art-7e96667157c64f7b9f587c6ff930299b2023-01-11T19:18:14ZengDove Medical PressOpen Access Emergency Medicine1179-15002023-01-01Volume 1511180768How Effective is Angiotensin II in Decreasing Mortality of Vasodilatory Shock? A Systematic ReviewSemedi BPRehatta NMSoetjipto SNugraha JMahyuddin MHArnindita JNWairooy NAPBambang Pujo Semedi,1,2 Nancy Margarita Rehatta,2 Soetjipto Soetjipto,3 Jusak Nugraha,4 Muhammad H Mahyuddin,5 Jannatin N Arnindita,5 Nabilah A P Wairooy5 1Doctoral Program of Medical Science, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, 60132, Indonesia; 2Department of Anesthesiology and Reanimation, Medical Faculty of Medicine, Universitas Airlangga—Dr Soetomo General Hospital, Surabaya, East Java, 60132, Indonesia; 3Department of Medical Biochemistry, Medical Faculty of Universitas Airlangga, Surabaya, East Java, 60132, Indonesia; 4Department of Clinical Pathology, Medical Faculty of Universitas Airlangga, Surabaya, East Java, 60132, Indonesia; 5Medical Faculty Universitas Airlangga, Surabaya, East Java, 60132, IndonesiaCorrespondence: Nancy Margarita Rehatta, Email margaritarehatta@gmail.comBackground: Patients with severe vasodilation accompanied by refractory hypotension despite high doses of vasopressors were associated with a high mortality rate. The Ang-2 for the Treatment of High-Output Shock (ATHOS) 3 trial demonstrated that angiotensin 2 (Ang-2) could effectively increase MAP and blood pressure in vasodilatory shock patients. This systematic review aims to summarize the impact of Ang-2 for the treatment of vasodilatory shock on clinical outcomes, including length of stay, MAP level (before and after), and mortality also Ang-2 dose needed.Methods: A systematic search in PubMed, Sage, ScienceDirect, Scopus and Gray literature was conducted to obtain studies about the use of Ang-2 in vasodilatory shock patients.Results: In all of the studies that we obtained, there were different results regarding mortality in patients with vasodilatory shock with Ang-2. Mortality was significantly lower when Ang-2 was administered to patients with elevated renin. The initial dose of Ang-2 can be started at 10– 20 ng/kg/min, but there is no agreement on the maximum dose. Ang-2 may be considered a third-line vasopressor if the targeted MAP has not been achieved after administration of norepinephrine > 200 ng/kg/min for more than 6 hours. Although not statistically significant, the use of Ang-2 can reduce the length of stay in the ICU and in the hospital when compared to patients without Ang-2 therapy, in addition to reducing the dose of vasopressor.Conclusion: Overall, the use of Ang-2 has potential to be a regimen for patients with vasodilatory shock. Further study is needed to obtain more data.Keywords: angiotensin II, vasodilatory shock, vasopressor, mortalityhttps://www.dovepress.com/how-effective-is-angiotensin-ii-in-decreasing-mortality-of-vasodilator-peer-reviewed-fulltext-article-OAEMangiotensin iivasodilatory shockvasopressormortality |
| spellingShingle | Semedi BP Rehatta NM Soetjipto S Nugraha J Mahyuddin MH Arnindita JN Wairooy NAP How Effective is Angiotensin II in Decreasing Mortality of Vasodilatory Shock? A Systematic Review Open Access Emergency Medicine angiotensin ii vasodilatory shock vasopressor mortality |
| title | How Effective is Angiotensin II in Decreasing Mortality of Vasodilatory Shock? A Systematic Review |
| title_full | How Effective is Angiotensin II in Decreasing Mortality of Vasodilatory Shock? A Systematic Review |
| title_fullStr | How Effective is Angiotensin II in Decreasing Mortality of Vasodilatory Shock? A Systematic Review |
| title_full_unstemmed | How Effective is Angiotensin II in Decreasing Mortality of Vasodilatory Shock? A Systematic Review |
| title_short | How Effective is Angiotensin II in Decreasing Mortality of Vasodilatory Shock? A Systematic Review |
| title_sort | how effective is angiotensin ii in decreasing mortality of vasodilatory shock a systematic review |
| topic | angiotensin ii vasodilatory shock vasopressor mortality |
| url | https://www.dovepress.com/how-effective-is-angiotensin-ii-in-decreasing-mortality-of-vasodilator-peer-reviewed-fulltext-article-OAEM |
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