Angiotensin II Infusion for Shock A Multicenter Study of Postmarketing Use
Angiotensin II Infusion for Shock A Multicenter Study of Postmarketing Use
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DOI：
10.1016/j.chest.2020.08.2074
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发表时间：
2021-02-04
期刊：
影响因子：
9.6
通讯作者：
Barreto, Erin F.
中科院分区：
文献类型：
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作者：
Wieruszewski, Patrick M.;Wittwer, Erica D.;Barreto, Erin F.
背景技术背景：血管扩张性休克对儿茶酚胺类血管加压药和精氨酸加压素无效，是一种高度病态的疾病，可导致显著的死亡。合成血管紧张素II是一种有效的血管收缩剂，可能适用于这些patients.RESEARCH问题：什么是血管紧张素II的安全性和有效性，什么变量与良好的血流动力学反应？研究设计和方法：我们在美国的五个三级医疗中心进行了一项多中心回顾性研究。血管紧张素II的血流动力学反应的主要终点定义为达到平均动脉压（MAP）≥ 65毫米汞柱与一个稳定的或减少总血管加压药剂量3小时后，药物initiation.Results：纳入的270例患者中，181（67%）表现出血管紧张素II的血流动力学反应。应答者的MAP增加更大（+10.3 mm Hg vs +1.6 mm Hg，P
BACKGROUND: Vasodilatory shock refractory to catecholamine vasopressors and arginine vasopressin is highly morbid and responsible for significant mortality. Synthetic angiotensin II is a potent vasoconstrictor that may be suitable for use in these patients.RESEARCH QUESTION: What is the safety and effectiveness of angiotensin II and what variables are associated with a favorable hemodynamic response?STUDY DESIGN AND METHODS: We performed a multicenter, retrospective study at five tertiary medical centers in the United States. The primary end point of hemodynamic responsiveness to angiotensin II was defined as attainment of mean arterial pressure (MAP) of >= 65 mm Hg with a stable or reduced total vasopressor dosage 3 h after drug initiation.RESULTS: Of 270 included patients, 181 (67%) demonstrated hemodynamic responsiveness to angiotensin II. Responders showed a greater increase in MAP (+10.3 mm Hg vs +1.6 mm Hg, P