keyword
https://read.qxmd.com/read/35920615/the-pharmacotherapeutic-options-in-patients-with-catecholamine-resistant-vasodilatory-shock
#21
REVIEW
Timothy E Albertson, James A Chenoweth, Justin C Lewis, Janelle V Pugashetti, Christian E Sandrock, Brian M Morrissey
INTRODUCTION: Septic and vasoplegic shock are common types of vasodilatory shock (VS) with high mortality. After fluid resuscitation and the use of catecholamine-mediated vasopressors (CMV), vasopressin, angiotensin II, methylene blue (MB), and hydroxocobalamin can be added to maintain blood pressure. AREAS COVERED: VS treatment utilizes a phased approach with secondary vasopressors added to vasopressor agents to maintain an acceptable mean arterial pressure (MAP)...
August 2022: Expert Review of Clinical Pharmacology
https://read.qxmd.com/read/35813323/cirmi-a-new-term-for-a-concept-worthy-of-further-exploration-a-narrative-review
#22
REVIEW
Gladness Dakalo Nethathe, Jeffrey Lipman, Ronald Anderson, Charles Feldman
BACKGROUND AND OBJECTIVE: Critical illness-related corticosteroid insufficiency (CIRCI) describes hypothalamic-pituitary-axis impairment during critical illness associated with three major pathophysiological events; dysregulation of the hypothalamic-pituitary-axis, altered cortisol metabolism, and tissue corticosteroid resistance. Similar changes are evident with regard to mineralocorticoid dysfunction in critical illness. Hyperreninemic hypoaldosteronism describes a sub-population of critically ill patients with an impaired adrenal aldosterone response to increased levels of renin...
June 2022: Annals of Translational Medicine
https://read.qxmd.com/read/35708041/angiotensin-ii-and-angiotensin-ii-receptor-2-levels-can-predict-shock-and-mortality-in-septic-patients
#23
JOURNAL ARTICLE
Ayse B Ozer, Murat Bicakcioglu, Seyma Baykan, Nilüfer Bulut, Serkan Kalkan, Selcuk Demircan, Zeliha Korkmaz Disli, Deccane Duzenci, Mustafa Said Aydogan, Aytac Yucel, Neslihan Yucel, Yasemin Ersoy, Nermin Kibrislioglu Uysal, Zafer Dogan
BACKGROUND: The aim of this study is to evaluate the place of angiotensin II and its receptors in the prognosis of septic patients. METHODS: Patients with sepsis and septic shock were included in the study group. The control group consisted of patients who were followed up in the ICU and had no sepsis/septic shock. Plasma angiotensin II, angiotensin receptor-1 and 2 (AT-1, AT-2) levels were evaluated first and third days. RESULTS: Angiotensin II levels were significantly lower in the septic shock and non-survivor...
June 15, 2022: Minerva Anestesiologica
https://read.qxmd.com/read/35677822/vasopressors-and-risk-of-acute-mesenteric-ischemia-a-worldwide-pharmacovigilance-analysis-and-comprehensive-literature-review
#24
JOURNAL ARTICLE
Mathieu Jozwiak, Guillaume Geri, Driss Laghlam, Kevin Boussion, Charles Dolladille, Lee S Nguyen
Vasodilatory shock, such as septic shock, requires personalized management which include adequate fluid therapy and vasopressor treatments. While these potent drugs are numerous, they all aim to counterbalance the vasodilatory effects of a systemic inflammatory response syndrome. Their specific receptors include α- and β-adrenergic receptors, arginine-vasopressin receptors, angiotensin II receptors and dopamine receptors. Consequently, these may be associated with severe adverse effects, including acute mesenteric ischemia (AMI)...
2022: Frontiers in Medicine
https://read.qxmd.com/read/35644899/timing-of-vasoactive-agents-and-corticosteroid-initiation-in-septic-shock
#25
REVIEW
Mahmoud A Ammar, Abdalla A Ammar, Patrick M Wieruszewski, Brittany D Bissell, Micah T Long, Lauren Albert, Ashish K Khanna, Gretchen L Sacha
Septic shock remains a health care concern associated with significant morbidity and mortality. The Surviving Sepsis Campaign Guidelines for Management of Sepsis and Septic Shock recommend early fluid resuscitation and antimicrobials. Beyond initial management, the guidelines do not provide clear recommendations on appropriate time to initiate vasoactive therapies and corticosteroids in patients who develop shock. This review summarizes the literature regarding time of initiation of these interventions. Clinical data regarding time of initiation of these therapies in relation to shock onset, sequence of treatments with regard to each other, and clinical markers evaluated to guide initiation are summarized...
May 30, 2022: Annals of Intensive Care
https://read.qxmd.com/read/35072084/effectiveness-of-angiotensin-ii-for-catecholamine-refractory-septic-or-distributive-shock-on-mortality-a-propensity-score-weighted-analysis-of-real-world-experience-in-the-medical-icu
#26
JOURNAL ARTICLE
Michele Quan, Nam Cho, Thomas Bushell, Joseph Mak, Nolan Nguyen, Jane Litwak, Nicholas Rockwood, H Bryant Nguyen
Angiotensin II (ATII) was approved for septic or other distributive shock due to its property of increasing blood pressure within 3 hours. Limited data exist regarding its effectiveness when used in real-world clinical practice. OBJECTIVES: This study examined ATII as a third-line vasopressor based on institutional approval. DESIGN: Retrospective observational cohort study. SETTING AND PARTICIPANTS: Medical ICU at an academic tertiary care medical center...
January 2022: Critical care explorations
https://read.qxmd.com/read/35038567/platelet-protects-angiotensin-ii-driven-abdominal-aortic-aneurysm-formation-through-inhibition-of-inflammation
#27
JOURNAL ARTICLE
Xiaowei Liu, Xiaofeng Chen, Chen Xu, Jiangjie Lou, Yingzheng Weng, Lijiang Tang
BACKGROUND: Inflammation is the primary cause of abdominal aortic aneurysm (AAA) formation and development. It has been reported that platelets protect against septic shock by inhibiting inflammation. However, it is unclear whether platelets protect AAA progress via suppressing inflammation. METHODS: A mouse model of AAA was established by a daily administration of angiotensin II (Ang II, 1000 ng/kg/min) for 28-day. The AAA mice received 1 × 109 platelets transfusion in normal saline every 3rd day for 1 month...
January 14, 2022: Experimental Gerontology
https://read.qxmd.com/read/35035614/construction-and-validation-of-a-risk-prediction-model-for-acute-kidney-injury-in-patients-suffering-from-septic-shock
#28
JOURNAL ARTICLE
Suru Yue, Shasha Li, Xueying Huang, Jie Liu, Xuefei Hou, Yufeng Wang, Jiayuan Wu
BACKGROUND: Acute kidney injury (AKI) is an important complication in critically ill patients, especially in sepsis and septic shock patients. Early prediction of AKI in septic shock can provide clinicians with sufficient information for timely intervention so that improve the patients' survival rate and quality of life. The aim of this study was to establish a nomogram that predicts the risk of AKI in patients with septic shock in the intensive care unit (ICU). METHODS: The data were collected from the Medical Information Mart for Intensive Care III (MIMIC-III) database between 2001 and 2012...
2022: Disease Markers
https://read.qxmd.com/read/34785486/beyond-the-bundle-clinical-controversies-in-the-management-of-sepsis-in-emergency-medicine-patients
#29
REVIEW
Kavita Krishnan, Travis B Wassermann, Patrick Tednes, Veronica Bonderski, Megan A Rech
Sepsis is a condition characterized by life-threatening organ dysfunction caused by a dysregulated host response to infection. The emergency department (ED) serves as a crucial entry point for patients presenting with sepsis. Given the heterogeneous presentation and high mortality rate associated with sepsis and septic shock, several clinical controversies have emerged in the management of sepsis. These include the use of novel therapeutic agents like angiotensin II, hydrocortisone, ascorbic acid, thiamine ("HAT") therapy, and levosimendan, Additionally, controversies with current treatments in vasopressor dosing, and the use of and balanced or unbalanced crystalloid are crucial to consider...
January 2022: American Journal of Emergency Medicine
https://read.qxmd.com/read/34597810/dysregulation-of-the-renin-angiotensin-system-in-septic-shock-mechanistic-insights-and-application-of-angiotensin-ii-in-clinical-management
#30
REVIEW
Fortunato Senatore, Pitchai Balakumar, Gowraganahalli Jagadeesh
Synergistic physiologic mechanisms involving the renin-angiotensin system (RAS), the sympathetic nervous system, and the arginine-vasopressin system play an integral role in blood pressure homeostasis. A subset of patients with sepsis experience septic shock with attendant circulatory, cellular, and metabolic abnormalities. Septic shock is associated with increased mortality because of an inadequacy to maintain mean arterial blood pressure (MAP) despite volume resuscitation and the use of vasopressors. Vasodilatory shock raises the dose of vasopressors required to maintain a MAP of > 65 mm Hg...
December 2021: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://read.qxmd.com/read/33850878/angiotensin-ii-mediated-improvement-of-renal-mitochondrial-function-via-the-ampk-pgc-1%C3%AE-nrf-2-pathway-is-superior-to-norepinephrine-in-a-rat-model-of-septic-shock-associated-with-acute-renal-injury
#31
JOURNAL ARTICLE
Hui An, Zhenjie Hu, Yuhong Chen, Lianfang Cheng, Jian Shi, Linan Han
BACKGROUND: This study sought to compare the therapeutic effects of angiotensin II (ANG II) and norepinephrine (NE) on cecal ligation and puncture (CLP)-induced septic acute kidney injury (AKI) in rats. METHODS: Sepsis shock was induced in anesthesia Sprague-Dawley male rats by CLP model for 24 hours. A total of 40 rats were divided into five groups, including control group, sham group, CLP group, CLP + ANG II group, and CLP + NE group. CLP + ANG II and CLP + NE group were administration of ANG II or NE after sepsis shock respectively, maintaining the MAP at 75-85 mmHg...
March 2021: Annals of Translational Medicine
https://read.qxmd.com/read/33617825/angiotensin-ii-receptor-type-1-blockade-improves-hyporesponsiveness-to-vasopressors-in-septic-shock
#32
JOURNAL ARTICLE
Daniel Fernandes, Letícia Kramer Pacheco, Regina Sordi, Karin Scheschowitsch, Gustavo Campos Ramos, Jamil Assreuy
Sepsis activates the renin-angiotensin system and the production of angiotensin II, which has a key role in the regulation of blood pressure through AT1 receptors. However, excessive activation of AT1 receptor is associated with deleterious effects. We investigated the consequences of a differential blockade of AT1 receptor caused by two doses of losartan (0.25 mg/kg or 15 mg/kg, s.c), a selective AT1 receptor antagonist on sepsis outcome. These doses reduced the effect of angiotensin II in normal rats by 30% and >90% 8 h after administration, respectively, but only the higher dose maintained its inhibitory effect (~70%) 24 h after injection...
April 15, 2021: European Journal of Pharmacology
https://read.qxmd.com/read/33591012/prior-exposure-to-angiotensin-ii-receptor-blockers-in-patients-with-septic-shock-to-individualize-mean-arterial-pressure-target-a-post-hoc-analysis-of-the-sepsis-and-mean-arterial-pressure-sepsispam-trial
#33
JOURNAL ARTICLE
Julien Demiselle, Valérie Seegers, Marie Lemerle, Ferhat Meziani, Fabien Grelon, Bruno Megarbane, Nadia Anguel, Jean-Paul Mira, Pierre-François Dequin, Soizic Gergaud, Nicolas Weiss, François Legay, Yves Le Tulzo, Marie Conrad, René Robert, Frédéric Gonzalez, Christophe Guitton, Fabienne Tamion, Jean-Marie Tonnelier, Jean-Pierre Bédos, Thierry Van Der Linden, Antoine Vieillard-Baron, Eric Mariotte, Gaël Pradel, Olivier Lesieur, Jean-Damien Ricard, Fabien Hervé, Damien du Cheyron, Claude Guerin, Jean-Louis Teboul, Julie Helms, Peter Radermacher, Pierre Asfar
OBJECTIVES: Individualizing a target mean arterial pressure is challenging during the initial resuscitation of patients with septic shock. The Sepsis and Mean Arterial Pressure (SEPSISPAM) trial suggested that targeting high mean arterial pressure might reduce the occurrence of acute kidney injury among those included patients with a past history of chronic hypertension. We investigated whether the class of antihypertensive medications used before the ICU stay in chronic hypertensive patients was associated with the severity of acute kidney injury occurring after inclusion, according to mean arterial pressure target...
April 1, 2021: Critical Care Medicine
https://read.qxmd.com/read/33577171/intraoperative-use-of-angiotensin-ii-for-severe-vasodilatory-shock-during-liver-transplantation-a-case-report
#34
JOURNAL ARTICLE
Kati Running, Devin Weinberg, William Trudo, Cinnamon L Sullivan, Gaurav P Patel
Refractory hypotension is a known entity in liver transplantation. Catecholamine and vasopressin infusions are first-line therapies. There has been recent interest in angiotensin II (Ang-2) as an alternative vasopressor; however, liver failure patients were excluded from the original trials. Ang-2 has potential in this patient population. This case discusses a patient who received an infusion of Ang-2 during a liver transplant for combined liver failure-induced distributive shock and septic shock. It is the first known successful use of intraoperative Ang-2 in this situation, and it shows that Ang-2 may be safe in liver transplantation when traditional therapies fail...
February 11, 2021: A&A Practice
https://read.qxmd.com/read/33381880/promotion-of-vascular-integrity-in-sepsis-through-modulation-of-bioactive-adrenomedullin-and-dipeptidyl-peptidase-3
#35
REVIEW
D van Lier, M Kox, P Pickkers
Sepsis represents one of the major medical challenges of the 21st century. Despite substantial improvements in the knowledge on pathophysiological mechanisms, this has so far not translated into novel adjuvant treatment strategies for sepsis. In sepsis, both vascular tone and vascular integrity are compromised, and contribute to the development of shock, which is strongly related to the development of organ dysfunction and mortality. In this review, we focus on dipeptidyl peptidase 3 (DPP3) and adrenomedullin (ADM), two molecules that act on the vasculature and are involved in the pathophysiology of sepsis and septic shock...
December 30, 2020: Journal of Internal Medicine
https://read.qxmd.com/read/33377956/mineralocorticoid-dysfunction-during-critical-illness
#36
REVIEW
Gladness Dakalo Nethathe, Jeremy Cohen, Jeffrey Lipman, Ronald Anderson, Charles Feldman
The recent demonstration of the significant reduction in mortality in patients with septic shock treated with adjunctive glucocorticoids combined with fludrocortisone and the effectiveness of angiotensin II in treating vasodilatory shock have renewed interest in the role of the mineralocorticoid axis in critical illness. Glucocorticoids have variable interactions at the mineralocorticoid receptor. Similarly, mineralocorticoid receptor-aldosterone interactions differ from mineralocorticoid receptor-glucocorticoid interactions and predicate receptor-ligand interactions that differ with respect to cellular effects...
August 1, 2020: Anesthesiology
https://read.qxmd.com/read/33292658/non-catecholamine-vasopressors-in-the-treatment-of-adult-patients-with-septic-shock-evidence-from-meta-analysis-and-trial-sequential-analysis-of-randomized-clinical-trials
#37
JOURNAL ARTICLE
Lei Zhong, Xiao-Wei Ji, Hai-Li Wang, Guang-Ming Zhao, Qing Zhou, Bo Xie
BACKGROUND: Norepinephrine (NE) has currently been the first-choice vasopressor in treating septic shock despite generally insufficient for patients with refractory septic shock. The aim of this update meta-analysis was to assess the safety and efficacy of a combination of non-catecholamine vasopressors (vasopressin/pituitrin/terlipressin/selepressin/angiotensin II) and NE versus NE in managing adult septic shock patients. METHODS: We conducted this study of literatures published from the inception to April 30, 2020, using PubMed, Embase, and the Cochrane Library databases without language restriction...
October 31, 2020: Journal of Intensive Care
https://read.qxmd.com/read/32837036/the-pathophysiology-diagnosis-and-treatment-of-corona-virus-disease-2019-covid-19
#38
REVIEW
Subir Kumar Das
Since the beginning of this century, beta coronaviruses (CoV) have caused three zoonotic outbreaks. However, little is currently known about the biology of the newly emerged SARS-CoV-2 in late 2019. There is a spectrum of clinical features from mild to severe life threatening disease with major complications like severe pneumonia, acute respiratory distress syndrome, acute cardiac injury and septic shock. The genome of SARS-CoV-2 encodes polyproteins, four structural proteins and six accessory proteins. SARS-CoV-2 tends to utilize Angiotensin-converting enzyme 2 (ACE2) of various mammals...
October 2020: Indian Journal of Clinical Biochemistry: IJCB
https://read.qxmd.com/read/32820475/vasopressor-therapy-in-the-intensive-care-unit
#39
JOURNAL ARTICLE
James A Russell, Anthony C Gordon, Mark D Williams, John H Boyd, Keith R Walley, Niranjan Kissoon
After fluid administration for vasodilatory shock, vasopressors are commonly infused. Causes of vasodilatory shock include septic shock, post-cardiovascular surgery, post-acute myocardial infarction, postsurgery, other causes of an intense systemic inflammatory response, and drug -associated anaphylaxis. Therapeutic vasopressors are hormones that activate receptors-adrenergic: α1, α2, β1, β2; angiotensin II: AG1, AG2; vasopressin: AVPR1a, AVPR1B, AVPR2; dopamine: DA1, DA2. Vasopressor choice and dose vary widely because of patient and physician practice heterogeneity...
February 2021: Seminars in Respiratory and Critical Care Medicine
https://read.qxmd.com/read/32787515/treatment-of-renin-angiotensin-aldosterone-system-dysfunction-with-angiotensin-ii-in-high-renin-septic-shock
#40
JOURNAL ARTICLE
Jonathan H Chow, Marianne Wallis, Allison S Lankford, Zackary Chancer, Rolf N Barth, Joseph R Scalea, John C LaMattina, Michael A Mazzeffi, Michael T McCurdy
Endothelial dysfunction is common in septic shock and has been shown to impair angiotensin converting enzyme and the renin-angiotensin-aldosterone system (RAAS). Dysregulation of this pathway, which can be measured with plasma renin activity (PRA), is important not only because RAAS dysfunction is associated with increased mortality but also because treatment with angiotensin II (Ang-2) has been shown to decrease mortality. In this case series of 2 patients, serial PRA levels identified septic shock patients with RAAS dysfunction...
March 2021: Seminars in Cardiothoracic and Vascular Anesthesia
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