Treatment of Renin-Angiotensin-Aldosterone System Dysfunction With Angiotensin II in High-Renin Septic Shock

作者：Jonathan H. Chow, Marianne Wallis, Allison Lankford, Zackary Chancer, Rolf N. Barth, Joseph R. Scalea, John C. LaMattina, Michael Mazzeffi, Michael T. McCurdy · 发表于：Seminars in Cardiothoracic and Vascular Anesthesia · 年份：2020 · DOI：10.1177/1089253220949070 · 被引用次数：11 · 研究领域：Sepsis Diagnosis and Treatment、Electrolyte and hormonal disorders、Renal function and acid-base balance

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. The patients were treated with Ang-2, an angiotensin type 1 receptor agonist, which resulted in significant improvements in hemodynamics and PRA levels during treatment.