The DOI matches its Crossref record; 19 of the 19 references it cites were found in a registry or an index.
Intravenous angiotensin II for the treatment of high-output shock (ATHOS trial): a pilot study
Open accessAbstract
Introduction: Patients with distributive shock who require high dose vasopressors have a high mortality. Angiotensin II (ATII) may prove useful in patients who remain hypotensive despite catecholamine and vasopressin therapy. The appropriate dose of parenteral angiotensin II for shock is unknown. Methods: In total, 20 patients with distributive shock and a cardiovascular Sequential Organ Failure Assessment score of 4 were randomized to either ATII infusion (N =10) or placebo (N =10) plus standard of care. ATII was started at a dose of 20 ng/kg/min, and titrated for a goal of maintaining a mean arterial pressure (MAP) of 65 mmHg. The infusion (either ATII or placebo) was continued for 6 hours then titrated off. The primary endpoint was the effect of ATII on the standing dose of norepinephrine required to maintain a MAP of 65 mmHg. Results: ATII resulted in marked reduction in norepinephrine dosing in all patients. The mean hour 1 norepinephrine dose for the placebo cohort was 27.6 ± 29.3 mcg/min versus 7.4 ± 12.4 mcg/min for the ATII cohort ( P =0.06). The most common adverse event attributable to ATII was hypertension, which occurred in 20% of patients receiving ATII. 30-day mortality for the ATII cohort and the placebo cohort was similar (50% versus 60%, P =1.00). Conclusion: Angiotensin II is an effective rescue vasopressor agent in patients with distributive shock requiring multiple vasopressors. The initial dose range of ATII that appears to be appropriate for patients with distributive shock is 2 to 10 ng/kg/min. Trial registration: Clinicaltrials.gov NCT01393782 . Registered 12 July 2011.
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“There are data from RCTs in specific conditions such as pneumonia (286-289), urinary tract infections (290), bacteremia (291, 292), and intraabdominal infections (293).”
From Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. (2021) · cites this paper as [290]
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“After a small, short-term pilot of 20 patients with vasodilatory (septic) shock 10 patients in each group which showed physiological efficacy without obvious safety issues [365]”
From Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 (2021) · cites this paper as [365]
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Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021
Evans, L., Rhodes, A., Alhazzani, W., Antonelli, M., Coopersmith, C. M., French, C., Machado, F. R., Mcintyre, L., Ostermann, M., Prescott, H. C., et al. (2021) · Intensive Care Medicine · doi:10.1007/s00134-021-06506-y · Cited by 5,082
Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021.
Evans, L., Rhodes, A., Alhazzani, W., Antonelli, M., Coopersmith, C. M., French, C., Machado, F. R., Mcintyre, L., Ostermann, M., Prescott, H. C., et al. (2021) · Critical Care Medicine · doi:10.1097/ccm.0000000000005337 · Cited by 2,935
Peerapornratana, S., Manrique‐Caballero, C. L., Gómez, H., & Kellum, J. A. (2019) · Kidney International · doi:10.1016/j.kint.2019.05.026 · Cited by 1,557
Angiotensin II for the Treatment of Vasodilatory Shock
Khanna, A., English, S. W., Wang, X. S., Ham, K., Tumlin, J., Szerlip, H., Busse, L. W., Altaweel, L., Albertson, T. E., Mackey, C., et al. (2017) · New England Journal of Medicine · doi:10.1056/nejmoa1704154 · Cited by 916
Self-citationBellomo, R., Kellum, J. A., Ronco, C., Wald, R., Mårtensson, J., Maiden, M. J., Bagshaw, S. M., Glassford, N. J., Lankadeva, Y. R., Vaara, S. T., et al. (2017) · Intensive Care Medicine · doi:10.1007/s00134-017-4755-7 · Cited by 794
Metadata
- Authors
- Chawla, L. S., Busse, L., Brasha-Mitchell, E., Davison, D., Honiq, J., Alotaibi, Z., & Seneff, M. G.
- Affiliations
- United States Department of Veterans Affairs (US)
- Inova Fairfax Hospital (US)
- Riyadh Armed Forces Hospital (SA)
- Corresponding author
- Chawla, Lakhmir S
- Venue
- Critical Care
- Published
- 2014-10-06
- Volume
- 18
- Issue
- 5
- Pages
- 534-534
- ISSN
- 1364-8535 (ISSN-L)
- PMC
- PMC4212099
- OpenAlex
- W2031987490
- Cited by
- 197
- References
- 19
- Citations by year
- 2026: 11 · 2025: 19 · 2024: 20 · 2023: 19 · 2022: 11 · 2021: 16 · 2020: 25 · 2019: 28 · 2018: 21 · 2017: 17 · 2016: 7 · 2015: 2 · 2014: 1
- FWCI
- 8.93
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Critical Care (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- George Washington University
- Topics
- Health Sciences › Medicine › Surgery › Hemodynamic Monitoring and Therapy
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Trauma, Hemostasis, Coagulopathy, Resuscitation
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Sepsis Diagnosis and Treatment
- Keywords
- angiotensin II, distributive shock, 30-day mortality
- MeSH terms
- Aged, Angiotensin II, Blood Pressure, Cardiac Output, Catecholamines, Female, Humans, Male, Middle Aged, Norepinephrine, Pilot Projects, Shock, Septic, Vasoconstrictor Agents, Treatment Outcome, Administration, Intravenous
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