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Abby Massey MD
Date of Graduation
Objective: To assess whether or not angiotensin II in combination with current treatment has a favorable outcome in the treatment of distributive shock in terms of decreasing duration of vasopressor usage, increasing mean arterial pressure (MAP) above 65 mmHg, and improving mortality.
Design: Systematic Literature Review
Methods: Searches were conducted in PubMed, Google Scholar, and the James Madison University Library Database for the key terms angiotensin II, shock, septic shock, vasodilatory shock, distributive shock, blood pressure, double-blind, humans, and vasoconstrictor agents. Search results were filtered by year, for animal trials, irrelevant therapies, meta-analysis, retrospective studies, and case studies. Only original studies published within the last ten years that used angiotensin II for human trials in the treatment of distributive shock were included in the review.
Results: Two of three studies showed statistically significant data supporting the ability of angiotensin II to increase MAP above 65 mmHg; however, statistical significance was not found in the reduction of mortality.
Conclusion: The addition of angiotensin II to current standard therapy for the treatment of distributive shock decreases the requirement for vasopressors and increases MAP. Further studies are needed to address the long-term effects of angiotensin II and to investigate outcomes in specific types of shock such as sepsis-induced and anaphylaxis.
Jennifer D Leach, Daniel P Curran. Angiotensin II in the Treatment of Distributive Shock, an Old Theory Revitalized. Posted online December 14 2020.