Key result
Angiotensin II resolves refractory post-bypass shock in an anephric patient with catecholamine-sparing effects.
Why the study?
Vasodilatory shock after cardiopulmonary bypass can be refractory to standard therapies, making angiotensin II a promising potential treatment in patients with baseline impaired renin-angiotensin-aldosterone systems.
Does Angiotensin II improve severe refractory shock in an anephric patient following cardiac surgery?
Case Report (n=1)
Does Angiotensin II improve severe refractory shock in an anephric patient following cardiac surgery?
Angiotensin II may offer a catecholamine-sparing effect and successful treatment for severe refractory shock following cardiopulmonary bypass, especially in patients with impaired RAAS.
ANG II may stabilize refractory post-CPB shock; hypothesis-generating case report requiring randomized confirmation.
Vasodilatory shock is common following cardiac surgery, caused by an inflammatory response to cardiopulmonary bypass (CPB). Some cases are refractory to volume resuscitation, high-dose catecholamines, arginine vasopressin, and established adjunctive therapies. Angiotensin II (ANG-2), an endogenous hormone in the renin-angiotensin-aldosterone system (RAAS), has several direct and indirect vasoconstrictive properties that make it a promising potential treatment. This case describes the successful use of ANG-2 in an anephric patient who suffered from severe refractory shock following CPB, offering a unique potential mechanism of benefit in a broader population of patients with baseline impaired RAAS.
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Cutler et al. (2020) conducted a case report in Severe refractory shock following cardiopulmonary bypass (n=1). Angiotensin II (ANG-2) was evaluated on Catecholamine-sparing effect / successful treatment of shock. Angiotensin II was successfully used to treat severe refractory shock following cardiopulmonary bypass in an anephric patient, demonstrating a catecholamine-sparing effect.
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