医学
血管紧张素II
内科学
休克(循环)
器官功能障碍
不利影响
耐火材料(行星科学)
心脏病学
重症监护医学
血压
败血症
天体生物学
物理
作者
Lane M. Smith,Graciela Mentz,Milo Engoren
标识
DOI:10.1097/ccm.0000000000005975
摘要
OBJECTIVES: To determine if angiotensin II is associated with improved outcomes as measured by 30- and 90-day mortality as well as other secondary outcomes such as organ dysfunction and adverse events. DESIGN: Retrospective, matched analysis of patients receiving angiotensin II compared with both historical and concurrent controls receiving equivalent doses of nonangiotensin II vasopressors. SETTING: Multiple ICUs in a large, university-based hospital. PATIENTS: Eight hundred thirteen adult patients with shock admitted to an ICU and requiring vasopressor support. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Angiotensin II use had no association with the primary outcome of 30-day mortality (60% vs 56%; p = 0.292). The secondary outcome of 90-day mortality was also similar (65% vs 63%; p = 0.440) as were changes in Sequential Organ Failure Assessment scores over a 5-day monitoring period after enrollment. Angiotensin II was not associated with increased rates of kidney replacement therapy (odds ratio [OR], 1.39; 95% CI, 0.88–2.19; p = 0.158) or receipt of mechanical ventilation (OR, 1.50; 95% CI, 0.41–5.51; p = 0.539) after enrollment, and the rate of thrombotic events was similar between angiotensin II and control patients (OR, 1.02; 95% CI, 0.71–1.48; p = 0.912). CONCLUSIONS: In patients with severe shock, angiotensin II was not associated with improved mortality or organ dysfunction and was not associated with an increased rate of adverse events.
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