Observational studyChest2021
Angiotensin II Infusion for Shock: A Multicenter Study of Postmarketing Use.
Observational study in Chest, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06539234 (Angiotensin II Stress Test. Renin Kinetics During Treatment of Vasoplegic Shock With Angiotensin II in Relation to Hemodynamic Response to Treatment With Angiotensin II.), which is not on this map. Cited by 30 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Angiotensin II Stress Test. Renin Kinetics During Treatment of Vasoplegic Shock With Angiotensin II in Relation to Hemodynamic Response to Treatment With Angiotensin II.
Who cites it
30 citing papers in PubMed, 1 synthesis or guideline pooled it.
- An overview of reviews of Angiotensin II in distributive shock.BMC anesthesiology · 2026Pooled it
- An index of the initial blood pressure response to angiotensin II treatment and its association with clinical outcomes in vasodilatory shock.Critical care (London, England) · 2025Trial
- Initiating angiotensin II at lower vasopressor doses in vasodilatory shock: an exploratory post-hoc analysis of the ATHOS-3 clinical trial.Critical care (London, England) · 2023Trial
- Trial
- Role of Angiotensin II as a Vasoactive Agent to Treat Distributive Shock With a Focus on Preliminary Data in Pediatric-Aged Patients.Paediatric anaesthesia · 2026Review
- Continuous Hemodynamic Response to Angiotensin II in Critically Ill Pediatric Patients: A Single Center Cohort Study.The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2025Article
- Vasoactive Agents in Burn Patients: Perspectives on Angiotensin-II.Journal of burn care & research : official publication of the American Burn Association · 2025Review
- Vasopressin and its analogues in patients with septic shock: holy Grail or unfulfilled promise?Critical care (London, England) · 2025Review
- [Vasoactive agents in septic shock-individualized strategies].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2025Review
- Association between timing of angiotensin II administration and outcomes in vasoplegia after cardiac surgery.JTCVS open · 2025Article
- Angiotensin II administration in severe thrombocytopenia and chronic venous thrombosis: A case report.World journal of critical care medicine · 2024Article
- Angiotensin II-Real-Life Use and Literature Review.Medicina (Kaunas, Lithuania) · 2024Review
- Clinical Outcomes of Angiotensin II Therapy in Vasoplegic Shock: A Systematic Review and Meta-Analysis.Life (Basel, Switzerland) · 2024Review
- Angiotensin II as a Vasopressor for Perioperative Hypotension in Solid Organ Transplant.Biomedicines · 2024Review
- Angiotensin ii therapy in refractory septic shock: which patient can benefit most? A narrative review.Journal of anesthesia, analgesia and critical care · 2024Review
- Precision fluid and vasoactive drug therapy for critically ill patients.Pharmacotherapy · 2023Review
- Adoption of a Novel Vasopressor Agent in Critically Ill Adults.Annals of the American Thoracic Society · 2023Article
- Management of Sepsis and Septic Shock: What Have We Learned in the Last Two Decades?Microorganisms · 2023Review
- Article
- Reply to: Rethinking Vasopressor Education: The Need to Avoid Teaching the Bare Minimum.ATS scholar · 2023Article
Corrections and comments
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Authors and funding
13 authors.
Funding
Abstract
backgroundVasodilatory shock refractory to catecholamine vasopressors and arginine vasopressin is highly morbid and responsible for significant mortality. Synthetic angiotensin II is a potent vasoconstrictor that may be suitable for use in these patients. RESEARCH QUESTION: What is the safety and effectiveness of angiotensin II and what variables are associated with a favorable hemodynamic response? STUDY DESIGN AND
methodsWe performed a multicenter, retrospective study at five tertiary medical centers in the United States. The primary end point of hemodynamic responsiveness to angiotensin II was defined as attainment of mean arterial pressure (MAP) of ≥ 65 mm Hg with a stable or reduced total vasopressor dosage 3 h after drug initiation.
resultsOf 270 included patients, 181 (67%) demonstrated hemodynamic responsiveness to angiotensin II. Responders showed a greater increase in MAP (+10.3 mm Hg vs +1.6 mm Hg, P < .001) and reduction in vasopressor dosage (-0.20 μg/kg/min vs +0.04 μg/kg/min; P < .001) compared with nonresponders at 3 h. Variables associated with favorable hemodynamic response included lower lactate concentration (OR 1.11; 95% CI, 1.05-1.17, P < .001) and receipt of vasopressin (OR, 6.05; 95% CI, 1.98-18.6; P = .002). In severity-adjusted multivariate analysis, hemodynamic responsiveness to angiotensin II was associated with reduced likelihood of 30-day mortality (hazard ratio, 0.50; 95% CI, 0.35-0.71; P < .001). Arrhythmias occurred in 28 patients (10%) and VTE was identified in 4 patients.
interpretationIn postmarketing use for vasopressor-refractory shock, 67% of angiotensin II recipients demonstrated a favorable hemodynamic response. Patients with lower lactate concentrations and those receiving vasopressin were more likely to respond to angiotensin II. Patients who responded to angiotensin II experienced reduced mortality.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.