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The body's natural response to shock is to release catecholamines and vasopressin and to activate the renin-angiotensin-aldosterone system. Standard care of patients with vasodilatory shock includes infusions of norepinephrine and vasopressin, but we have no pharmacologic agents that support the renin-angiotensin-aldosterone system. Investigators hypothesized that synthetic human angiotensin II could complement standard vasopressors in treating patients with shock.
In a multinational trial, 321 patients with vasodilatory shock (80% with sepsis) were randomized to receive either synthetic angiotensin II or placebo. All patients were receiving vasopressors (predominantly vasopressin) with an average mean arterial pressure (MAP) of 66 mm Hg bef…