Angiotensin II stresstest. Reninkinetik under behandling af vasoplegisk shock med angiotensin II. (TENSINTEST)
12. september 2026 opdateret af: Andreja Möller Petrun, MD, PhD, University Medical Centre Maribor
Angiotensin II stresstest. Reninkinetik under behandling af vasoplegisk shock med angiotensin II i relation til hæmodynamisk respons på behandling med angiotensin II.
Chok er en livstruende tilstand, som kan forårsage flere organsvigt og endda død.
Et kendetegn ved chok er lavt blodtryk, som behandles med lægemidler kaldet vasopressorer.
Hyppigst anvendte vasopressorer er noradrenalin, vasopressin og for nylig også angiotensin II.
Angiotensin II er til stede i kroppen og har en fysiologisk rolle i at opretholde blodtrykket hos raske personer.
Renin er et enzym og en nøglefaktor i angiotensin II-produktionen i kroppen.
Hos patienter med shock er der mangel på angiotensin II og et overskud af renin i kroppen.
På grund af litteraturen har renin potentialet til at være en markør for sværhedsgraden af shock.
Syntetisk angiotensin II anvendes til patienter med shock, hvor vi ikke kan normalisere blodtrykket med noradrenalin og vasopressin.
Med hensyn til videnskabelige data reducerer brugen af syntetisk angiotensin II dosis af noradrenalin og vasopressin og forekomsten af akut nyreskade.
Formålet med vores undersøgelse er at finde ud af, hvad der er sammenhængen mellem koncentrationen af renin før og 6 timer efter start af brug af angiotensin II hos patienter med shock og deres kliniske udfald.
Da ikke alle patienter med shock reagerer på angiotensin II, er formålet med vores undersøgelse også at finde ud af, hvilke patienter der kunne have størst gavn af syntetisk angiotensin II.
Studieoversigt
Status
Rekruttering
Betingelser
Detaljeret beskrivelse
Hos patienter med distributivt chok (≥18 år) med noradrenalin >0,3 mcg/kg/min og vasopressin >0,03 IE/min, der ikke opnår et passende gennemsnitligt arterielt tryk (65-85 mmHg), vil en angiotensin II-infusion blive startet ved 20 ng/kg/min og derefter justeret til en maksimal dosis på 40 ng/kg/min, hvis det er nødvendigt.
Før infusionen og 6 timer efter starten af angiotensin II-infusionen vil der blive udtaget en blodprøve for at bestemme reninkoncentrationen.
Det primære resultat vil være dage uden organsvigt og fridage på intensivafdelingen.
Sekundært resultat vil være behovet for vasopressorer, dialyse, mekanisk ventilation, tendens til reninkoncentration.
Undersøgelsestype
Observationel
Tilmelding (Anslået)
121
Kontakter og lokationer
Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.
Studiekontakt
- Navn: Andreja Möller Petrun, PhD
- Telefonnummer: +38623211571
- E-mail: drejapet@web.de
Studiesteder
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-
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Maribor, Slovenien, 2000
- Rekruttering
- Medical ICU, University Medical Centre Maribor
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Kontakt:
- Andrej Markota, PhD
- Telefonnummer: +38623212472
- E-mail: andrej.markota@ukc-mb.si
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Maribor, Slovenien, 2000
- Rekruttering
- Surgical ICU, University Medical Centre Maribor
-
Kontakt:
- Andreja Möller Petrun, PhD
- E-mail: drejapet@web.de
-
-
Deltagelseskriterier
Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.
Berettigelseskriterier
Aldre berettiget til at studere
- Voksen
- Ældre voksen
Tager imod sunde frivillige
N/A
Prøveudtagningsmetode
Ikke-sandsynlighedsprøve
Studiebefolkning
Patienter (≥ 18 år) med distributivt shock (<72 timers varighed) uanset ætiologi uden begrænsninger for behandling og en forventet overlevelse >24 timer.
Beskrivelse
Inklusionskriterier:
- patienter med distributivt chok, der varer < 72 timer
- et mål gennemsnitligt arterielt tryk (65-85 mmHg) ikke opnået på trods af en infusion af mindst noradrenalin 0,3 mcg/kg/min og vasopressin 0,03 IE/min.
- patienten fik ikke angiotensin II før
- forudsagt overlevelse er >24 timer
- ingen begrænsninger for aktiv behandling
Ekskluderingskriterier:
- forbrændinger > 20 % kropsareal
- akut koronarsyndrom
- bronkospasme
- leversygdom (MELD ≥30)
- alvorlig akut blødning (behov for 4 eller flere enheder koncentreret erytrocyt)
- akut mesenterisk iskæmi
- aortadissektion
- leukopeni <1000/mm3
- graviditet
- Raynauds sygdom, systemisk sklerose, vasospastisk sygdom
- behovet for en daglig dosis hydrocortison på 500 mg eller mere
- ECMO
Studieplan
Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Association between 0-6-hour change in relative renin ratio (ΔRRR = RRR6h - RRR0h) and 28-day organ failure-free days (without vasopressors, mechanical ventilation and renal replacement therapy (RRT))
Tidsramme: 0-28 days
|
days alive without the need of vasopressors, ventilators, or dialysis
|
0-28 days
|
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Association between ΔRRR and 28-day ICU free days
Tidsramme: 0-28 days
|
28 minus ICU stay
|
0-28 days
|
|
Association between ΔRRR and vasopressor free days
Tidsramme: 0-28 days
|
time without vasopressors
|
0-28 days
|
|
Association between ΔRRR and cumulative dose of vasopressors expressed in norepinephrine equivalent dose (NED)
Tidsramme: 0-28 days
|
cumulative dose of vasopressors expressed in norepinephrine equivalent dose (NED)
|
0-28 days
|
|
Association between ΔRRR and the RRT free days
Tidsramme: 0-28 days
|
28 minus days with RRT (renal replacement therapy)
|
0-28 days
|
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Association between ΔRRR and invasive mechanical ventilation free days
Tidsramme: 0-28 days
|
28 minus days with invasive mechanical ventilation
|
0-28 days
|
|
Determination of responders and nonresponders based on calculation of the ratio between change in MAP between 0 and 1 hours of protocol to the change in total vasopressor NED between 0 and 1 hours of protocol.
Tidsramme: 0-1 hour
|
0-1 hour
|
|
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Comparison of the prognostic performance of renin and lactate at 0 and 6 hours for 28-day mortality.
Tidsramme: 0-6 hour
|
0-6 hour
|
|
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product ( [renin] x [lactate]) at baseline and 6 hours after start of angiotensin II infusion
Tidsramme: baseline - just before start of angiotensin II infusion; 6 hours - 6 hours after start of angiotensin II infusion
|
Determination if the product ( [renin] x [lactate]) at baseline and 6 hours after start of angiotensin II infusion predicts 28-day organ failure free days, mortality, cumulative dose of vasopressors expressed in NED, renal replacement therapy and mechanical ventilation
|
baseline - just before start of angiotensin II infusion; 6 hours - 6 hours after start of angiotensin II infusion
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Change in total norepinephrine-base dose equivalen (NED) at baseline and 1 hour predicts mortality
Tidsramme: change in norepinephrine-base dose equivalent (NED) from start of angiotensin II infusion (baseline) and 1 hour after start of angiotensin II infusion
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Change in norepinephrine-base dose equivalent (NED) at baseline and 1 hour predicts mortality
|
change in norepinephrine-base dose equivalent (NED) from start of angiotensin II infusion (baseline) and 1 hour after start of angiotensin II infusion
|
Samarbejdspartnere og efterforskere
Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.
Efterforskere
- Studiestol: Andreja Möller Petrun, PhD, University Medical Centre Maribor
Publikationer og nyttige links
Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.
Generelle publikationer
- Yehya N, Harhay MO, Curley MAQ, Schoenfeld DA, Reeder RW. Reappraisal of Ventilator-Free Days in Critical Care Research. Am J Respir Crit Care Med. 2019 Oct 1;200(7):828-836. doi: 10.1164/rccm.201810-2050CP.
- Paparella D, Yau TM, Young E. Cardiopulmonary bypass induced inflammation: pathophysiology and treatment. An update. Eur J Cardiothorac Surg. 2002 Feb;21(2):232-44. doi: 10.1016/s1010-7940(01)01099-5.
- Evans L, Rhodes A, Alhazzani W, Antonelli M, Coopersmith CM, French C, Machado FR, Mcintyre L, Ostermann M, Prescott HC, Schorr C, Simpson S, Wiersinga WJ, Alshamsi F, Angus DC, Arabi Y, Azevedo L, Beale R, Beilman G, Belley-Cote E, Burry L, Cecconi M, Centofanti J, Coz Yataco A, De Waele J, Dellinger RP, Doi K, Du B, Estenssoro E, Ferrer R, Gomersall C, Hodgson C, Moller MH, Iwashyna T, Jacob S, Kleinpell R, Klompas M, Koh Y, Kumar A, Kwizera A, Lobo S, Masur H, McGloughlin S, Mehta S, Mehta Y, Mer M, Nunnally M, Oczkowski S, Osborn T, Papathanassoglou E, Perner A, Puskarich M, Roberts J, Schweickert W, Seckel M, Sevransky J, Sprung CL, Welte T, Zimmerman J, Levy M. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021. Intensive Care Med. 2021 Nov;47(11):1181-1247. doi: 10.1007/s00134-021-06506-y. Epub 2021 Oct 2. No abstract available.
- Bronicki RA, Hall M. Cardiopulmonary Bypass-Induced Inflammatory Response: Pathophysiology and Treatment. Pediatr Crit Care Med. 2016 Aug;17(8 Suppl 1):S272-8. doi: 10.1097/PCC.0000000000000759.
- Hall R. Identification of inflammatory mediators and their modulation by strategies for the management of the systemic inflammatory response during cardiac surgery. J Cardiothorac Vasc Anesth. 2013 Oct;27(5):983-1033. doi: 10.1053/j.jvca.2012.09.013. Epub 2012 Dec 29. No abstract available.
- Stoppe C, McDonald B, Benstoem C, Elke G, Meybohm P, Whitlock R, Fremes S, Fowler R, Lamarche Y, Jiang X, Day AG, Heyland DK. Evaluation of Persistent Organ Dysfunction Plus Death As a Novel Composite Outcome in Cardiac Surgical Patients. J Cardiothorac Vasc Anesth. 2016 Jan;30(1):30-8. doi: 10.1053/j.jvca.2015.07.035. Epub 2015 Jul 29.
- Maslove DM, Tang B, Shankar-Hari M, Lawler PR, Angus DC, Baillie JK, Baron RM, Bauer M, Buchman TG, Calfee CS, Dos Santos CC, Giamarellos-Bourboulis EJ, Gordon AC, Kellum JA, Knight JC, Leligdowicz A, McAuley DF, McLean AS, Menon DK, Meyer NJ, Moldawer LL, Reddy K, Reilly JP, Russell JA, Sevransky JE, Seymour CW, Shapiro NI, Singer M, Summers C, Sweeney TE, Thompson BT, van der Poll T, Venkatesh B, Walley KR, Walsh TS, Ware LB, Wong HR, Zador ZE, Marshall JC. Redefining critical illness. Nat Med. 2022 Jun;28(6):1141-1148. doi: 10.1038/s41591-022-01843-x. Epub 2022 Jun 17.
- Stolk RF, van der Pasch E, Naumann F, Schouwstra J, Bressers S, van Herwaarden AE, Gerretsen J, Schambergen R, Ruth MM, van der Hoeven JG, van Leeuwen H, Pickkers P, Kox M. Norepinephrine Dysregulates the Immune Response and Compromises Host Defense during Sepsis. Am J Respir Crit Care Med. 2020 Sep 15;202(6):830-842. doi: 10.1164/rccm.202002-0339OC.
- De Backer D, Cecconi M, Chew MS, Hajjar L, Monnet X, Ospina-Tascon GA, Ostermann M, Pinsky MR, Vincent JL. A plea for personalization of the hemodynamic management of septic shock. Crit Care. 2022 Dec 1;26(1):372. doi: 10.1186/s13054-022-04255-y.
- Auriemma CL, Taylor SP, Harhay MO, Courtright KR, Halpern SD. Hospital-Free Days: A Pragmatic and Patient-centered Outcome for Trials among Critically and Seriously Ill Patients. Am J Respir Crit Care Med. 2021 Oct 15;204(8):902-909. doi: 10.1164/rccm.202104-1063PP. No abstract available.
- Vincent JL, Singer M, Einav S, Moreno R, Wendon J, Teboul JL, Bakker J, Hernandez G, Annane D, de Man AME, Monnet X, Ranieri VM, Hamzaoui O, Takala J, Juffermans N, Chiche JD, Myatra SN, De Backer D. Equilibrating SSC guidelines with individualized care. Crit Care. 2021 Nov 17;25(1):397. doi: 10.1186/s13054-021-03813-0. No abstract available.
- Suzuki Y, Ruiz-Ortega M, Lorenzo O, Ruperez M, Esteban V, Egido J. Inflammation and angiotensin II. Int J Biochem Cell Biol. 2003 Jun;35(6):881-900. doi: 10.1016/s1357-2725(02)00271-6.
- Laghlam D, Jozwiak M, Nguyen LS. Renin-Angiotensin-Aldosterone System and Immunomodulation: A State-of-the-Art Review. Cells. 2021 Jul 13;10(7):1767. doi: 10.3390/cells10071767.
- Bitker L, Burrell LM. Classic and Nonclassic Renin-Angiotensin Systems in the Critically Ill. Crit Care Clin. 2019 Apr;35(2):213-227. doi: 10.1016/j.ccc.2018.11.002. Epub 2019 Jan 28.
- Paul M, Poyan Mehr A, Kreutz R. Physiology of local renin-angiotensin systems. Physiol Rev. 2006 Jul;86(3):747-803. doi: 10.1152/physrev.00036.2005.
- Correa TD, Takala J, Jakob SM. Angiotensin II in septic shock. Crit Care. 2015 Mar 16;19(1):98. doi: 10.1186/s13054-015-0802-3.
- Garcia B, Zarbock A, Bellomo R, Legrand M. The alternative renin-angiotensin system in critically ill patients: pathophysiology and therapeutic implications. Crit Care. 2023 Nov 20;27(1):453. doi: 10.1186/s13054-023-04739-5.
- Hall A, Busse LW, Ostermann M. Angiotensin in Critical Care. Crit Care. 2018 Mar 20;22(1):69. doi: 10.1186/s13054-018-1995-z.
- Bellomo R, Zarbock A, Landoni G. Angiotensin II. Intensive Care Med. 2024 Feb;50(2):279-282. doi: 10.1007/s00134-023-07290-7. Epub 2024 Jan 8. No abstract available.
- Forrester SJ, Booz GW, Sigmund CD, Coffman TM, Kawai T, Rizzo V, Scalia R, Eguchi S. Angiotensin II Signal Transduction: An Update on Mechanisms of Physiology and Pathophysiology. Physiol Rev. 2018 Jul 1;98(3):1627-1738. doi: 10.1152/physrev.00038.2017.
- Sica DA. Angiotensin receptor blockers: new considerations in their mechanism of action. J Clin Hypertens (Greenwich). 2006 May;8(5):381-5. doi: 10.1111/j.1524-6175.2005.05141.x.
- Busse LW, Barker N, Petersen C. Vasoplegic syndrome following cardiothoracic surgery-review of pathophysiology and update of treatment options. Crit Care. 2020 Feb 4;24(1):36. doi: 10.1186/s13054-020-2743-8.
- Levy B, Fritz C, Tahon E, Jacquot A, Auchet T, Kimmoun A. Vasoplegia treatments: the past, the present, and the future. Crit Care. 2018 Feb 27;22(1):52. doi: 10.1186/s13054-018-1967-3.
- Squiccimarro E, Stasi A, Lorusso R, Paparella D. Narrative review of the systemic inflammatory reaction to cardiac surgery and cardiopulmonary bypass. Artif Organs. 2022 Apr;46(4):568-577. doi: 10.1111/aor.14171. Epub 2022 Jan 21.
- Bernstein KE, Khan Z, Giani JF, Cao DY, Bernstein EA, Shen XZ. Angiotensin-converting enzyme in innate and adaptive immunity. Nat Rev Nephrol. 2018 May;14(5):325-336. doi: 10.1038/nrneph.2018.15. Epub 2018 Mar 26.
- Chappell MC. Nonclassical renin-angiotensin system and renal function. Compr Physiol. 2012 Oct;2(4):2733-52. doi: 10.1002/cphy.c120002.
- Bryniarski P, Nazimek K, Marcinkiewicz J. Immunomodulatory Activity of the Most Commonly Used Antihypertensive Drugs-Angiotensin Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers. Int J Mol Sci. 2022 Feb 4;23(3):1772. doi: 10.3390/ijms23031772.
- Persson PB. Renin: origin, secretion and synthesis. J Physiol. 2003 Nov 1;552(Pt 3):667-71. doi: 10.1113/jphysiol.2003.049890. Epub 2003 Aug 29.
- Kotani Y, Belletti A, Maiucci G, Lodovici M, Fresilli S, Landoni G, Bellomo R, Zarbock A. Renin as a Prognostic Marker in Intensive Care and Perioperative Settings: A Scoping Review. Anesth Analg. 2024 May 1;138(5):929-936. doi: 10.1213/ANE.0000000000006682. Epub 2023 Oct 24.
- Khanna AK. Tissue Perfusion and Prognosis in the Critically Ill-Is Renin the New Lactate? Crit Care Med. 2019 Feb;47(2):288-290. doi: 10.1097/CCM.0000000000003582. No abstract available.
- See EJ, Chaba A, Spano S, Maeda A, Clapham C, Burrell LM, Liu J, Khasin M, Liskaser G, Eastwood G, Bellomo R. Renin Levels and Angiotensin II Responsiveness in Vasopressor-Dependent Hypotension. Crit Care Med. 2024 Aug 1;52(8):1218-1227. doi: 10.1097/CCM.0000000000006273. Epub 2024 Mar 21.
- Qadri F, Culman J, Veltmar A, Maas K, Rascher W, Unger T. Angiotensin II-induced vasopressin release is mediated through alpha-1 adrenoceptors and angiotensin II AT1 receptors in the supraoptic nucleus. J Pharmacol Exp Ther. 1993 Nov;267(2):567-74.
- Bellomo R, Wunderink RG, Szerlip H, English SW, Busse LW, Deane AM, Khanna AK, McCurdy MT, Ostermann M, Young PJ, Handisides DR, Chawla LS, Tidmarsh GF, Albertson TE. Angiotensin I and angiotensin II concentrations and their ratio in catecholamine-resistant vasodilatory shock. Crit Care. 2020 Feb 6;24(1):43. doi: 10.1186/s13054-020-2733-x.
- Zhang W, Chen X, Huang L, Lu N, Zhou L, Wu G, Chen Y. Severe sepsis: Low expression of the renin-angiotensin system is associated with poor prognosis. Exp Ther Med. 2014 May;7(5):1342-1348. doi: 10.3892/etm.2014.1566. Epub 2014 Feb 20.
- Bellomo R, Forni LG, Busse LW, McCurdy MT, Ham KR, Boldt DW, Hastbacka J, Khanna AK, Albertson TE, Tumlin J, Storey K, Handisides D, Tidmarsh GF, Chawla LS, Ostermann M. Renin and Survival in Patients Given Angiotensin II for Catecholamine-Resistant Vasodilatory Shock. A Clinical Trial. Am J Respir Crit Care Med. 2020 Nov 1;202(9):1253-1261. doi: 10.1164/rccm.201911-2172OC.
- Prondzinsky R, Knupfer A, Loppnow H, Redling F, Lehmann DW, Stabenow I, Witthaut R, Unverzagt S, Radke J, Zerkowski HR, Werdan K. Surgical trauma affects the proinflammatory status after cardiac surgery to a higher degree than cardiopulmonary bypass. J Thorac Cardiovasc Surg. 2005 Apr;129(4):760-6. doi: 10.1016/j.jtcvs.2004.07.052.
- Hickey E, Karamlou T, You J, Ungerleider RM. Effects of circuit miniaturization in reducing inflammatory response to infant cardiopulmonary bypass by elimination of allogeneic blood products. Ann Thorac Surg. 2006 Jun;81(6):S2367-72. doi: 10.1016/j.athoracsur.2006.02.071.
- Leisman DE, Fernandes TD, Bijol V, Abraham MN, Lehman JR, Taylor MD, Capone C, Yaipan O, Bellomo R, Deutschman CS. Impaired angiotensin II type 1 receptor signaling contributes to sepsis-induced acute kidney injury. Kidney Int. 2021 Jan;99(1):148-160. doi: 10.1016/j.kint.2020.07.047. Epub 2020 Aug 31.
- Garcia B, Su F, Dewachter L, Favory R, Khaldi A, Moiroux-Sahraoui A, Annoni F, Vasques-Novoa F, Rocha-Oliveira E, Roncon-Albuquerque R Jr, Hubesch G, Njimi H, Vincent JL, Taccone FS, Creteur J, Herpain A. Myocardial effects of angiotensin II compared to norepinephrine in an animal model of septic shock. Crit Care. 2022 Sep 18;26(1):281. doi: 10.1186/s13054-022-04161-3.
- Khanna A, English SW, Wang XS, Ham K, Tumlin J, Szerlip H, Busse LW, Altaweel L, Albertson TE, Mackey C, McCurdy MT, Boldt DW, Chock S, Young PJ, Krell K, Wunderink RG, Ostermann M, Murugan R, Gong MN, Panwar R, Hastbacka J, Favory R, Venkatesh B, Thompson BT, Bellomo R, Jensen J, Kroll S, Chawla LS, Tidmarsh GF, Deane AM; ATHOS-3 Investigators. Angiotensin II for the Treatment of Vasodilatory Shock. N Engl J Med. 2017 Aug 3;377(5):419-430. doi: 10.1056/NEJMoa1704154. Epub 2017 May 21.
- Chawla LS, Busse L, Brasha-Mitchell E, Davison D, Honiq J, Alotaibi Z, Seneff MG. Intravenous angiotensin II for the treatment of high-output shock (ATHOS trial): a pilot study. Crit Care. 2014 Oct 6;18(5):534. doi: 10.1186/s13054-014-0534-9.
- Wieruszewski PM, Bellomo R, Busse LW, Ham KR, Zarbock A, Khanna AK, Deane AM, Ostermann M, Wunderink RG, Boldt DW, Kroll S, Greenfeld CR, Hodges T, Chow JH; Angiotensin II for the Treatment of High-Output Shock 3 (ATHOS-3) Investigators. Initiating angiotensin II at lower vasopressor doses in vasodilatory shock: an exploratory post-hoc analysis of the ATHOS-3 clinical trial. Crit Care. 2023 May 5;27(1):175. doi: 10.1186/s13054-023-04446-1.
- Smith SE, Newsome AS, Guo Y, Hecht J, McCurdy MT, Mazzeffi MA, Chow JH, Kethireddy S. A Multicenter Observational Cohort Study of Angiotensin II in Shock. J Intensive Care Med. 2022 Jan;37(1):75-82. doi: 10.1177/0885066620972943. Epub 2020 Nov 24.
- See EJ, Clapham C, Liu J, Khasin M, Liskaser G, Chan JW, Serpa Neto A, Costa Pinto R, Bellomo R. A PILOT STUDY OF ANGIOTENSIN II AS PRIMARY VASOPRESSOR IN CRITICALLY ILL ADULTS WITH VASODILATORY HYPOTENSION: THE ARAMIS STUDY. Shock. 2023 May 1;59(5):691-696. doi: 10.1097/SHK.0000000000002109. Epub 2023 Mar 18.
- Wieruszewski PM, Wittwer ED, Kashani KB, Brown DR, Butler SO, Clark AM, Cooper CJ, Davison DL, Gajic O, Gunnerson KJ, Tendler R, Mara KC, Barreto EF. Angiotensin II Infusion for Shock: A Multicenter Study of Postmarketing Use. Chest. 2021 Feb;159(2):596-605. doi: 10.1016/j.chest.2020.08.2074. Epub 2020 Aug 31.
- Coulson TG, Miles LF, Serpa Neto A, Pilcher D, Weinberg L, Landoni G, Zarbock A, Bellomo R. A double-blind randomised feasibility trial of angiotensin-2 in cardiac surgery. Anaesthesia. 2022 Sep;77(9):999-1009. doi: 10.1111/anae.15802.
- Coulson TG, Miles LF, Zarbock A, Burrell LM, Patel SK, von Groote T, Pilcher D, Weinberg L, Landoni G, Bellomo R. Renin-angiotensin-aldosterone system dynamics after targeted blood pressure control using angiotensin II or norepinephrine in cardiac surgery: mechanistic randomised controlled trial. Br J Anaesth. 2023 Oct;131(4):664-672. doi: 10.1016/j.bja.2023.06.056. Epub 2023 Jul 20.
- Wieruszewski PM, Seelhammer TG, Barreto EF, Busse LW, Chow JH, Davison DL, Gaglani B, Khanna AK, Ten Lohuis CC, Mara KC, Wittwer ED. Angiotensin II for Vasodilatory Hypotension in Patients Requiring Mechanical Circulatory Support. J Intensive Care Med. 2023 May;38(5):464-471. doi: 10.1177/08850666221145864. Epub 2022 Dec 15.
- Wan L, Langenberg C, Bellomo R, May CN. Angiotensin II in experimental hyperdynamic sepsis. Crit Care. 2009;13(6):R190. doi: 10.1186/cc8185. Epub 2009 Nov 30.
- Lankadeva YR, Kosaka J, Evans RG, Bellomo R, May CN. Urinary Oxygenation as a Surrogate Measure of Medullary Oxygenation During Angiotensin II Therapy in Septic Acute Kidney Injury. Crit Care Med. 2018 Jan;46(1):e41-e48. doi: 10.1097/CCM.0000000000002797.
- Gleeson PJ, Crippa IA, Mongkolpun W, Cavicchi FZ, Van Meerhaeghe T, Brimioulle S, Taccone FS, Vincent JL, Creteur J. Renin as a Marker of Tissue-Perfusion and Prognosis in Critically Ill Patients. Crit Care Med. 2019 Feb;47(2):152-158. doi: 10.1097/CCM.0000000000003544.
- Jeyaraju M, McCurdy MT, Levine AR, Devarajan P, Mazzeffi MA, Mullins KE, Reif M, Yim DN, Parrino C, Lankford AS, Chow JH. Renin Kinetics Are Superior to Lactate Kinetics for Predicting In-Hospital Mortality in Hypotensive Critically Ill Patients. Crit Care Med. 2022 Jan 1;50(1):50-60. doi: 10.1097/CCM.0000000000005143.
- Leisman DE, Handisides DR, Busse LW, Chappell MC, Chawla LS, Filbin MR, Goldberg MB, Ham KR, Khanna AK, Ostermann M, McCurdy MT, Adams CD, Hodges TN, Bellomo R; ATHOS-3 Investigators. ACE inhibitors and angiotensin receptor blockers differentially alter the response to angiotensin II treatment in vasodilatory shock. Crit Care. 2024 Apr 18;28(1):130. doi: 10.1186/s13054-024-04910-6.
- Lesnik P, Lysenko L, Krzystek-Korpacka M, Woznica-Niesobska E, Mierzchala-Pasierb M, Janc J. Renin as a Marker of Tissue Perfusion, Septic Shock and Mortality in Septic Patients: A Prospective Observational Study. Int J Mol Sci. 2022 Aug 15;23(16):9133. doi: 10.3390/ijms23169133.
- Chung KS, Song JH, Jung WJ, Kim YS, Kim SK, Chang J, Park MS. Implications of Plasma Renin Activity and Plasma Aldosterone Concentration in Critically Ill Patients with Septic Shock. Korean J Crit Care Med. 2017 May;32(2):142-153. doi: 10.4266/kjccm.2017.00094. Epub 2017 May 31.
- Nguyen M, Denimal D, Dargent A, Guinot PG, Duvillard L, Quenot JP, Bouhemad B. Plasma Renin Concentration is Associated With Hemodynamic Deficiency and Adverse Renal Outcome in Septic Shock. Shock. 2019 Oct;52(4):e22-e30. doi: 10.1097/SHK.0000000000001285.
- Stanski NL, Pode Shakked N, Zhang B, Cvijanovich NZ, Fitzgerald JC, Jain PN, Schwarz AJ, Nowak J, Weiss SL, Allen GL, Thomas NJ, Haileselassie B, Goldstein SL. Serum renin and prorenin concentrations predict severe persistent acute kidney injury and mortality in pediatric septic shock. Pediatr Nephrol. 2023 Sep;38(9):3099-3108. doi: 10.1007/s00467-023-05930-0. Epub 2023 Mar 20.
- Flannery AH, Ortiz-Soriano V, Li X, Gianella FG, Toto RD, Moe OW, Devarajan P, Goldstein SL, Neyra JA. Serum renin and major adverse kidney events in critically ill patients: a multicenter prospective study. Crit Care. 2021 Aug 14;25(1):294. doi: 10.1186/s13054-021-03725-z.
- Zelniker TA, Kaya Z, Gamerdinger E, Spaich S, Stiepak J, Giannitsis E, Katus HA, Preusch MR. Relationship between markers of inflammation and hemodynamic stress and death in patients with out-of-hospital cardiac arrest. Sci Rep. 2021 May 11;11(1):9954. doi: 10.1038/s41598-021-88474-3.
- Meersch M, Weiss R, Massoth C, Kullmar M, Saadat-Gilani K, Busen M, Chawla L, Landoni G, Bellomo R, Gerss J, Zarbock A. The Association Between Angiotensin II and Renin Kinetics in Patients After Cardiac Surgery. Anesth Analg. 2022 May 1;134(5):1002-1009. doi: 10.1213/ANE.0000000000005953.
- Kullmar M, Saadat-Gilani K, Weiss R, Massoth C, Lagan A, Cortes MN, Gerss J, Chawla LS, Fliser D, Meersch M, Zarbock A. Kinetic Changes of Plasma Renin Concentrations Predict Acute Kidney Injury in Cardiac Surgery Patients. Am J Respir Crit Care Med. 2021 May 1;203(9):1119-1126. doi: 10.1164/rccm.202005-2050OC.
- Eleuteri D, Montini L, Cutuli SL, Rossi C, Alcaro F, Antonelli M. Renin-angiotensin system dysregulation in critically ill patients with acute respiratory distress syndrome due to COVID-19: a preliminary report. Crit Care. 2021 Mar 1;25(1):91. doi: 10.1186/s13054-021-03507-7. No abstract available.
- Tumlin JA, Murugan R, Deane AM, Ostermann M, Busse LW, Ham KR, Kashani K, Szerlip HM, Prowle JR, Bihorac A, Finkel KW, Zarbock A, Forni LG, Lynch SJ, Jensen J, Kroll S, Chawla LS, Tidmarsh GF, Bellomo R; Angiotensin II for the Treatment of High-Output Shock 3 (ATHOS-3) Investigators. Outcomes in Patients with Vasodilatory Shock and Renal Replacement Therapy Treated with Intravenous Angiotensin II. Crit Care Med. 2018 Jun;46(6):949-957. doi: 10.1097/CCM.0000000000003092.
Datoer for undersøgelser
Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.
Studer store datoer
Studiestart (Faktiske)
1. august 2024
Primær færdiggørelse (Anslået)
1. juni 2027
Studieafslutning (Anslået)
1. september 2027
Datoer for studieregistrering
Først indsendt
1. august 2024
Først indsendt, der opfyldte QC-kriterier
1. august 2024
Først opslået (Faktiske)
6. august 2024
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
16. september 2026
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
12. september 2026
Sidst verificeret
1. september 2026
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
- UKC-MB-KME-33/24
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