Hemodynamic Response to Angiotensin-II When Used as the Second Vasopressor Agent for Septic Shock

Launched by KINGMAN REGIONAL MEDICAL CENTER · Nov 3, 2023

Keywords

ClinConnect Summary

This clinical trial is investigating the effects of angiotensin-II, a medication used as a second treatment for patients experiencing septic shock, a serious condition caused by infections that can lead to dangerously low blood pressure. The study aims to determine how effective angiotensin-II is when added to norepinephrine, which is the primary medication used to help raise blood pressure. Researchers believe that starting angiotensin-II earlier may be more beneficial, but they want to gather more data to understand how and when to use it best.

To be eligible for this trial, patients must be 18 years or older and have been admitted to the intensive care unit (ICU) within 12 hours of arriving at the emergency department with septic shock. They should be receiving norepinephrine to help manage their blood pressure but still need additional support. Participants can expect to receive careful monitoring and follow-up during the study. It’s important to note that those with certain conditions, such as significant bleeding issues or those requiring higher doses of norepinephrine, would not be able to participate.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Patients admitted to the ICU within 12 hours of presentation to the emergency department for septic shock requiring 15-25 mcg/min of norepinephrine. Septic shock will be defined as having a known or presumed infection with two or more criteria of systemic inflammatory response syndrome, a mean arterial pressure \<65 mm Hg despite fluid resuscitation requiring vasopressor support, and a serum lactate \>2 mmol/L. Criteria of systemic inflammatory response syndrome include a temperature \>100.4°F or \<96.8°F; heart rate \>90/min; respiratory rate \>20/min and a white blood cell count \>12,000/mm3 or \<4,000/mm3.
• Exclusion Criteria:
• • Age \<18 years
• • Pregnancy or lactation
• • Known allergic reactions to angiotensin-II or hydrocortisone sodium succinate
• • Requiring \>25 mcg/min of norepinephrine or on any vasopressor other than norepinephrine at study enrollment
• • Clinically significant bleeding precluding the use of chemical prophylaxis for venous thromboembolism
• • Treatment with another investigational drug or other intervention during study timeframe