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Angiotensin II for the Treatment of Vasodilatory Shock

Angiotensin II for the Treatment of Vasodilatory Shock

Abstract

Visodilatory shock which doesn’t respond to a relatively high dose vasopressors is usually associated with significantly high mortality rates (Dellinger, Levy, Rhodes, 2012). An investigation is done on the effectiveness of angiotensin II in treating patients with such a condition.

Introduction

Shock is a syndrome that is significantly life threatening and is majorly characterized by the decreased organ perfusion which is likely to progress to organ failure that is irreversible. The vasodilatory shock is a type of shock that is most common and is usually characterized by a reduction in blood pressure despite the cardiac output that’s preserved and peripheral vasodilation. The research question is whether angiotensin II responds effectively to the treatment of patients with vasodilatory shock. The variables of interest include blood pressure, ml per kilogram of weight and time. Blood pressure is the pressure at which blood flows in the circulatory system.

Method

The sample size was 344 patients. The methods and procedures were described hence the study could be replicated without the need for any further information. Patients with vasodilatory shock who were receiving 0.2 micrograms of norepinephrine per kilogram of body weight per minute. The primary end point is the response with respect to mean arterial pressure at hour three after the start of infusion, the response is defined as an increase from baseline of at least 10 mm Hg without an increase in the dose of background vasopressors. I wouldn’t replicate this study.

Participants

The participants were all patients suffering from vasodilatory shock, however, when conducting the study they were selected randomly and hence there wasn’t any biasness during sampling. The samples were appropriate for the population in which the researcher wished to generalize. One characteristic of the sample population is that all were suffering from vasodilatory shock and they were 18 years of age or older.

Research Design

The study was conducted under a special protocol assessment agreement with the U.S. Trial data was collected by the investigators through the assistance of a contract research organization and were analysed by the sponsor. The study weight was provided by an independent data and monitoring board. The writing committee included the investigators and representatives of the sponsor, drafted the manuscript and vouch for the accuracy and completeness of data and analyses with manuscript revisions.

There was no control group.

Measures

Blood presser was dependent of the dose of vasopressors in micrograms per body weight and also doses of angiotensin II. Blood pressure was dependent of these drugs since after angiotensin was administered blood pressure found to increase effectively in the patients with vasodilatory shock. The instruments were accurate and hence were reliable. The validity and reliability of the data justifies the measure. The measures are appropriate since they give desired results. Inter-rater agreement was reliable since collection and analysis of data was not done by on body. It was a collaboration of different individuals including the investigators, representatives of the sponsor and a research organization.

Variables and Data Analysis

The dependent variables were the blood pressure and the dosage. The dependent variable was time. Tests of significance were done with the SAS analysis software with a 95% confidence interval. The researchers however do not report the means and standard deviation as they do not have much meaning to the study.

In the conclusion angiotensin II was found to efficiently increase the blood pressure in patients with vasodilatory shock that did not respond to the high doses of conventional vasopressors. This conclusion is useful as it proves our hypothesis to be true. One of the strengths of the study is that the tests conducted produced the desired results and hence broadened the knowledge the matter. One of the limitations is that it put some patient at risk since through inducing certain doses some had a high risk of getting a heart attack. I learnt that angiotensin II can be used in the effective treatment of vasodilatory shock (The England Journal of Medicine, 2017).

References

Dellinger RP, Levy MM, Rhodes A, et al (2012). Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock. Intensive Care Med 2013;39:165-228

The England Journal of Medicine, (2017). Angiotensin II for the Treatment of Vasodilatory Shock. Retrieved from: http://www.nejm.org/doi/full/10.1056/NEJMoa1704154#t=references