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Title: Angiotensin II - A Brief Review and Role in Severe SARS-COV-2 Sepsis.
Austin Authors: Carà, Gianmarco A;Pasin, Laura;Alborino, Ettore;Zarbock, Alexander;Bellomo, Rinaldo ;Landoni, Giovanni
Affiliation: Department of Critical Care, School of Medicine, The University of Melbourne, Melbourne, Victoria, Australia..
Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy..
Data Analytics Research and Evaluation (DARE) Centre
Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia..
Intensive Care
Department of Anesthesia and Intensive Care, Azienda Ospedale-Università di Padova, Padova, Italy..
Department of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Münster, Münster, Germany..
School of Medicine, Vita-Salute San Raffaele University, Milan, Italy..
Issue Date: 22-Jul-2022
Date: 2022
Publication information: Journal of Cardiothoracic and Vascular Anesthesia 2022; 36(12)
Abstract: The renin-angiotensin-aldosterone system (RAAS), whose major vasopressor effector is angiotensin II (ATII), has multiple activities and regulates sodium-water homeostasis and fluid and blood pressure homeostasis. RAAS plays a crucial role in cardiocirculatory shock because it counteracts hypotension and hypovolemia by activating different physiologic responses. Based on the encouraging results of the ATHOS-3 trial, the US Food and Drug Administration and the European Medicines Agency approved the use of ATII for catecholamine-resistant vasodilatory shock. More recently, ATII was used for the compassionate treatment of critically ill patients with COVID-19. Beyond its vasopressor properties, ATII was hypothesized to have antiviral activity because it induces internalization and degradation of angiotensin-converting enzyme 2 receptors used by SARS-Cov-2 to infect cells. Overall, the use of ATII in patients with COVID-19 showed promising results because its administration was associated with the achievement and maintenance of target mean arterial pressure, increased PaO2/FIO2 ratio, and decreased FIO2. The aim of this narrative review is to summarize the available knowledge on the use of ATII in patients with COVID-19.
DOI: 10.1053/j.jvca.2022.07.022
ORCID: 0000-0002-1650-8939
Journal: Journal of Cardiothoracic and Vascular Anesthesia
PubMed URL: 35995637
PubMed URL:
Type: Journal Article
Subjects: COVID-19
Appears in Collections:Journal articles

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