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Table 2 Blood pressure effect of Ang II versus other vasoactive medications

From: The effect of angiotensin II on blood pressure in patients with circulatory shock: a structured review of the literature

Author (year)

Total number of cases

BP effects directly associated with Ang II

Cases with combined effect (Ang II + other)

Disclosed effects in cases with combined medication (Ang II + other)

Del Greco (1961) [25]

20

17

3

All three patients with initial BP 0/0 (cardiac arrest). 2/3 had no ROSC with addition of NE 54–200 mcg/min. 1/3 had ROSC with addition of NE at unknown dose, resulting in BP 100/0.

Nassif (1963) [34]

14

14

0

-

Wedeena (1963) [35]

15

7

0

Data available for only the 7 who responded. In these 7, NE was discontinued before Ang II started.

Beanlands (1964) [36]

17

13

4

All 4 patients received concomitant EPI 2–4 mcg/min.

Udhojia (1964) [26]

12

6

0

Data only available for 6 patients in whom Ang II was used alone.

Belle (1965) [37]

1

1

0

Co-administered with metaraminol (unknown dose) with hypotension on metaraminol alone. BP rose as direct result of Ang II

Cohn (1965) [27]

6

6

0

3 of 6 patients received NE before Ang II dose but NE was turned off prior to Ang II administration.

Cohn (1965) [27]

22

22

0

-

Singh (1966) [28]

25

25

0

-

Wallace (1967) [29]

7

7

0

-

Sorensen (1986) [32]

8

8

0

-

Moore (1989) [33]

9

9

0

-

Geary (1990) [38]

1

1

0

-

Thacker (1990)

2

0

2

1 patient received PHENYL (unknown dose), NE 3 mcg/kg/min, an EPI bolus (unknown dose) and DOPA 5 mcg/kg/min plus Ang II. 1 patient received DOPA 5 mcg/kg/min, EPI 4 mcg/min, PHENYL (unknown dose), and NE 3mcg/kg/min plus Ang II.

Thomas (1991) [40]

1

1

0

Co-administered with DOPA 6 mcg/kg/min, dobutamine (unknown dose), and NE 17 mcg/kg/min, but BP effect seen only after Ang II administration.

Jackson (1993) [20]

1

1

0

Co-administered with DOPA 3 mcg/kg/min and EPI 0.02 mcg/kg/min, but BP only responded after administration of Ang II.

Trilli (1994) [21]

1

1

0

Co-administered with DOPA 20mcg/kg/min, dobutamine (unknown dose), and NE 14.5mcg/min, but upon initiation of Ang II NE dose declined to 7mcg/min.

Ryding (1995) [41]

1

1

0

Co-administered with DOPA 4 mcg/kg/min, dobutamine (unknown dose), and NE at 28mcg/min, which were all titrated off after administration of Ang II and amrinone (unknown dose).

Newby (1995) [22]

1

1

0

Co-administered with DOPA 2.5 mcg/kg/min and NE 1 mg bolus, but BP only responded after Ang II administration.

Wray (1995) [24]

1

1

0

Co-administered with NE 8.3 mcg/kg/min and DOPA (low unknown dose), but BP only responded after administration of Ang II.

Tovar (1997) [23]

1

1

0

Co-administered with DOPA 4.9 mcg/kg/min and NE 60 mcg/min. BP only responded to addition of Ang II, which caused DOPA and NE to be turned off, both of which had to be restarted with Ang II cessation.

Eyraud (1998) [30]

14

14

0

-

Chawla (2014) [10]

10

10

0

Co-administered with VASO 0.02–0.08 u/min and NE 7.3–7.4 mcg/min. NE dose fell from a baseline 19.8 mcg/min upon initiation of Ang II.

Khannab (2017) [11]

163

163

0

Co-administered with a NE equivalent of 0.45 mcg/kg/min ranging down to 0.4 mcg/kg/min during 3 hours of Ang II administration, with positive BP effect seen at 3 hours, per study protocol.

Total

353

330

9

 
  1. Ang II angiotensin II, BP blood pressure, ROSC return of spontaneous circulation, NE norepinephrine, EPI epinephrine, PHENYL phenylephrine, DOPA dopamine, VASO vasopressin
  2. aPatients from Wedeen et al. and 6 patents from Udhoji et al. were included in total number of patients who received Ang II for hypotension, but were not included in any quantitative analysis due to incomplete data. It cannot be determined whether these patients received Ang II alone
  3. bNE equivalence established a priori as part of ATHOS-3 protocol