Trajectory of PaO 2 /FiO 2 Ratio in Shock After Angiotensin II

High-dose catecholamines can impair hypoxic pulmonary vasoconstriction and increase shunt fraction. We aimed to determine if Angiotensin II (Ang-2) is associated with improved PaO /FiO and SpO /FiO in patients in shock. Adult patients at four tertiary care centers and one community hospital in the U...

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Published in:Journal of intensive care medicine 2023-05, p.8850666231174870
Main Authors: Wieruszewski, Patrick M, Coleman, Patrick J, Levine, Andrea R, Davison, Danielle, Smischney, Nathan J, Kethireddy, Shravan, Guo, Yanglin, Hecht, Jason, Mazzeffi, Michael A, Chow, Jonathan H
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Language:English
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Summary:High-dose catecholamines can impair hypoxic pulmonary vasoconstriction and increase shunt fraction. We aimed to determine if Angiotensin II (Ang-2) is associated with improved PaO /FiO and SpO /FiO in patients in shock. Adult patients at four tertiary care centers and one community hospital in the United States who received Ang-2 from July 2018-September 2020 were included in this retrospective, observational cohort study. PaO , SpO , and FiO were measured at 13 timepoints during the 48-h before and after Ang-2 initiation. Piecewise linear mixed models of PaO /FiO and SpO /FiO were created to evaluate hourly changes in oxygenation after Ang-2 initiation. The difference in the proportion of patients with PaO /FiO  ≤ 300 mm Hg at the time of Ang-2 initiation and 48 h after was also examined. The study included 254 patients. In the 48 h prior to Ang-2 initiation, oxygenation was significantly declining (hourly PaO /FiO change -4.7 mm Hg/hr, 95% CI - 6.0 to -3.5,  
ISSN:1525-1489