Patients experiencing vasoplegia, a type of distributive shock, have limited options when conventional vasopressors are not appropriate or sufficient. This is especially true for patients with cardiac dysfunction, whether after heart transplant or ventricular assist device (VAD) implantation. Angiotensin II has been used in various clinical settings for distributive shock; however, its role in patients after orthotopic heart transplant or VAD implantation is not well studied. We present two cases where angiotensin II played a vital role in correcting vasoplegia for critical cardiac patients.
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http://dx.doi.org/10.14797/mdcvj.576 | DOI Listing |
Cureus
November 2024
Department of Intensive Care Medicine, Centro Hospitalar Universitário de São João, Porto, PRT.
A 73-year-old man presented with nausea, abdominal discomfort, and distention persisting for the past five days. He had previously been diagnosed with stage III peripheral CD4+ T cell lymphoma and had initiated chemotherapy comprising vincristine two weeks prior to presentation. An evaluation revealed diffuse colon distention and pneumatosis intestinalis without mechanical obstruction, consistent with acute colonic pseudo-obstruction.
View Article and Find Full Text PDFJ Burn Care Res
December 2024
Regional One Health, Department of Pharmacy, Memphis, TN, USA.
Severe burn injury poses significant clinical challenges, often necessitating the use of vasoactive agents to maintain perfusion. This narrative review explores the current landscape of vasoactive agents in acute burn shock resuscitation and severe burn-injured patients who develop septic shock, with a particular focus on the potential role of the novel vasoactive agent, synthetic angiotensin-II (AT-II), in these settings. While catecholamines and vasopressin remain cornerstone therapies, adverse effects, variable patient response, and a new understanding of burn injury pathophysiology highlight the potentially evolving role of vasoactive agents in these clinical scenarios.
View Article and Find Full Text PDFCardiol Clin
February 2025
Division of Cardiology, Department of Internal Medicine, Lahey Hospital and Medical Center, 41 Mall Road, Burlington, MA 01805, USA; Department of Medicine (Research), Cardio-Oncology Program, Lahey Hospital and Medical Center, 41 Mall Road, Burlington, MA 01805, USA. Electronic address:
Cureus
October 2024
Internal Medicine, South Shore University Hospital, Bay Shore, USA.
Curr Opin Crit Care
December 2024
Department of Emergency Medicine Hennepin Healthcare.
Purpose Of Review: The aim of this study was to outline recent developments in calcium channel blocker (CCB) poisoning. The dihydropyridine CCB amlodipine is commonly prescribed in the United States, and amlodipine poisoning is increasing in frequency, presenting new challenges for clinicians because current paradigms of CCB poisoning management arose from literature on non-dihydropyridine agents.
Recent Findings: Amlodipine is now the most common CCB involved in poisoning.
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