Angiotensin II: a new approach for refractory shock management?

Patients with distributive shock still have a high mortality rate and remain an important issue for intensivists. Management of catecholamine-resistant shock in these patients poses a challenging problem. Despite significant advances in the knowledge of its pathophysiology, all innovative therapeutic approaches and interventions have failed to improve outcome. In the previous issue of Critical Care, Chawla and colleagues explored the impact of angiotensin II administration in patients with persistent hypotension despite adapted hemodynamic resuscitation. The authors demonstrate that, in case of distributive shock, angiotensin II is an effective vasopressor therapy. Its impact on outcome and adverse effects still needs to be further explored.