血管紧张素II用于近乎溺水：病例系列
Angiotensin II for Near Drowning: A Case Series.
作者信息
Smith Susan E, Butler Sydney A, Martin Joshua, Gerard Daniel, Sikora Newsome Andrea
机构信息
Department of Clinical and Administrative Pharmacy, University of Georgia College of Pharmacy, Athens, GA.
McLaren Medical Group Critical Care/Intensivist Service, McLaren Northern Michigan, Petoskey, MI.
出版信息
Crit Care Explor. 2021 May 21;3(5):e0434. doi: 10.1097/CCE.0000000000000434. eCollection 2021 May.
UNLABELLED
This case series describes the effect of angiotensin II administration on hemodynamics in patients with parenchymal lung injury due to submersion injury.
CASE SUMMARY
A 33-year-old female and a 72-year-old female were both brought to the emergency department after incidents of near drowning. Upon arrival to the emergency department, both patients were hemodynamically unstable and were eventually intubated for airway protection. Imaging done by conventional chest radiograph for both patients revealed bilateral pulmonary edema. Due to their hemodynamic status, vasopressors were initiated for both patients and were quickly titrated, leading to the initiation of angiotensin II. In one patient, angiotensin II was initiated early in shock and resulted in rapid improvement of hemodynamics. In the other patient, angiotensin II was initiated later and a more muted response was observed.
CONCLUSIONS
In patients with near drowning, angiotensin II appeared to improve hemodynamic status rapidly. This is the first case series to report the use of this new vasoactive agent in this population and poses noteworthy mechanistic considerations.
未标注
本病例系列描述了血管紧张素 II 给药对因溺水伤导致实质性肺损伤患者血流动力学的影响。
病例摘要
一名 33 岁女性和一名 72 岁女性在发生近乎溺水事件后均被送往急诊科。到达急诊科时，两名患者血流动力学均不稳定，最终均因气道保护而行气管插管。两名患者通过传统胸部 X 光片进行的影像学检查均显示双侧肺水肿。由于其血流动力学状态，两名患者均开始使用血管升压药并迅速调整剂量，随后开始使用血管紧张素 II。在一名患者中，血管紧张素 II 在休克早期开始使用，血流动力学迅速改善。在另一名患者中，血管紧张素 II 使用较晚，观察到的反应较为微弱。
结论
在近乎溺水的患者中，血管紧张素 II 似乎能迅速改善血流动力学状态。这是首个报告在该人群中使用这种新型血管活性药物的病例系列，并提出了值得注意的机制方面的考虑。
Zotero 插件