Cardiothoracic & vascular anesthesia
The Effects of Angiotensin II versus Norepinephrine on Pulmonary Vascular Resistance in Cardiac Surgery: Post Hoc Analysis of a Randomized Controlled Trial
Authors' conclusion
The results of this study suggest that in cardiac surgery patients and at doses used in the prior feasibility study, angiotensin II did not have significant effects on the pulmonary vasculature compared with norepinephrine. Moreover, at doses used in this study, neither drug appeared to have a substantial effect on the pulmonary circulation relative to surgical and patient factors.
Study context
- Population
- Adults undergoing cardiac surgery with CPB at elevated risk of acute kidney injury (AKI), 2 tertiary hospitals, Melbourne, Australia
- Participants
- 58 adults
- Comparison
- Angiotensin II vs norepinephrine infusion
- Primary endpoint
- Pulmonary vascular resistance (PVR), intraoperatively and postoperatively
Methodological detailspost hoc analysis, double-blinded, feasibility study, two-centre
- Post hoc analysis
- Double-blinded
- Feasibility study
- Two-centre
Primary result
As reported in the abstract
PVR · intraoperatively and postoperatively
- Study drug infusion rate associated with small increase in pulmonary vascular resistance (PVR) (β)
- 0.08; p = 0.01
- Strongest association with PVR: random (patient) effect
- p < 0.001
Secondary outcomes
| Outcome | β | P value |
|---|---|---|
| Mean systemic arterial to mean pulmonary arterial pressure ratio · postoperativelyReduced ratio with norepinephrine | −0.65 | P = 0.01 |
Secondary outcomes
- Patient effect consistent across secondary outcomes
Original publication
The Effects of Angiotensin II versus Norepinephrine on Pulmonary Vascular Resistance in Cardiac Surgery: Post Hoc Analysis of a Randomized Controlled Trial. J Cardiothorac Vasc Anesth. Published 3 October 2024. doi:10.
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