• Bruno Garcia, Fuhong Su, Laurence Dewachter, Raphaël Favory, Amina Khaldi, Alexander Moiroux-Sahraoui, Filippo Annoni, Francisco Vasques-Nóvoa, Estela Rocha-Oliveira, Roberto Roncon-Albuquerque, Geraldine Hubesch, Hassane Njimi, Jean-Louis Vincent, Fabio S Taccone, Jacques Creteur, and Antoine Herpain.
• Experimental Laboratory of Intensive Care, Université Libre de Bruxelles, Brussels, Belgium. br.garcia@icloud.com.
• Crit Care. 2022 Sep 18; 26 (1): 281281.

BackgroundAngiotensin II is one of the vasopressors available for use in septic shock. However, its effects on the septic myocardium remain unclear. The aim of the study was to compare the effects of angiotensin II and norepinephrine on cardiac function and myocardial oxygen consumption, inflammation and injury in experimental septic shock.MethodsThis randomized, open-label, controlled study was performed in 20 anesthetized and mechanically ventilated pigs. Septic shock was induced by fecal peritonitis in 16 animals, and four pigs served as shams. Resuscitation with fluids, antimicrobial therapy and abdominal drainage was initiated one hour after the onset of septic shock. Septic pigs were randomly allocated to receive one of the two drugs to maintain mean arterial pressure between 65 and 75 mmHg for 8 h.ResultsThere were no differences in MAP, cardiac output, heart rate, fluid balance or tissue perfusion indices in the two treatment groups but myocardial oxygen consumption was greater in the norepinephrine-treated animals. Myocardial mRNA expression of interleukin-6, interleukin-6 receptor, interleukin-1 alpha, and interleukin-1 beta was higher in the norepinephrine than in the angiotensin II group.ConclusionsIn septic shock, angiotensin II administration is associated with a similar level of cardiovascular resuscitation and less myocardial oxygen consumption, and inflammation compared to norepinephrine.© 2022. The Author(s).

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