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Critical care clinics · Apr 2019
ReviewClassic and Nonclassic Renin-Angiotensin Systems in the Critically Ill.
- Laurent Bitker and Louise M Burrell.
- Department of Intensive Care, ICU Research Office, Austin Hospital, 145 Studley Road, Heidelberg, Victoria 3084, Australia. Electronic address: laurent.bitker@austin.org.au.
- Crit Care Clin. 2019 Apr 1; 35 (2): 213227213-227.
AbstractClassic and nonclassic renin-angiotensin systems (RAS) are 2 sides of an ubiquitous endocrine/paracrine cascade regulating blood pressure and homeostasis. Angiotensin II and angiotensin-converting enzyme (ACE) levels are associated with severity of disease in the critically ill, and are central to the physiology and the pathogenesis of circulatory shock. Angiotensin (1-7) and ACE2 act as an endogenous counterregulatory arm to the angiotensin II/ACE axis. The tissue-based RAS has paracrine effects dissociated from those of the circulating RAS. Exogenous angiotensin II or ACE2 may improve the outcome of septic shock and acute respiratory distress syndrome, respectively.Copyright © 2018 Elsevier Inc. All rights reserved.
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