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When All Else Fails: Novel Use of Angiotensin II for Vasodilatory Shock: A Case Report

Chow, Jonathan H. MD*; Galvagno, Samuel M. Jr DO, PhD*; Tanaka, Kenichi A. MD, MSc; Mazzeffi, Michael A. MD, MPH; Chancer, Zackary MD*; Henderson, Reney MD; McCurdy, Michael T. MD

doi: 10.1213/XAA.0000000000000775
Case Reports

Angiotensin (AT) II is an endogenous hormone that acts on venous and arterial smooth muscle to cause vasoconstriction. Recent trials have sparked great interest in its ability to be used as a vasopressor for catecholamine-refractory hypotension. Herein, we describe the successful use of AT II in a patient with a colonic perforation with septic shock refractory to conventional treatment. After AT II initiation, there was an immediate reduction in catecholamine requirement, and the patient survived.

From the Department of Anesthesiology, *Division of Critical Care Medicine

Division of Cardiovascular Anesthesiology, University of Maryland School of Medicine, Baltimore, Maryland

Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Maryland School of Medicine, Baltimore, Maryland.

Accepted for publication March 6, 2018.

Funding: None.

Conflicts of Interest: See Disclosures at the end of the article.

Address correspondence to Jonathan H. Chow, MD, Department of Anesthesiology, University of Maryland School of Medicine, 22 S Greene St, Suite S11D20, Baltimore, MD 21201. Address e-mail to

Copyright © 2018 International Anesthesia Research Society
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