Abstract
Two children with severe septic shock are reported. One had meningococcal septicaemia and the other Escherichia coli septicaemia. They remained hypotensive despite high concentrations of conventional inotropes and vasopressors. In one child, using a pulmonary artery catheter, extended haemodynamic variables were measured. To restore blood pressure, in both cases, an infusion of angiotensin II was used; there was significant improvement in clinical status, resulting in a rapid reduction in the concentration of inotropes required. Both patients successfully survived their septic episodes. Angiotensin II in cases of severe refractory septic hypotension in the paediatric population offers an extra therapeutic manoeuvre.
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- Goldman A. P., Kerr S. J., Butt W., Marsh M. J., Murdoch I. A., Paul T., Firmin R. K., Tasker R. C., Macrae D. J. Extracorporeal support for intractable cardiorespiratory failure due to meningococcal disease. Lancet. 1997 Feb 15;349(9050):466–469. doi: 10.1016/s0140-6736(96)12106-1. [DOI] [PubMed] [Google Scholar]
- Julou-Schaeffer G., Gray G. A., Fleming I., Schott C., Parratt J. R., Stoclet J. C. Loss of vascular responsiveness induced by endotoxin involves L-arginine pathway. Am J Physiol. 1990 Oct;259(4 Pt 2):H1038–H1043. doi: 10.1152/ajpheart.1990.259.4.H1038. [DOI] [PubMed] [Google Scholar]
- Schaller M. D., Waeber B., Nussberger J., Brunner H. R. Angiotensin II, vasopressin, and sympathetic activity in conscious rats with endotoxemia. Am J Physiol. 1985 Dec;249(6 Pt 2):H1086–H1092. doi: 10.1152/ajpheart.1985.249.6.H1086. [DOI] [PubMed] [Google Scholar]
- Wray G. M., Coakley J. H. Severe septic shock unresponsive to noradrenaline. Lancet. 1995 Dec 16;346(8990):1604–1604. doi: 10.1016/s0140-6736(95)91933-3. [DOI] [PubMed] [Google Scholar]