The renin–angiotensin–aldosterone-system in sepsis and its clinical modulation with exogenous angiotensin II
Matthieu Legrand, Ashish K. Khanna, Marlies Ostermann, Yuki Kotani, Ricard Ferrer, Massimo Girardis, Marc Léone, Gennaro DePascale, Peter Pickkers, Pierre Tissières, Filippo Annoni, Katarzyna Kotfis, Giovanni Landoni, Alexander Zarbock, Patrick M. Wieruszewski, Daniel De Backer, Jean‐Louis Vincent, Rinaldo Bellomo
Abstract
Dysregulation of the renin-angiotensin-aldosterone-system (RAAS) in sepsis is a complex and early phenomenon with a likely significant contribution to organ failure and patient outcomes. A better understanding of the pathophysiology and intricacies of the RAAS in septic shock has led to the use of exogenous angiotensin II as a new therapeutic agent. In this review, we report a multinational and multi-disciplinary expert panel discussion on the role and implications of RAAS modulation in sepsis and the use of exogenous angiotensin II. The panel proposed guidance regarding patient selection and treatment options with exogenous angiotensin II which should trigger further research.