Using angiotensin II to treat septic shock in the emergency department

ANGIOtensin II for Septic Shock in the Emergency Department: ANGIO-ED Study

This study is testing if giving angiotensin II can help people in septic shock maintain their blood pressure better in the emergency department.

Quick facts

• Phase: PHASE4
• Study type: Interventional
• Enrollment: 20 (estimated)
• Ages: 18 Years to 99 Years
• Sex: All
• Sponsor: University of Iowa (other)
• Locations: 1 site (Iowa City, Iowa)
• Trial ID: NCT06693726 on ClinicalTrials.gov

What this trial studies

This pilot study aims to enroll 20 patients experiencing septic shock who require emergency vasopressor support. Participants will receive an intravenous infusion of angiotensin II for blood pressure support, with their response monitored over a 60-minute period. The primary goal is to assess the feasibility of this treatment approach in the emergency department setting, particularly looking for reductions in norepinephrine dosage and improvements in mean arterial pressure. The study will help determine if early administration of angiotensin II can effectively support blood pressure in these critically ill patients.

Who should consider this trial

Good fit: Ideal candidates are adults aged 18 and older who require norepinephrine support despite adequate fluid resuscitation.

Not a fit: Patients with acute coronary syndrome, cardiogenic shock, or those with a very limited life expectancy may not benefit from this study.

Why it matters

Potential benefit: If successful, this treatment could provide a new option for managing septic shock in emergency settings, potentially improving patient outcomes.

How similar studies have performed: While this approach is novel in the emergency department context, similar studies have explored angiotensin II's efficacy in other settings, showing promising results.

Eligibility criteria

Inclusion Criteria

1. Age ≥18; and
2. Requiring norepinephrine at a dose of 0.05-0.25 mcg/kg/min mcg/kg/minute despite adequate fluid resuscitation; and
3. Receiving intravenous antibiotics or clinician's intention to administer antibiotics at the time of enrollment; and
4. Can provide written informed consent (or legally authorized representative).

Exclusion Criteria

1. Acute coronary syndrome;
2. Cardiogenic shock;
3. Patients with a history of mesenteric ischemia;
4. Patients with a history of having an aortic dissection or abdominal aortic aneurysm;
5. Patients with an expected lifespan of \<12 hours;
6. Patients with hemorrhagic shock (e.g., actively receiving transfusion of packed red blood cells);
7. Active administration of two vasoactive agents before enrollment; and
8. Pre-existing thromboembolic disease or inability to tolerate pharmacologic VTE prophylaxis.

Where this trial is running

Iowa City, Iowa

• University of Iowa Hospitals and Clinics — Iowa City, Iowa, United States (RECRUITING)

Study contacts

• Study coordinator: Brett Faine, PharmD

Conditions: Septic Shock, Angiotensin II