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Please use this identifier to cite or link to this item: https://hdl.handle.net/11055/1161
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dc.contributor.authorCoulson TGen_US
dc.contributor.authorMiles LFen_US
dc.contributor.authorSerpa Neto Aen_US
dc.contributor.authorPilcher Den_US
dc.contributor.authorWeinberg Len_US
dc.contributor.authorLandoni Gen_US
dc.contributor.authorZarbock Aen_US
dc.contributor.authorBellomo Ren_US
dc.date.accessioned2023-05-01T02:14:50Z-
dc.date.available2023-05-01T02:14:50Z-
dc.identifier.citation2022 Sep;77(9):999-1009en_US
dc.identifier.issn0003-2409en_US
dc.identifier.urihttps://hdl.handle.net/11055/1161-
dc.description.abstractAcute kidney injury is common after cardiac surgery. Vasoplegic hypotension may contribute to kidney injury, and different vasopressors may have variable effects on kidney function. We conducted a double-blind, randomised feasibility trial comparing peri-operative angiotensin-2 with noradrenaline. We randomly allocated 60 patients at two centres to a blinded equipotent angiotensin-2 or noradrenaline infusion intra-operatively and for up to 48 h postoperatively, titrated to mean arterial pressure of 70-80 mmHg. Primary feasibility outcomes included consent rate, protocol adherence, infusion duration, mean arterial pressure maintenance in the target range and major adverse outcomes. Secondary outcomes included kidney injury rate. The consent rate was 47%. Protocol adherence was 100% in the angiotensin-2 group and 94% in the noradrenaline group. Study drug duration was median (IQR [range]) 217 (160-270 [30-315]) vs. 185 (135-301 [0-480]) min (p = 0.78) min intra-operatively, and 5 (0-16 [0-48]) vs. 14.5 (4.8-29 [0-48]) hours (p = 0.075) postoperatively for angiotensin-2 and noradrenaline, respectively. The mean arterial pressure target was achieved postoperatively in 25 of 28 (89%) of the angiotensin-2 group and 27 of 32 (84%) of the noradrenaline group. One participant had a stroke, one required extracorporeal support and three required renal replacement therapy, all in the noradrenaline group (p = 0.99, p = 0.99 and p = 0.1). Acute kidney injury occurred in 7 of 28 in the angiotensin-2 group vs. 12 of 32 patients in the noradrenaline group (p = 0.31). This pilot study suggests that a trial comparing angiotensin-2 with noradrenaline is feasible. Its findings justify further investigations of angiotensin-2 in cardiac surgery.en_US
dc.subjectangiotensin-2en_US
dc.subjectcardiac surgeryen_US
dc.subjectkidney injuryen_US
dc.subjectnoradrenalineen_US
dc.subjectnorepinephrineen_US
dc.subjectrandomised controlled trialen_US
dc.subjectrenal dysfunctionen_US
dc.subjectrenal failureen_US
dc.titleA double-blind randomised feasibility trial of angiotensin-2 in cardiac surgeryen_US
dc.typeJournal Articleen_US
dc.type.contentTexten_US
dc.identifier.journaltitleAnaesthesiaen_US
dc.identifier.doi10.1111/anae.15802en_US
dc.description.affiliatesDepartment of Anaesthesiology and Peri-Operative Medicine, Monash University and Alfred Health, Melbourne, Australiaen_US
dc.description.affiliatesDepartment of Anaesthesia, Austin Health, Melbourne, Australiaen_US
dc.description.affiliatesAustralian and New Zealand Intensive Care Research Centre (ANZIC-RC), Monash University, Melbourne, Australiaen_US
dc.description.affiliatesDepartment of Intensive Care, Alfred Health, Melbourne, Australiaen_US
dc.description.affiliatesDepartment of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute and Vita-Salute San Raffaele University, Milan, Italy.en_US
dc.description.affiliatesDepartment of Anaesthesiology, Intensive Care and Pain Medicine, University Hospital Münster, Germanyen_US
dc.description.affiliatesDepartment of Intensive Care, Austin Health, Melbourne, Australiaen_US
dc.description.pubmedurihttps://pubmed.ncbi.nlm.nih.gov/35915923/en_US
dc.type.studyortrialPilot/Feasibility Studyen_US
dc.identifier.studynameAngiotensin-two for Reduction of Acute Kidney Injury after cardiac surgery - a pilot to determine feasibility of a definitive double blind randomised controlled trial: A-TRAK.en_US
dc.ispartof.anzcaresearchfoundationYesen_US
dc.type.specialtyAnaesthesiaen_US
dc.identifier.fulltextlinkhttps://doi.org/10.1111/anae.15802en_US
item.fulltextNo Fulltext-
item.grantfulltextnone-
item.cerifentitytypePublications-
item.openairetypeJournal Article-
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
Appears in Collections:Scholarly and Clinical
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