Primjena angiotenzina II u distributivnom šoku

master's thesis

• Title (english): Angiotensin II in distributive shock
• Author: Katarina Grubišić
• Mentor: Ana Vujaklija Brajković (mentor)
• Committee member: Luka Bielen (predsjednik povjerenstva)
• Committee member: Ivana Vuković Brinar (član povjerenstva)
• Committee member: Ana Vujaklija Brajković (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; Zagreb
• Defense date and country: 2024-07-12, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Intensive Care

Abstract

Šok je životno ugrožavajuće stanje zatajenja cirkulacije koje je obilježeno
neprimjerenom dopremom ili iskorištavanjem kisika u tkivima, što dovodi do stanične
i tkivne hipoksije. Inicijalne promjene su reverzibilne, no u vrlo kratkom roku postaju
ireverzibilne i dovode do multiorganskog zatajenja i, u najgorim slučajevima, smrti.
Važno je što ranije započeti liječenje šoka kako bi se izbjegle ireverzibilne posljedice,
uz istovremeno traženje uzroka šoka, koje omogućuje primjenu ciljanog liječenja.
Distributivni šok je okarakteriziran teškom perifernom vazodilatacijom (sinonim mu je
vazodilatatorni šok). Najčešći uzroci distributivnog šoka su septički, anafilaktički i
neurogeni šok.
Liječenje distributivnog šoka trenutno se temelji na primjeni tekućine i vazopresora.
Adrenalin je vazopresor prve linije u anafilaktičkom šoku, a noradrenalin u septičkom
i neurogenom šoku. Angiotenzin II indiciran je za liječenje refraktorne hipotenzije u
odraslih bolesnika sa septičkim ili drugim distributivnim šokom koji su hipotenzivni
unatoč adekvatnoj nadoknadi volumena, primjeni kateholamina i vazopresina.
Europska agencija za lijekove je 2019. godine odobrila angiotenzin II. Klinička
istraživanja su pokazala da je učinak angiotenzina II na arterijski tlak usporediv s
učincima kateholamina, a obzirom na drugačiji mehanizam djelovanja moguća je
istovremena uporaba u refraktornom distributivnom šoku.

Abstract (english)

Shock is a life-threatening condition of circulatory failure characterized by inadequate
delivery or utilization of oxygen in tissues, leading to cellular and tissue hypoxia.
Initial changes are reversible, but in a very short time, they become irreversible and
lead to multi-organ failure and, in the worst cases, death. It is critical to initiate
treatment of shock as early as possible to avoid irreversible consequences while
simultaneously searching for the cause of shock to enable targeted treatment.
Distributive shock is characterized by severe peripheral vasodilation (its synonym is
vasodilatory shock). The most common causes of distributive shock are septic,
anaphylactic, and neurogenic shock.
The treatment of distributive shock currently relies on the administration of fluids and
vasopressors. Adrenaline is the first-line vasopressor in anaphylactic shock and
noradrenaline in septic and neurogenic shock. Angiotensin II is indicated for the
treatment of refractory hypotension in adult patients with septic or other distributive
shock who are hypotensive despite adequate volume resuscitation and the
administration of catecholamines and vasopressin. The European Medicines Agency
approved angiotensin II in 2019. Clinical studies have shown that the effect of
angiotensin II on arterial pressure is comparable to that of catecholamines, and given
its different mechanism of action, simultaneous use in refractory distributive shock is
possible.

• Keywords: šok; distributivni šok; angiotenzin II
• Keywords (english): shock; distributive shock; angiotensin II
• Language: croatian
• URN:NBN: urn:nbn:hr:105:269094
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2024-07-08 22:02:54