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Alternative Pharmacological Approaches for Septic Shock Management: Beyond Traditional Amine-Based...
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Alternative Pharmacological Approaches for Septic Shock Management: Beyond Traditional Amine-Based Therapies

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Pharmaceutical Science".

Deadline for manuscript submissions: 30 September 2024 | Viewed by 543

Special Issue Editors

Dr. Guglielmo Consales

E-Mail Website
Guest Editor
Department of Emergency and Critical Care, Section of Anesthesiology and Critical Care, Azienda USL Toscana Centro, Prato, Italy
Interests: sepsis; renal replacement therapy; ARDS
Dr. Iacopo Cappellini

E-Mail
Guest Editor
Department of Emergency and Critical Care, Section of Anesthesiology and Critical Care, Azienda USL Toscana Centro, Prato, Italy
Interests: sepsis; septic cardiomyopathy; ARDS; electrical impedance tomography

Special Issue Information

Dear Colleagues,

We are excited to announce the forthcoming Special Issue titled "Alternative Pharmacological Approaches for Septic Shock Management: Beyond Traditional Amine-Based Therapies". This issue aims to shed light on the innovative and emerging strategies in the management of septic shock, moving beyond the conventional reliance on amine-based treatments.

The Special Issue seeks contributions that delve into a variety of pharmacological interventions, each targeting different aspects of septic shock pathophysiology:

  1. Vasopressin Use and Vascular Tone: Manuscripts discussing the role of vasopressin in modulating vascular tone and reducing catecholamine requirements are highly encouraged.
  2. Beta Blockers in Septic Shock: We invite research on beta blockers like esmolol and landiolol, exploring their potential in reducing adrenergic stress and improving patient outcomes.
  3. Levosimendan for Septic Cardiomyopathy: Papers investigating the dual role of levosimendan as a myocardial contractility enhancer and vasodilator are sought after.
  4. Endocrine Support with Hydrocortisone and Levothyroxine: We are interested in articles that examine the use of hydrocortisone and levothyroxine in supporting compromised endocrine functions in septic shock.
  5. Methylene Blue in Nitric Oxide Modulation: Submissions exploring the role of methylene blue in managing vasoplegia and its impact on nitric oxide synthase are welcome.
  6. Angiotensin II as a Novel Vasopressor: We look forward to research on the use of angiotensin II in septic shock, especially its effects on the renin–angiotensin system and blood pressure management.

Our goal is to compile a comprehensive collection of articles that provide a detailed overview of these alternative treatments, discussing their mechanisms, clinical evidence, benefits and limitations. We believe that this Special Issue will be an invaluable resource for clinicians, researchers and students interested in the cutting-edge developments in septic shock management.

We encourage authors to submit their original research articles and reviews. This is an excellent opportunity to contribute to a critical field of medical research and share your insights with a global audience. Together, let us explore the frontiers of septic shock treatment and pave the way for improved patient outcomes.

Dr. Guglielmo Consales
Dr. Iacopo Cappellini
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Life is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • decatecholaminisation
  • non-amine-based therapy
  • beta blockers
  • hormone replacement
  • levosimendan
  • Angiotensin II
  • sepsis
  • septic shock
  • septic cardiomyopathy

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Published Papers (1 paper)

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13 pages, 3004 KiB  
Systematic Review
Clinical Outcomes of Angiotensin II Therapy in Vasoplegic Shock: A Systematic Review and Meta-Analysis
by Ans Alamami, Alaa Rahhal, Bara Alqudah, Ahmed Shebani, Abdelkarim Alammora, Hashim Mohammad, Amr S. Omar and Ahmed Labib Shehatta
Life 2024, 14(9), 1085; https://doi.org/10.3390/life14091085 (registering DOI) - 29 Aug 2024
Viewed by 181
Abstract
Background: Angiotensin II is a peptide hormone vasopressor that activates angiotensin type 1 (AT1) receptors leading to vasoconstriction, the augmentation of arterial blood pressure (ABP), and organ perfusion. Angiotensin II was found to increase the ABP in catecholamine-refractory vasodilatory shock. Whether this effect [...] Read more.
Background: Angiotensin II is a peptide hormone vasopressor that activates angiotensin type 1 (AT1) receptors leading to vasoconstriction, the augmentation of arterial blood pressure (ABP), and organ perfusion. Angiotensin II was found to increase the ABP in catecholamine-refractory vasodilatory shock. Whether this effect improves the chances of survival or not remains inconclusive. Therefore, we conducted a systematic review and meta-analysis to evaluate the efficacy and safety of angiotensin II in vasoplegic shock. Objectives: To evaluate the clinical significance of angiotensin II effects in vasoplegic shock concerning the hemodynamic impact, mortality outcomes, and side effects. Methods: Following PRISMA guidelines, we searched PubMed and EMBASE for experimental and observational studies published in English exploring the clinical outcomes of angiotensin II use in vasodilatory shock till 1 July 2024. Two independent authors assessed the quality and risk of bias of the included studies. A random effect model (Mantel–Haenszel) was used to combine data. The primary outcome was in-hospital mortality associated with angiotensin II use in comparison to standard therapy, while the secondary outcomes were mean arterial pressure (MAP) change, multi-organ failure (MOF), and the incidence of atrial fibrillation (AF). The Q test and I2 were used to examine heterogeneity, with I2 > 50% indicating marked heterogeneity. Results: A total of eight studies (n = 974) comparing angiotensin II to standard therapy in vasoplegic shock were included in the systematic review, with three studies comprising 461 patients included in the final analysis of the primary outcome. Only one study evaluated the use of angiotensin II as a primary vasopressor, while the rest reported angiotensin II use in catecholamine-refractory vasodilatory shock. Overall, angiotensin II use was associated with similar in-hospital mortality compared to standard therapy (risk ratio [RR] = 0.83; 95% CI, 0.68–1.02, I2 = 0%). Likewise, there was no difference in MOF and AF (MOF: RR = 1.01; 95% CI, 0.61–1.65, I2 = 0%; AF: RR = 1.27; 95% CI, 0.38–4.23, I2 = 5%). However, angiotensin II use demonstrated a significant MAP increase (mean difference = −9.60; 95% CI, −9.71, −9.49, I2 = 0%). Conclusions: In vasodilatory shock, angiotensin II use demonstrated comparable in-hospital mortality compared to standard therapy. Nevertheless, it resulted in significant MAP change, which may encourage clinicians to use it in cases of profound hypotension. Full article
(This article belongs to the Special Issue Alternative Pharmacological Approaches for Septic Shock Management: Beyond Traditional Amine-Based Therapies)
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