加護病房查房日誌(ICU notes)20170828
因為老師開始有日本的朋友，我應該要試著用英文寫一些東西(其實依該寫日文比較好，只是老師不會日文)。
(Due to Nippon friends, I should try to teach by English.)
今天來分享一個新的資訊，大家應該都知道angiotensin receptor blocker或是angiotensin-coenzyme inhibitors對吧?可以用來降血壓。但是今天要講的是angiotensin II，用來治療休克的血管收素劑。
(I will share a new study, you should know about angiotensin receptor blocker or angiotensin-coenzyme inhibitors, which can lower blood pressure. However, I will talk about angiotensin II as vasopressor for shock.)
有個隨機的臨床試驗研究angiotensin II的安全性和效果，作為血管收縮劑用在休克病人身上，大多是敗血性休克
(A randomized trial investigated the safety and efficacy of angiotensin II as a vasopressor agent for patients with vasodilatory (mostly septic) shock)
文獻來源(references): N Engl J Med. 2017;377(5):419. Epub 2017 May 21.
針對使用高劑量norepinephrine的病人，此研究比較加上angiotensin或安慰組。
(For patients receiving high-dose norepinephrine, the trial compared the addition of angiotensin or placebo.)
在並用angiotensin II這組的平均動脈壓比較高。
(The increase in mean arterial pressure (MAP) was greater in the angiotensin II group.)
此外，在angiotensin II這組的norepinephrine用量也比較少，而且在兩組的嚴重副作用並沒有差別。
(As well, less norepinephrine was required in the angiotensin II group and there was no difference in serious adverse events between the groups.)
不過在uptodate中提到，這樣的結果雖然振奮人心，但仍需要更多的研究來決定該藥品的角色。
(These results are encouraging, but further trials are indicated to determine the role of angiotensin II for the treatment of vasodilatory shock.)
ps: 我覺得九州大學找原文全文的功能不只比醫院好，也都比北醫快。
(ps: I think the speed of finding the full test is shorter than my hospital and tmu.)
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