Cardiology

Plasma renin activity

Dopamine

Internal medicine

Urology

Medicine

Norepinephrine

Cardiac surgery

Angiotensin II

Blood pressure

Surgery

Renin–angiotensin system

Cardiopulmonary bypass

Anesthesia

Anesthesia & Analgesia

BACKGROUND: Hyperreninemia after cardiac surgery is associated with cardiovascular instability. Angiotensin II (AT-II) could potentially attenuate hyperreninemia while maintaining target blood pressure. This study assesses the association between AT-II usage and renin levels in cardiac surgery patients with postoperative hyperreninemia and vasoplegia. METHODS: Between September 2020 and March 2021, we retrospectively identified 40 cardiac surgery patients with high Δ-renin levels (4 hours after cardiopulmonary bypass [CPB] minus preoperative levels) (defined as higher than 3.7 µU/mL) and vasopressor use who received a vasopressor therapy with either AT-II or continued norepinephrine alone. The primary outcome was the renin plasma level at 12 hours after surgery, adjusted by the renin plasma level at 4 hours after surgery. RESULTS: Overall, the median renin plasma concentration increased from a baseline with median of 44.3 µU/mL (Q1–Q3, 14.6–155.5) to 188.6 µU/mL (Q1–Q3, 29.8–379.0) 4 hours after CPB. High Δ-r...

The Association Between Angiotensin II and Renin Kinetics in Patients After Cardiac Surgery