Running head: CRITICAL ANALYSIS OF RESSEARCH ARTICLE 1 CRITICAL ANALYSIS OF RESSEARCH ARTICLE 2 Angiotensin II for the Treatment of Vasodilatory Shock Angiotensin II for the Treatment of Vasodilatory Shock Abstract Visodilatory shock which doesn’t respond to a relatively high dose vasopressors is usually associated with significantly high mortality rates (Dellinger, Levy, Rhodes, 2012). An investigation is done on the effectiveness of angiotensin II in treating patients with such a condition. Introduction Shock is a syndrome that is significantly life threatening and is majorly characterized by the decreased organ perfusion which is likely to progress to organ failure that is irreversible. The vasodilatory shock is a type of shock that is most common and is usually characterized by a reduction in blood pressure despite the cardiac output that’s preserved and peripheral vasodilation. The research question is whether angiotensin II responds effectively to the treatment of patients with vasodilatory shock. The variables of interest include blood pressure, ml per kilogram of weight and time. Blood pressure is the pressure at which blood flows in the circulatory system. Method The sample size was 344 patients. The methods and procedures were described hence the study could be replicated without the need for any further information. Patients with vasodilatory shock who were receiving 0.2 micrograms of norepinephrine per kilogram of body weight per minute. The primary end point is the response with respect to mean arterial pressure at hour three after the start of infusion, the response is defined as an increase from baseline of at least 10 mm Hg without an increase in the dose of background vasopressors. I wouldn’t replicate this study. Participants The participants were all patients suffering from vasodilatory shock, however, when conducting the study they were selected randomly and hence there wasn’t any biasness during sampling. The samples were appropriate for the population in which the researcher wished to generalize. One characteristic of the sample population is that all were suffering from vasodilatory shock and they were 18 years of age or older. Research Design The study was conducted under a special protocol assessment agreement with the U.S. Trial data was collected by the investigators through the assistance of a contract research organization and were analysed by the sponsor. The study weight was provided by an independent data and monitoring board. The writing committee included the investigators and representatives of the sponsor, drafted the manuscript and vouch for the accuracy and completeness of data and analyses with manuscript revisions. There was no control group. Measures Blood presser was dependent of the dose of vasopressors in micrograms per body weight and also doses of angiotensin II. Blood pressure was dependent of these drugs since after angiotensin was administered blood pressure found to increase ...

1. Running head: CRITICAL ANALYSIS OF RESSEARCH
ARTICLE
1
CRITICAL ANALYSIS OF RESSEARCH ARTICLE
2
Angiotensin II for the Treatment of Vasodilatory Shock
Angiotensin II for the Treatment of Vasodilatory Shock
Abstract
Visodilatory shock which doesn’t respond to a relatively high
dose vasopressors is usually associated with significantly high
mortality rates (Dellinger, Levy, Rhodes, 2012). An
investigation is done on the effectiveness of angiotensin II in
treating patients with such a condition.
Introduction
Shock is a syndrome that is significantly life threatening and is
majorly characterized by the decreased organ perfusion which is
likely to progress to organ failure that is irreversible. The
vasodilatory shock is a type of shock that is most common and
is usually characterized by a reduction in blood pressure despite
the cardiac output that’s preserved and peripheral vasodilation.
The research question is whether angiotensin II responds
effectively to the treatment of patients with vasodilatory shock.
The variables of interest include blood pressure, ml per
kilogram of weight and time. Blood pressure is the pressure at
which blood flows in the circulatory system.
Method
The sample size was 344 patients. The methods and procedures

2. were described hence the study could be replicated without the
need for any further information. Patients with vasodilatory
shock who were receiving 0.2 micrograms of norepinephrine per
kilogram of body weight per minute. The primary end point is
the response with respect to mean arterial pressure at hour three
after the start of infusion, the response is defined as an increase
from baseline of at least 10 mm Hg without an increase in the
dose of background vasopressors. I wouldn’t replicate this
study.
Participants
The participants were all patients suffering from vasodilatory
shock, however, when conducting the study they were selected
randomly and hence there wasn’t any biasness during sampling.
The samples were appropriate for the population in which the
researcher wished to generalize. One characteristic of the
sample population is that all were suffering from vasodilatory
shock and they were 18 years of age or older.
Research Design
The study was conducted under a special protocol assessment
agreement with the U.S. Trial data was collected by the
investigators through the assistance of a contract research
organization and were analysed by the sponsor. The study
weight was provided by an independent data and monitoring
board. The writing committee included the investigators and
representatives of the sponsor, drafted the manuscript and vouch
for the accuracy and completeness of data and analyses with
manuscript revisions.
There was no control group.
Measures

3. Blood presser was dependent of the dose of vasopressors in
micrograms per body weight and also doses of angiotensin II.
Blood pressure was dependent of these drugs since after
angiotensin was administered blood pressure found to increase
effectively in the patients with vasodilatory shock. The
instruments were accurate and hence were reliable. The validity
and reliability of the data justifies the measure. The measures
are appropriate since they give desired results. Inter-rater
agreement was reliable since collection and analysis of data was
not done by on body. It was a collaboration of different
individuals including the investigators, representatives of the
sponsor and a research organization.
Variables and Data Analysis
The dependent variables were the blood pressure and the
dosage. The dependent variable was time. Tests of significance
were done with the SAS analysis software with a 95%
confidence interval. The researchers however do not report the
means and standard deviation as they do not have much meaning
to the study.
In the conclusion angiotensin II was found to efficiently
increase the blood pressure in patients with vasodilatory shock
that did not respond to the high doses of conventional
vasopressors. This conclusion is useful as it proves our
hypothesis to be true. One of the strengths of the study is that
the tests conducted produced the desired results and hence
broadened the knowledge the matter. One of the limitations is
that it put some patient at risk since through inducing certain
doses some had a high risk of getting a heart attack. I learnt that
angiotensin II can be used in the effective treatment of
vasodilatory shock (The England Journal of Medicine, 2017).
References

4. Dellinger RP, Levy MM, Rhodes A, et al (2012). Surviving
Sepsis Campaign: international guidelines for management of
severe sepsis and septic shock. Intensive Care Med
2013;39:165-228
The England Journal of Medicine, (2017). Angiotensin II for the
Treatment of Vasodilatory Shock. Retrieved from:
http://www.nejm.org/doi/full/10.1056/NEJMoa1704154#t=refere
nces
Running head: CRITICAL ANALYSIS OF RESSEARCH
ARTICLE
1
CRITICAL ANALYSIS OF RESSEARCH ARTICLE
2
Angiotensin II for the Treatment of Vasodilatory Shock
Angiotensin II for the Treatment of Vasodilatory Shock
Abstract
Visodilatory shock which doesn’t respond to a relatively high
dose vasopressors is usually associated with significantly high
mortality rates (Dellinger, Levy, Rhodes, 2012). An
investigation is done on the effectiveness of angiotensin II in
treating patients with such a condition.
Introduction
Shock is a syndrome that is significantly life threatening and is
majorly characterized by the decreased organ perfusion which is
likely to progress to organ failure that is irreversible. The
vasodilatory shock is a type of shock that is most common and
is usually characterized by a reduction in blood pressure despite
the cardiac output that’s preserved and peripheral vasodilation.
The research question is whether angiotensin II responds

5. effectively to the treatment of patients with vasodilatory shock.
The variables of interest include blood pressure, ml per
kilogram of weight and time. Blood pressure is the pressure at
which blood flows in the circulatory system.
Method
The sample size was 344 patients. The methods and procedures
were described hence the study could be replicated without the
need for any further information. Patients with vasodilatory
shock who were receiving 0.2 micrograms of norepinephrine per
kilogram of body weight per minute. The primary end point is
the response with respect to mean arterial pressure at hour three
after the start of infusion, the response is defined as an increase
from baseline of at least 10 mm Hg without an increase in the
dose of background vasopressors. I wouldn’t replicate this
study.
Participants
The participants were all patients suffering from vasodilatory
shock, however, when conducting the study they were selected
randomly and hence there wasn’t any biasness during sampling.
The samples were appropriate for the population in which the
researcher wished to generalize. One characteristic of the
sample population is that all were suffering from vasodilatory
shock and they were 18 years of age or older.
Research Design
The study was conducted under a special protocol assessment
agreement with the U.S. Trial data was collected by the
investigators through the assistance of a contract research
organization and were analysed by the sponsor. The study
weight was provided by an independent data and monitoring
board. The writing committee included the investigators and

6. representatives of the sponsor, drafted the manuscript and vouch
for the accuracy and completeness of data and analyses with
manuscript revisions.
There was no control group.
Measures
Blood presser was dependent of the dose of vasopressors in
micrograms per body weight and also doses of angiotensin II.
Blood pressure was dependent of these drugs since after
angiotensin was administered blood pressure found to increase
effectively in the patients with vasodilatory shock. The
instruments were accurate and hence were reliable. The validity
and reliability of the data justifies the measure. The measures
are appropriate since they give desired results. Inter-rater
agreement was reliable since collection and analysis of data was
not done by on body. It was a collaboration of different
individuals including the investigators, representatives of the
sponsor and a research organization.
Variables and Data Analysis
The dependent variables were the blood pressure and the
dosage. The dependent variable was time. Tests of significance
were done with the SAS analysis software with a 95%
confidence interval. The researchers however do not report the
means and standard deviation as they do not have much meaning
to the study.
In the conclusion angiotensin II was found to efficiently
increase the blood pressure in patients with vasodilatory shock
that did not respond to the high doses of conventional
vasopressors. This conclusion is useful as it proves our
hypothesis to be true. One of the strengths of the study is that

7. the tests conducted produced the desired results and hence
broadened the knowledge the matter. One of the limitations is
that it put some patient at risk since through inducing certain
doses some had a high risk of getting a heart attack. I learnt that
angiotensin II can be used in the effective treatment of
vasodilatory shock (The England Journal of Medicine, 2017).
References
Dellinger RP, Levy MM, Rhodes A, et al (2012). Surviving
Sepsis Campaign: international guidelines for management of
severe sepsis and septic shock. Intensive Care Med
2013;39:165-228
The England Journal of Medicine, (2017). Angiotensin II for the
Treatment of Vasodilatory Shock. Retrieved from:
http://www.nejm.org/doi/full/10.1056/NEJMoa1704154#t=refere
nces