Angiotensin for septic shock unresponsive to noradrenaline

Two children with severe septic shock are reported. One had meningococcal s epticaemia and the other Escherichia coli septicaemia. They remained hypote nsive despite high concentrations of conventional inotropes and vasopressor s. In one child, using a pulmonary artery catheter, extended haemodynamic v ariables were measured. To restore blood pressure, in both cases, an infusi on of angiotensin II was used; there was significant improvement in clinica l status, resulting in a rapid reduction in the concentration of inotropes required. Both patients successfully survived their septic episodes. Angiot ensin II in cases of severe refractory septic hypotension in the paediatric population offers an extra therapeutic manoeuvre.