A Prospective Angiotensin II Versus Noradrenaline Trial for Hypotension Management to Reduce Cardiac-surgery Associated Acute Kidney Injury (PAN-AKI)
The study intervention focuses on exploring the use of angiotensin II as a primary vasopressor compared to norepinephrine in cardiac surgery patients to investigate whether angiotensin II can reduce the occurrence of moderate/severe acute kidney injury (AKI). Despite its potential, as suggested by trials involving surgical patients, there is currently no human data confirming its effectiveness in preventing moderate/severe AKI in this context. The intervention aims to address this gap by evaluating angiotensin II's impact compared to norepinephrine.
• Cardiac surgery using cardiopulmonary bypass including coronary artery bypass grafting (CABG) surgery, valve surgery, or combined CABG/valve surgery
• Elevated risk of AKI as predicted by a score ≥ 1.5 on the following scale:
‣ hemoglobin \< 130g/l = 2
⁃ creatinine \> 1.1 mg/dl = 2
⁃ age \> 70 years =1.5
⁃ New York Heart Association Classification (NYHA) 4 =1.5
⁃ Body Mass Index (BMI) \> 30 =1.5
• Adult ≥ 18 years
• Written informed consent