Angiotensin II to Treat Intraoperative Vasoplegic Shock in an Infant

Vasoplegic shock is defined by a pathological reduction in systemic vascular resistance, leading to hypotension despite normal or elevated cardiac output. A key therapeutic challenge lies in the profound and often refractory nature of the hypotension, which may not respond to conventional fluid resuscitation or adrenergic vasopressors. In this report, we describe the intraoperative use of a novel vasoactive agent, angiotensin II, for the treatment of vasoplegic shock during bilateral nephrectomy in an infant. We review current therapeutic options for vasoplegic shock, summarize existing pediatric reports involving angiotensin II, and discuss its emerging role in the management of this difficult-to-treat condition.