Analysis of clinical experience with angiotensin II: A meta-analysis and 4 AI

Angiotensin II (ATII) was approved for distributive shock in Spain (2023). The objective is to assess the experience with ATII by comparing a meta-analysis (MTA) and 4 Artificial Intelligence (AI) tools.

A search was conducted in Pubmed®, Central®, Embase®, and Scopus®. Randomized clinical trials, non-randomized trials, and observational studies were included. The primary outcome was all-cause mortality. Odds ratios (OR) with 95% confidence intervals (CI) were pooled. Four AI tools were used: Consensus, Perplexity, Elicit, and Scite.

Intensive care medicine.

One thousand six hundred and thirty-six studies were identified, with 10 studies included in the MTA.

No interventions.

Mortality, efficacy, and safety.

ATII shows a trend towards mortality reduction when compared with controls, OR 0.86 (95% CI: 0.60-1.23); this reduction reaches significance in patient subgroups: High Renin Levels, OR 0.45 (95% CI: 0.22-0.93); shock with renal replacement therapy, OR 0.38 (95% CI: 0.17-0.84). ATII is very effective in increasing mean arterial pressure, OR 3.25 (95% CI: 2.24-4.73), without increasing events, OR 0.77 (95% CI: 0.51-1.14). The AI reached the same conclusions, but only 25%-30% of the studies were included in the MTA.

ATII effectively increases blood pressure without side effects and without altering mortality. AI can assist in evaluating clinical evidence.