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A better understanding of the pathophysiology and intricacies of the RAAS in septic shock has led to the use of exogenous angiotensin II as a new therapeutic agent. In this review, we report a multinational and multi-disciplinary expert panel discussion on the role and implications of RAAS modulation in sepsis and the use of exogenous angiotensin II. The panel proposed guidance regarding patient selection and treatment options with exogenous angiotensin II which should trigger further research.<\/jats:p>","DOI":"10.1186\/s13054-024-05123-7","type":"journal-article","created":{"date-parts":[[2024,11,26]],"date-time":"2024-11-26T02:53:09Z","timestamp":1732589589000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":39,"title":["The renin\u2013angiotensin\u2013aldosterone-system in sepsis and its clinical modulation with exogenous angiotensin II"],"prefix":"10.1186","volume":"28","author":[{"given":"Matthieu","family":"Legrand","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashish K.","family":"Khanna","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marlies","family":"Ostermann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuki","family":"Kotani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricard","family":"Ferrer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Girardis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Leone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gennaro","family":"DePascale","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Pickkers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"Tissieres","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filippo","family":"Annoni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katarzyna","family":"Kotfis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Landoni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Zarbock","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick M.","family":"Wieruszewski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"De Backer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Louis","family":"Vincent","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rinaldo","family":"Bellomo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,11,26]]},"reference":[{"key":"5123_CR1","doi-asserted-by":"publisher","first-page":"607","DOI":"10.1097\/MCC.0000000000001092","volume":"29","author":"B Garcia","year":"2023","unstructured":"Garcia B, Zarbock A, Bellomo R, Legrand M. 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Mathieu Legrand is supported by grant number R01-GM151494-01 from NIGMS\/NIH and received consulting fees from Alexion, Radiometer, Viatris and La Jolla. Giovanni Landoni received speaker fees from Medis, Paion and Viatris, and consultancy fees from Paion and Viatris. PMW received consultant fees from Viatris. AKK has previously received consulting fees from La Jolla Pharma, including grant funding for the ATHOS3 trial. He has also previously received consulting fees from Innoviva Therapeutics and Viatris Pharmaceuticals. He is supported by a Wake Forest Cardiovascular Sciences Center Award and a NIH\/NCATS Award \u201cDysfunction Renin in Septic Shock\u201d. He has received consulting fees on advisory boards for Medtronic, Edwards Life Sciences, Philips Research North America, Baxter, GE Healthcare, Potrero Medical, Retia Medical, Pharmazz Inc., Trevena Pharma and Caretaker Medical for activities unrelated to the current manuscript. Katarzyna Kotfis is National Consultant in Anesthesiology and Critical Care\u00a0in Poland, Associate Editor for Intensive Care Medicine (ISSN 1432-1238), Advisory board member for Critical Care (ISSN: 1364-8535) and Member of the Advisory Board for Viatris. Alexander Zarbock has received consulting fees from Astute-Biomerieux, Baxter, Bayer, Novartis, Guard Therapeutics, AM Pharma, Paion, Viatris, Renibus, Alexion, Fresenius, research funding from Astute-Biomerieux, Fresenius, Baxter, and speakers fees from Astute-Biomerieux, Fresenius, Baxter. Daniel De Backer has received consulting fees from Edwards Lifesciences, Philips, Baxter, Viatris, Pharmazz. Other authors had not disclosures to declare.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"389"}}