Hemorrhagic Shock, Hypotensive Resuscitation, Norepinephrine
Conditions
Brief summary
The aim of this work was to investigate the effects of low dose of norepinephrine in preperiod of hypotensive resuscitation in hemorrhagic shock.
Detailed description
Hemorrhagic shock is one of the leading causes of death following trauma. New fluid resuscitation concepts, including hypotensive, hypothermic, and delayed resuscitation for uncontrolled hemorrhagic shock, have been put forward and obtained a good effect both in clinical and laboratory parameters. The 2019 European guideline on the management of major bleeding and coagulopathy following trauma recommends the use of norepinephrine (NE) for maintaining target arterial blood pressure in patients with life-threatening hypotension. NE has potent α-adrenergic receptor activation activity, which can stimulate α-1 adrenergic receptors on peripheral vascular smooth muscles. High-dose NE may result in excessive arteriolar vasoconstriction which subsequently leads to the disorder of microcirculation and tissue hypoxia.
Interventions
DRUGLow dose of Norepinephrine (NE)
Patients were received resuscitative fluid \[administered at beginning with the arrival of the patient in the emergency department (mean blood pressure \>70 mmHg)\] followed by low dose of NE (0.05-0.2 μg/kg/min).
DRUGHigh dose of Norepinephrine (NE)
Patients were received resuscitative fluid. If there were no response to treatment to resuscitative fluid, they received NE gradually till reach high dose (≥0.3 μg/kg/min).
Sponsors
Tanta University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age ≥ 18 years old. * Both sexes. * Patients with hemorrhagic shock
Exclusion criteria
* Patients with cardiac arrest at admission. * Severe brain. * Spinal injury (because of different target blood pressures). * Death due to hemostatic failure within 6 h of admission. * Pregnancy.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| 24 hours mortality | 24 hours after intervention | 24 hours mortality will be measured. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| 28 day mortality | 28 days after intervention | 28 day mortality will be measured. |
| Incidence of acute kidney injury | 24 hours after intervention | Incidence of acute kidney injury will be measured within 24 hours. |
| Length of hospital stay | 28 days after intervention | Length of hospital stay will be measured from admission till hospital discharge. |
| Length of intensive care unit stay | 28 days after intervention | Length of intensive care unit (ICU) stay will be measured from admission till intensive care discharge. |
Countries
Egypt
Contacts
Primary ContactRabab M Mohamed, MD
Outcome results
None listed