Early Initiated Vasopressor Therapy vs. Standard Fluid Therapy in Hypotensive Patients in the Emergency Department - A Randomized Controlled Trial

What this Trial Is About

Researchers are evaluating early treatment with peripheral intravenous noradrenaline compared to standard fluid therapy in adults with low blood pressure or shock in Danish and Swedish Emergency Departments. The study aims to see if early noradrenaline can help control shock faster, reduce ICU admissions, and lower mortality rates. This is a pragmatic, multi-center, randomized trial focused on improving emergency care for hypotensive patients. Participants will be randomly assigned to receive noradrenaline infused at 0.05-0.15 mcg/kg/min for up to 24 hours in the Emergency Department until shock control is achieved. If shock control is not reached within 24 hours, or treatment cannot be stopped, patients will be transferred to the ICU for further care without continuing the trial intervention. The comparison group will receive standard care, which includes fluid therapy and ICU transfer if needed but no noradrenaline during the ED stay. During the study, patient data will be collected from bedside monitoring, electronic health records, and national registries. One year after enrollment, participants will be contacted to assess their physical function and daily self-care ability. The primary outcome measures the proportion of patients achieving target blood pressure 90 minutes after inclusion. Secondary outcomes include ICU-free days alive within 30 days, time without shock within 24 hours, and mortality rates at 30 days and hospital discharge.

Early Initiated Vasopressor Therapy in the Emergency Department