Amphoe Mueang Nakhon Si Thammarat

Researchers are evaluating whether starting norepinephrine early with rapid dose changes improves outcomes for adults with septic shock. The trial focuses on reducing death within 28 days, faster control of shock, and lowering fluid needs without increasing side effects. It compares early norepinephrine with standard care that uses placebo and rescue norepinephrine if needed. Participants receive norepinephrine started within one hour of septic shock diagnosis at 0.05 mcg/kg/min, adjusted every 15 minutes up to a maximum of 0.15 mcg/kg/min, or a matching placebo with the same dosing schedule. Both groups can get rescue norepinephrine if required. Limb ischemia and vital signs are closely monitored every 15 minutes during the 24-hour treatment period. During the study, participants undergo frequent assessments of blood pressure, limb perfusion, and safety monitoring. They receive standard sepsis treatments such as fluids, antibiotics, and organ support as needed. Researchers follow participants for up to 28 days to measure survival and any adverse effects related to the treatments.