Vasopressor use following traumatic injury: protocol for a systematic review

Area of Science:

• Trauma and Emergency Medicine
• Critical Care
• Pharmacology

Background:

• Traumatic injuries result in millions of casualties globally, with hemorrhagic shock and brain injury being leading causes of death.
• Traditional fluid resuscitation for hemorrhage may be less effective than previously thought, with emerging evidence supporting permissive hypotension.
• The safety of permissive hypotension, especially in patients with traumatic brain injury, remains uncertain, necessitating further investigation into alternative treatments.

Purpose of the Study:

• To systematically review randomized controlled trials comparing early vasopressor resuscitation with placebo or standard care in adult trauma patients.
• To evaluate the impact of vasopressors on survival and outcomes in the context of traumatic injury and hemorrhagic shock.
• To assess the safety and efficacy of vasopressors as fluid-sparing adjuncts in trauma resuscitation.

Main Methods:

• Systematic review of randomized controlled trials (RCTs) identified through comprehensive database searches (MEDLINE, EMBASE, CENTRAL, trial registries, conference proceedings).
• Independent eligibility screening and data extraction by two reviewers, including risk of bias assessment.
• GRADE approach will be used to assess the overall quality of evidence for each outcome.

Main Results:

• This section is to be populated upon completion of the systematic review and data analysis.
• Results will detail the comparative effectiveness and safety of vasopressors versus placebo/standard care in trauma resuscitation.
• Specific outcomes such as mortality, organ perfusion, and adverse events will be analyzed.

Conclusions:

• This systematic review will provide evidence-based insights into the role of vasopressors in early trauma resuscitation.
• Findings will inform clinical guidelines and practice for managing hypotension in trauma patients, particularly those with traumatic brain injury.
• The study aims to clarify whether vasopressors offer a safer and more effective alternative or adjunct to traditional fluid therapy in trauma care.