Shock Clinical Trial
Official title:
A Multicenter, Randomized, Controlled Trial Assessing Arginine Vasopressin Versus Saline Placebo in Refractory Traumatic Hemorrhagic Shock Patients (VITRIS-study)
The purpose of the present trial is therefore to assess effects of arginine vasopressin vs.
saline placebo on hospital admission rate (primary end point), as well as hemodynamic
variables, fluid resuscitation requirements and hospital discharge rate (secondary study end
points) in presumed traumatic hemorrhagic shock patients with a systolic arterial blood
pressure <90 mm Hg after 10 min of standard shock treatment. Accordingly, the study reflects
an add-on design to standard traumatic shock therapy.
The hypothesis is that both arginine vasopressin and saline placebo have comparable effects
on hemodynamic variables, fluid resuscitation requirements, and hospital admission and
discharge rate. The alternative hypothesis is that arginine vasopressin has more beneficial
effects on hemodynamic variables, fluid resuscitation requirements, and hospital admission
and discharge rate than saline placebo.
The study will be designed as a multicenter, randomized, placebo-controlled clinical trial
with blinded assessment of the outcome in a study network with helicopter emergency medical
service units in Austria, Germany, Switzerland, Italy, Czech Republic and the Netherlands.
The protocol, information and consent procedure will be approved by the institutional review
board of each participating center. Since this is a study randomizing unconscious patients
who are unable to give informed consent at the time of randomization (§43a Emergency study),
the requirement of informed consent is planned to be waived in accordance with the ethical
standards of national legislation in Germany, Austria, Switzerland, Italy, Czech Republic
and the Netherlands and the guidelines for good clinical practice of the European Agency for
the Evaluation of Medicinal products. Depending on the patient's outcome, either the
surviving patient, or the patient's family in case of death of the patient or in case that
the patient survives but remains mentally handicapped will be informed about the trial (see
appendix for patient information sheet); the protocol specifies that if there are any
objections, the patient will be withdrawn from the study.
Treatment assignments of blinded study drugs will be randomly generated by computer in
blocks of two, with stratification according to center. Before the start of the trial, staff
at participating centers will be informed about the rationale of the protocol and the study;
participating centers will be subsequently contacted and visited to ensure proper
enrollment.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Double Blind (Subject, Caregiver), Primary Purpose: Treatment
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