TY - JOUR
T1 - Vasopressor use following traumatic injury
T2 - Protocol for a systematic review
AU - Hylands, Mathieu
AU - Toma, Augustin
AU - Beaudoin, Nicolas
AU - Frenette, Anne Julie
AU - D'Aragon, Frederick
AU - Belley-Côté, Emilie
AU - Hylander, Morten
AU - Lauzier, François
AU - Siemieniuk, Reed Alexander
AU - Charbonney, Emmanuel
AU - Kwong, Joey
AU - Laake, Jon Henrik
AU - Guyatt, Gordon
AU - Vandvik, Per Olav
AU - Rochwerg, Bram
AU - Green, Robert
AU - Ball, Ian
AU - Scales, Damon
AU - Murthy, Srinivas
AU - Rizoli, Sandro
AU - Asfar, Pierre
AU - Lamontagne, François
PY - 2017/2/1
Y1 - 2017/2/1
N2 - Introduction: Worldwide, traumatic casualties are projected to exceed 8 million by year 2020. Haemorrhagic shock and brain injury are the leading causes of death following trauma. While intravenous fluids have traditionally been used to support organ perfusion in the setting of haemorrhage, recent investigations have suggested that restricting fluid therapy by tolerating more severe hypotension may improve survival. However, the safety of permissive hypotension remains uncertain, particularly among patients who have suffered a traumatic brain injury. Vasopressors preferentially vasoconstrict blood vessels that supply nonvital organs and capacitance vessels, thereby mobilising the unstressed blood volume. Used as fluid-sparing adjuncts, these drugs can complement resuscitative measures by correcting hypotension without diluting clotting factors or increasing the risk for tissue oedema. Methods and analysis: We will identify randomised control trials comparing early resuscitation with vasopressors versus placebo or standard care in adults following traumatic injury. Data sources will include MEDLINE, EMBASE, CENTRAL, clinical trial registries and conference proceedings. Two reviewers will independently determine trial eligibility. For each included trial, we will conduct duplicate independent data extraction and risk of bias assessment. We will assess the overall quality of the data for each individual outcome using the GRADE approach. Ethics and dissemination: We will report this review in accordance with the PRISMA statement. We will disseminate our findings at critical care and trauma conferences and through a publication in a peerreviewed journal. We will also use this systematic review to create clinical guidelines (http://www.magicapp.org), which will be disseminated in a standalone publication. Trial registration number: CRD42016033437.
AB - Introduction: Worldwide, traumatic casualties are projected to exceed 8 million by year 2020. Haemorrhagic shock and brain injury are the leading causes of death following trauma. While intravenous fluids have traditionally been used to support organ perfusion in the setting of haemorrhage, recent investigations have suggested that restricting fluid therapy by tolerating more severe hypotension may improve survival. However, the safety of permissive hypotension remains uncertain, particularly among patients who have suffered a traumatic brain injury. Vasopressors preferentially vasoconstrict blood vessels that supply nonvital organs and capacitance vessels, thereby mobilising the unstressed blood volume. Used as fluid-sparing adjuncts, these drugs can complement resuscitative measures by correcting hypotension without diluting clotting factors or increasing the risk for tissue oedema. Methods and analysis: We will identify randomised control trials comparing early resuscitation with vasopressors versus placebo or standard care in adults following traumatic injury. Data sources will include MEDLINE, EMBASE, CENTRAL, clinical trial registries and conference proceedings. Two reviewers will independently determine trial eligibility. For each included trial, we will conduct duplicate independent data extraction and risk of bias assessment. We will assess the overall quality of the data for each individual outcome using the GRADE approach. Ethics and dissemination: We will report this review in accordance with the PRISMA statement. We will disseminate our findings at critical care and trauma conferences and through a publication in a peerreviewed journal. We will also use this systematic review to create clinical guidelines (http://www.magicapp.org), which will be disseminated in a standalone publication. Trial registration number: CRD42016033437.
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U2 - 10.1136/bmjopen-2016-014166
DO - 10.1136/bmjopen-2016-014166
M3 - Review article
C2 - 28246141
AN - SCOPUS:85014190537
SN - 2044-6055
VL - 7
JO - BMJ Open
JF - BMJ Open
IS - 2
M1 - e014166
ER -