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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT04569942
Registration number
NCT04569942
Ethics application status
Date submitted
23/09/2020
Date registered
30/09/2020
Titles & IDs
Public title
Australasian Resuscitation In Sepsis Evaluation: FLUid or Vasopressors In Emergency Department Sepsis
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Scientific title
Australasian Resuscitation In Sepsis Evaluation: FLUid or Vasopressors In Emergency Department Sepsis
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Secondary ID [1]
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ANZIC-RC/SP002
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Universal Trial Number (UTN)
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Trial acronym
ARISE FLUIDS
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Shock, Septic
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Condition category
Condition code
Infection
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Studies of infection and infectious agents
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Inflammatory and Immune System
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Other inflammatory or immune system disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Vasopressor
Other interventions - Fluids
Active comparator: Vasopressor - a restricted fluids and early vasopressor strategy
Active comparator: Fluids - a larger intravenous (IV) fluid volume and later vasopressor strategy
Treatment: Drugs: Vasopressor
Cease IV fluid resuscitation. If persisting hypotension and/or hypoperfusion commence a vasopressor infusion (e.g. noradrenaline) and titrate according to local practice to achieve target MAP. The target MAP will be determined by the treating clinician. Reassess at least hourly for up to 6 hours post-randomisation, then as clinically required in conjunction with the protocol. Boluses of 250ml of IV fluids are permitted if deemed indicated by the treating clinician.
Other interventions: Fluids
An fluid bolus of up to 1000ml will be administered over a maximum of 1 hour, if required, for persisting hypotension and/or hypoperfusion. Reassess at least hourly to 6 hours post-randomisation, then as clinically required in conjunction with the protocol. Further IV fluid boluses of 500ml are recommended as clinically indicated to achieve the target MAP. The target MAP will be determined by the treating clinician. Haemodynamic resuscitation will be guided by usual clinical assessment including vital signs, mentation, perfusion, and urine output until the treating clinician determines fluid resuscitation is no longer clinically required. A minimum of 2-3 L (30 ml/kg), including pre-randomisation fluids, is recommended within 3 hours of ED arrival consistent with the SSC guidelines, unless clinically contraindicated. Vasopressors may be commenced if blood pressure remains below target despite optimal fluid resuscitation as determined by the treating clinician.
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Intervention code [1]
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Treatment: Drugs
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Intervention code [2]
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Other interventions
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Days alive and out of hospital
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Assessment method [1]
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the number of days alive and out of hospital at 90 days post randomization
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Timepoint [1]
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From randomisation until 90 days post- randomization
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Secondary outcome [1]
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Mortality
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Assessment method [1]
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All-cause mortality
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Timepoint [1]
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From randomisation until 90 days post- randomization
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Secondary outcome [2]
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Time from randomization until death
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Assessment method [2]
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Time from randomization until death
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Timepoint [2]
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From randomisation until 90 days post- randomization
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Secondary outcome [3]
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Days alive and at home
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Assessment method [3]
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Days alive and at home at 90 days post-randomisation
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Timepoint [3]
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From randomisation until 90 days post- randomization
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Secondary outcome [4]
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Ventilator-free days to day 28
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Assessment method [4]
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Number of days not on invasive mechanical ventilation
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Timepoint [4]
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From randomisation until 28 days post- randomization
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Secondary outcome [5]
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Vasopressor-free days to day 28
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Assessment method [5]
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Number of days not on vasopressors
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Timepoint [5]
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From randomisation until 28 days post- randomization
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Secondary outcome [6]
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Renal replacement therapy-free days to day 28
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Assessment method [6]
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Number of days not on renal replacement therapy
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Timepoint [6]
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From randomisation until 28 days post- randomization
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Secondary outcome [7]
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Death or disability at 6 months
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Assessment method [7]
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Death or disability as measured by the World Health Organization Disability Assessment Schedule (WHODAS)
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Timepoint [7]
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at 6 months post randomization
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Secondary outcome [8]
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Death or disability at 12 months
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Assessment method [8]
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Death or disability as measured by the World Health Organization Disability Assessment Schedule (WHODAS)
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Timepoint [8]
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at 12 months post randomization
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Eligibility
Key inclusion criteria
* Clinically suspected infection;
* Systolic blood pressure (SBP) <90 mm Hg or mean arterial pressure (MAP) <65 mm Hg, despite a ?1000ml cumulative total bolus of IV fluid administered over a maximum of 60 minutes; including pre-hospital boluses;
* Arterial or venous blood lactate >2.0 mmol/L;
* At least one dose of an intravenous antimicrobial has been commenced.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
* Age <18 years;
* Confirmed or suspected pregnancy;
* Transferred from another acute care facility;
* Hypotension suspected to be due to a non-sepsis cause;
* >2L total IV fluid administered (including prehospital fluids but excluding drugs and flushes);
* More than 6 hours has elapsed since presentation to the ED or more than 2 hours has elapsed since last inclusion criterion has been met;
* Treating clinician considers that one or both of the treatment regimens are not suitable for the patient or the study protocol cannot be delivered e.g. limitation of care, requirement for immediate surgery;
* Death is considered imminent or inevitable;
* Underlying disease that makes survival to 90 days unlikely;
* Inability to follow patient up to day-90 e.g. unstable accommodation, overseas visitor;
* Previously enrolled in this study.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 3
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
26/10/2021
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
31/12/2025
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Actual
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Sample size
Target
1000
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW,QLD,SA,VIC,WA
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Recruitment hospital [1]
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Bankstown Hospital - Bankstown
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Recruitment hospital [2]
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Royal Prince Alfred Hospital - Camperdown
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Recruitment hospital [3]
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John Hunter Hospital - New Lambton Heights
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Recruitment hospital [4]
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Royal North Shore Hosptial - Sydney
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Recruitment hospital [5]
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Mackay Base Hospital - Mackay
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Recruitment hospital [6]
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Robina Hospital - Robina
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Recruitment hospital [7]
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Gold Coast University Hospital - Southport
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Recruitment hospital [8]
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Toowoomba Hospital - Toowoomba
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Recruitment hospital [9]
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The Queen Elizabeth Hospital - Adelaide
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Recruitment hospital [10]
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Bendigo Hospital - Bendigo
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Recruitment hospital [11]
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Box Hill Hospital - Box Hill
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Recruitment hospital [12]
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Angliss Hospital - Ferntree Gully
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Recruitment hospital [13]
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Austin Health - Heidelberg
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Recruitment hospital [14]
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Alfred Hospital - Melbourne
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Recruitment hospital [15]
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Maroondah Hospital - Ringwood East
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Recruitment hospital [16]
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St John of God Murdoch Hospital - Murdoch
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Recruitment hospital [17]
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Royal Perth Hospital - Perth
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Recruitment postcode(s) [1]
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2200 - Bankstown
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Recruitment postcode(s) [2]
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2050 - Camperdown
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Recruitment postcode(s) [3]
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2305 - New Lambton Heights
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Recruitment postcode(s) [4]
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2065 - Sydney
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Recruitment postcode(s) [5]
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4740 - Mackay
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Recruitment postcode(s) [6]
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4226 - Robina
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Recruitment postcode(s) [7]
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4215 - Southport
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Recruitment postcode(s) [8]
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4350 - Toowoomba
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Recruitment postcode(s) [9]
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5011 - Adelaide
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Recruitment postcode(s) [10]
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3550 - Bendigo
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Recruitment postcode(s) [11]
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3128 - Box Hill
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Recruitment postcode(s) [12]
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3156 - Ferntree Gully
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Recruitment postcode(s) [13]
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3084 - Heidelberg
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Recruitment postcode(s) [14]
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3004 - Melbourne
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Recruitment postcode(s) [15]
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3135 - Ringwood East
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Recruitment postcode(s) [16]
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6150 - Murdoch
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Recruitment postcode(s) [17]
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6000 - Perth
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Funding & Sponsors
Primary sponsor type
Other
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Name
Australian and New Zealand Intensive Care Research Centre
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Address
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Country
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Ethics approval
Ethics application status
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Summary
Brief summary
This multicentre, randomised controlled trial will enrol 1000 patients presenting with septic shock to the emergency department (ED) of participating hospitals in Australia and New Zealand. Participants will receive haemodynamic resuscitation with either a restricted fluids and early vasopressor regimen or a larger initial IV fluid volume with later introduction of vasopressors if required. Clinical care including the type of resuscitation fluid and vasopressor agent, will otherwise be in accordance with accepted standard care and according to clinician discretion. The study intervention will be delivered for at least 6 hours and up to 24 hours post-randomisation. Participants will be followed for up to 12 months and outcomes analysed on an intention-to-treat basis.
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Trial website
https://clinicaltrials.gov/study/NCT04569942
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Sandra Peake, MBBS
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Address
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Monash University
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Belinda D Howe, MPH
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Address
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Country
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Phone
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0399030340
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Undecided
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT04569942