6/28/23, 12:50 AM AVERT Shock Pathway Feedback Search Clinical Topics Home Studies AVERT Shock AVERT Shock Disease Traumatic hemorrhage Trial question What is the effect of low-dose supplementation of arginine vasopressin in patients with trauma and hemorrhagic shock? Study design Single center Double blinded RCT Population Characteristics of study participants 7.0% female N = 100 93.0% male 100 patients (7 female, 93 male) Inclusion criteria: adult trauma patients, aged 18-65 years, who received at least 6 U of any blood product within 12 hours of injury Key exclusion criteria: prehospital CPR, emergency department thoracotomy, corticosteroid use, chronic renal insufficiency, coronary artery disease, or arginine vasopressin administration before enrollment Interventions N=49 arginine vasopressin supplementation (4 U of bolus followed by 0.04 U/min infusion for 48 hours to maintain a mean arterial BP of at least 65 mmHg) https://web.pathway.md/studies/rect0bm3vBYDnT3eV 1/2 6/28/23, 12:50 AM AVERT Shock Pathway N=51 placebo (an equivalent volume of saline infusion for 48 hours to maintain a mean arterial BP of at least 65 mmHg) Primary outcome Total volume of blood product transfused at 48 hours 2.9 L 2.9 2.2 L 1.4 L 1.4 0.7 L Significant decrease 0.0 L Arginine vasopressin supplementation Placebo Significant decrease in total volume of blood product transfused at 48 hours (1.4 L vs. 2.9 L; AD -1.1 L, 95% CI -2.04 to 0) Secondary outcomes No significant difference in total vasopressor equivalents at 48 hours (0.4 g vs. 1.4 g; AD -0.23 g, 95% CI -1.37 to 0.53) No significant difference in crystalloid equivalents at 48 hours (9.9 L vs. 11 L; AD -1.07 L, 95% CI -3.04 to 0.62) No significant difference in death (12% vs. 12%; RR 1.04, 95% CI 0.36 to 3.01) Safety outcomes No significant difference in adverse events. Significant difference in deep vein thrombosis (11% vs. 34%). Conclusion In adult trauma patients, aged 18-65 years, who received at least 6 U of any blood product within 12 hours of injury, arginine vasopressin supplementation was superior to placebo with respect to total volume of blood product transfused at 48 hours. Reference Carrie A Sims, Daniel Holena, Patrick Kim et al. Effect of Low-Dose Supplementation of Arginine Vasopressin on Need for Blood Product Transfusions in Patients With Trauma and Hemorrhagic Shock: A Randomized Clinical Trial. JAMA Surg. 2019 Nov 1;154(11):994-1003. Open reference URL https://web.pathway.md/studies/rect0bm3vBYDnT3eV 2/2