Low Dose Vasopressin in Traumatic Shock

Hypothesis: We hypothesize that resuscitation regimens which minimize the total volume of resuscitation fluid, while restoring organ perfusion, will lead to lower morbidity and mortality in critically ill patients following trauma.

• Injuries
• Shock, Traumatic

• Drug: normal saline control
  no vasopressin added to bolus or 5 hour continuous infusion
• Drug: vasopressin
  vasopressin bolus 4 units followed by continuous infusion 2.4units/hr for 5 hours

• Experimental: I
  Vasopressin
  Intervention: Drug: vasopressin
• Placebo Comparator: 2
  bolus of NS followed by continuous infusion of NS, no vasopressin added
  Intervention: Drug: normal saline control

Inclusion Criteria:

To be eligible for enrollment in the study, a patient must meet all of the follow criteria at assessment:

• Patient is a male or female patient presumed to be at least 18 years of age;
• Patient has a systolic blood pressure < 90 mmHg;
• Patient has clinical evidence of acute traumatic injury;
• Infusion of study drug must start within one hour following SBP < 90 mmHg

Exclusion Criteria:

A patient meeting any one of the following criteria at hospital assessment is not eligible for enrollment:

• Patient is admitted to one of the study hospitals' Emergency Department greater than six hours after injury;
• Patient has received greater than 4 liters fluid since time of injury;
• Patient is enrolled in another shock trial;
• Patient is asystolic or requires CPR prior to randomization;
• Female patient is pregnant by report or suspicion;
• Patient has known "Do Not Resuscitate" orders or visible/identifiable method of objection to participation (e.g., exclusion bracelet);