Australasian Resuscitation In Sepsis Evaluation: FLUid or vasopressors In emergency Department Sepsis (ARISE FLUIDS) trial: study protocol

Introduction International consensus guidelines support the initial administration of 30 mL/kg of intravenous fluids for haemodynamic resuscitation of newly diagnosed septic shock. Practice variation exists between the volume of fluids administered and timing of vasopressor commencement. The optimal...

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Main Authors: Peter Jones, Gerben Keijzers, John F Fraser, Rinaldo Bellomo, Paul Young, Glenn Arendts, Diana Egerton-Warburton, Alisa Higgins, Anthony Delaney, Stephen P J Macdonald, Sandra L Peake, Daniel Fatovich, Patricia Williams, Belinda D Howe, Jonathon Burcham, Elissa Milford, Andrew Alexander Udy
Format: Article
Language:English
Published: BMJ Publishing Group 2025-07-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/15/7/e101215.full
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author Peter Jones
Gerben Keijzers
John F Fraser
Rinaldo Bellomo
Paul Young
Glenn Arendts
Diana Egerton-Warburton
Alisa Higgins
Anthony Delaney
Stephen P J Macdonald
Sandra L Peake
Daniel Fatovich
Patricia Williams
Belinda D Howe
Jonathon Burcham
Elissa Milford
Andrew Alexander Udy
author_facet Peter Jones
Gerben Keijzers
John F Fraser
Rinaldo Bellomo
Paul Young
Glenn Arendts
Diana Egerton-Warburton
Alisa Higgins
Anthony Delaney
Stephen P J Macdonald
Sandra L Peake
Daniel Fatovich
Patricia Williams
Belinda D Howe
Jonathon Burcham
Elissa Milford
Andrew Alexander Udy
author_sort Peter Jones
collection DOAJ
description Introduction International consensus guidelines support the initial administration of 30 mL/kg of intravenous fluids for haemodynamic resuscitation of newly diagnosed septic shock. Practice variation exists between the volume of fluids administered and timing of vasopressor commencement. The optimal approach in patients with septic shock is uncertain.Methods and analysis Australasian Resuscitation In Sepsis Evaluation: FLUid or vasopressors In emergency Department Sepsis is a 1000-participant multicentre, randomised, open-label, parallel group clinical trial conducted in patients with septic shock presenting to the emergency department in participating sites in Australia, New Zealand and Ireland. Participants are randomised (1:1) to either restricted fluids and early vasopressors or a larger initial intravenous fluid volume and later vasopressors. The primary outcome is days alive and out of hospital at day 90 postrandomisation. Secondary outcomes are all-cause mortality at day 90, time from randomisation until death (to day 90), days alive and at home at day 90 and ventilator-free, vasopressor-free and renal replacement-free days to day 28 postrandomisation and death or disability at 6-month and 12-month postrandomisation. Health-related quality of life will be assessed at day 180 and 12 months following randomisation.Ethics and dissemination The study was approved by Northern Sydney Local Health District Human Research Ethics Committee (HREC2020/ETH02874) on 21 January 2021. Patients will be enrolled under a waiver of prior consent. The patient or next-of-kin (or equivalent according to local jurisdiction) is approached at the first available opportunity and given a trial information sheet. According to local approvals, the patient or next-of-kin chooses to either continue in the trial or opt-out/decline continued participation. Results will be disseminated in peer-reviewed journals and presented at academic conferences.Trial registration number NCT04569942
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spelling doaj-art-766cb2ad1601400d99f26ba3598d68ae2025-08-20T03:12:31ZengBMJ Publishing GroupBMJ Open2044-60552025-07-0115710.1136/bmjopen-2025-101215Australasian Resuscitation In Sepsis Evaluation: FLUid or vasopressors In emergency Department Sepsis (ARISE FLUIDS) trial: study protocolPeter Jones0Gerben Keijzers1John F Fraser2Rinaldo Bellomo3Paul Young4Glenn Arendts5Diana Egerton-Warburton6Alisa Higgins7Anthony Delaney8Stephen P J Macdonald9Sandra L Peake10Daniel Fatovich11Patricia Williams12Belinda D Howe13Jonathon Burcham14Elissa Milford15Andrew Alexander Udy16Adult Emergency, Auckland District Health Board, Auckland, New ZealandSchool of Medicine, Griffith University, Southport, Queensland, AustraliaCritical Care Research Group, The Prince Charles Hospital and University of Queensland, Brisbane, Queensland, AustraliaDepartment of Intensive Care, Austin Hospital, Melbourne, Victoria, AustraliaWellington Hospital, Wellington, New ZealandMedical School, The University of Western Australia, Crawley, Western Australia, AustraliaEmergency Department, Monash Medical Centre Clayton, Clayton, Victoria, AustraliaANZIC Research Centre, Monash University, Melbourne, Victoria, AustraliaThe George Institute for Global Health, Sydney, New South Wales, AustraliaCentre for Clinical Research in Emergency Medicine, Harry Perkins Institute of Medical Research, Perth, Western Australia, AustraliaANZIC Research Centre, Monash University, Melbourne, Victoria, AustraliaCentre for Clinical Research in Emergency Medicine, Harry Perkins Institute of Medical Research, Perth, Western Australia, AustraliaANZIC Research Centre, Monash University, Melbourne, Victoria, AustraliaANZIC Research Centre, Monash University, Melbourne, Victoria, AustraliaEmergency Department, Royal Perth Hospital, Perth, Western Australia, AustraliaIntensive Care Unit, Royal Brisbane and Women’s Hospital, Herston, Queensland, AustraliaANZIC-RC, Monash University Faculty of Medicine Nursing and Health Sciences, Clayton, Victoria, AustraliaIntroduction International consensus guidelines support the initial administration of 30 mL/kg of intravenous fluids for haemodynamic resuscitation of newly diagnosed septic shock. Practice variation exists between the volume of fluids administered and timing of vasopressor commencement. The optimal approach in patients with septic shock is uncertain.Methods and analysis Australasian Resuscitation In Sepsis Evaluation: FLUid or vasopressors In emergency Department Sepsis is a 1000-participant multicentre, randomised, open-label, parallel group clinical trial conducted in patients with septic shock presenting to the emergency department in participating sites in Australia, New Zealand and Ireland. Participants are randomised (1:1) to either restricted fluids and early vasopressors or a larger initial intravenous fluid volume and later vasopressors. The primary outcome is days alive and out of hospital at day 90 postrandomisation. Secondary outcomes are all-cause mortality at day 90, time from randomisation until death (to day 90), days alive and at home at day 90 and ventilator-free, vasopressor-free and renal replacement-free days to day 28 postrandomisation and death or disability at 6-month and 12-month postrandomisation. Health-related quality of life will be assessed at day 180 and 12 months following randomisation.Ethics and dissemination The study was approved by Northern Sydney Local Health District Human Research Ethics Committee (HREC2020/ETH02874) on 21 January 2021. Patients will be enrolled under a waiver of prior consent. The patient or next-of-kin (or equivalent according to local jurisdiction) is approached at the first available opportunity and given a trial information sheet. According to local approvals, the patient or next-of-kin chooses to either continue in the trial or opt-out/decline continued participation. Results will be disseminated in peer-reviewed journals and presented at academic conferences.Trial registration number NCT04569942https://bmjopen.bmj.com/content/15/7/e101215.full
spellingShingle Peter Jones
Gerben Keijzers
John F Fraser
Rinaldo Bellomo
Paul Young
Glenn Arendts
Diana Egerton-Warburton
Alisa Higgins
Anthony Delaney
Stephen P J Macdonald
Sandra L Peake
Daniel Fatovich
Patricia Williams
Belinda D Howe
Jonathon Burcham
Elissa Milford
Andrew Alexander Udy
Australasian Resuscitation In Sepsis Evaluation: FLUid or vasopressors In emergency Department Sepsis (ARISE FLUIDS) trial: study protocol
BMJ Open
title Australasian Resuscitation In Sepsis Evaluation: FLUid or vasopressors In emergency Department Sepsis (ARISE FLUIDS) trial: study protocol
title_full Australasian Resuscitation In Sepsis Evaluation: FLUid or vasopressors In emergency Department Sepsis (ARISE FLUIDS) trial: study protocol
title_fullStr Australasian Resuscitation In Sepsis Evaluation: FLUid or vasopressors In emergency Department Sepsis (ARISE FLUIDS) trial: study protocol
title_full_unstemmed Australasian Resuscitation In Sepsis Evaluation: FLUid or vasopressors In emergency Department Sepsis (ARISE FLUIDS) trial: study protocol
title_short Australasian Resuscitation In Sepsis Evaluation: FLUid or vasopressors In emergency Department Sepsis (ARISE FLUIDS) trial: study protocol
title_sort australasian resuscitation in sepsis evaluation fluid or vasopressors in emergency department sepsis arise fluids trial study protocol
url https://bmjopen.bmj.com/content/15/7/e101215.full
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