The Australasian Resuscitation In Sepsis Evaluation

FLUid or vasopressors In Emergency Department Sepsis, a multicentre observational study (ARISE FLUIDS observational study): Rationale, methods and analysis plan

Gerben Keijzers, Stephen P.J. Macdonald, Andrew A. Udy, Glenn Arendts, Michael Bailey, Rinaldo Bellomo, Gabriel E. Blecher, Jonathon Burcham, Anthony Delaney, Andrew R. Coggins, Daniel M. Fatovich, John F. Fraser, Amanda Harley, Peter Jones, Fran Kinnear, Katya May, Sandra Peake, David Mc D. Taylor, Julian Williams, Patricia Williams & 1 others ARISE FLUIDS Study Group

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Objective: There is uncertainty about the optimal i.v. fluid volume and timing of vasopressor commencement in the resuscitation of patients with sepsis and hypotension. We aim to study current resuscitation practices in EDs in Australia and New Zealand (the Australasian Resuscitation In Sepsis Evaluation: FLUid or vasopressors In Emergency Department Sepsis [ARISE FLUIDS] observational study). Methods: ARISE FLUIDS is a prospective, multicentre observational study in 71 hospitals in Australia and New Zealand. It will include adult patients presenting to the ED during a 30 day period with suspected sepsis and hypotension (systolic blood pressure <100 mmHg) despite at least 1000 mL fluid resuscitation. We will obtain data on baseline demographics, clinical and laboratory variables, all i.v. fluid given in the first 24 h, vasopressor use, time to antimicrobial administration, admission to intensive care, organ failure and in-hospital mortality. We will specifically describe (i) the volume of fluid administered at the following time points: when meeting eligibility criteria, in the first 6 h, at 24 h and prior to vasopressor commencement and (ii) the frequency and timing of vasopressor use in the first 6 h and at 24 h. Screening logs will provide reliable estimates of the proportion of ED patients meeting eligibility criteria for a subsequent randomised controlled trial. Discussion: This multicentre, observational study will provide insight into current haemodynamic resuscitation practices in patients with sepsis and hypotension as well as estimates of practice variation and patient outcomes. The results will inform the design and feasibility of a multicentre phase III trial of early haemodynamic resuscitation in patients presenting to ED with sepsis and hypotension.

Original languageEnglish
Pages (from-to)90-96
Number of pages7
JournalEMA - Emergency Medicine Australasia
Volume31
Issue number1
DOIs
Publication statusPublished - 1 Feb 2019

Keywords

  • emergency department
  • fluid therapy
  • hypotension
  • sepsis
  • vasopressor

Cite this

Keijzers, Gerben ; Macdonald, Stephen P.J. ; Udy, Andrew A. ; Arendts, Glenn ; Bailey, Michael ; Bellomo, Rinaldo ; Blecher, Gabriel E. ; Burcham, Jonathon ; Delaney, Anthony ; Coggins, Andrew R. ; Fatovich, Daniel M. ; Fraser, John F. ; Harley, Amanda ; Jones, Peter ; Kinnear, Fran ; May, Katya ; Peake, Sandra ; Taylor, David Mc D. ; Williams, Julian ; Williams, Patricia ; ARISE FLUIDS Study Group. / The Australasian Resuscitation In Sepsis Evaluation : FLUid or vasopressors In Emergency Department Sepsis, a multicentre observational study (ARISE FLUIDS observational study): Rationale, methods and analysis plan. In: EMA - Emergency Medicine Australasia. 2019 ; Vol. 31, No. 1. pp. 90-96.
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title = "The Australasian Resuscitation In Sepsis Evaluation: FLUid or vasopressors In Emergency Department Sepsis, a multicentre observational study (ARISE FLUIDS observational study): Rationale, methods and analysis plan",
abstract = "Objective: There is uncertainty about the optimal i.v. fluid volume and timing of vasopressor commencement in the resuscitation of patients with sepsis and hypotension. We aim to study current resuscitation practices in EDs in Australia and New Zealand (the Australasian Resuscitation In Sepsis Evaluation: FLUid or vasopressors In Emergency Department Sepsis [ARISE FLUIDS] observational study). Methods: ARISE FLUIDS is a prospective, multicentre observational study in 71 hospitals in Australia and New Zealand. It will include adult patients presenting to the ED during a 30 day period with suspected sepsis and hypotension (systolic blood pressure <100 mmHg) despite at least 1000 mL fluid resuscitation. We will obtain data on baseline demographics, clinical and laboratory variables, all i.v. fluid given in the first 24 h, vasopressor use, time to antimicrobial administration, admission to intensive care, organ failure and in-hospital mortality. We will specifically describe (i) the volume of fluid administered at the following time points: when meeting eligibility criteria, in the first 6 h, at 24 h and prior to vasopressor commencement and (ii) the frequency and timing of vasopressor use in the first 6 h and at 24 h. Screening logs will provide reliable estimates of the proportion of ED patients meeting eligibility criteria for a subsequent randomised controlled trial. Discussion: This multicentre, observational study will provide insight into current haemodynamic resuscitation practices in patients with sepsis and hypotension as well as estimates of practice variation and patient outcomes. The results will inform the design and feasibility of a multicentre phase III trial of early haemodynamic resuscitation in patients presenting to ED with sepsis and hypotension.",
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author = "Gerben Keijzers and Macdonald, {Stephen P.J.} and Udy, {Andrew A.} and Glenn Arendts and Michael Bailey and Rinaldo Bellomo and Blecher, {Gabriel E.} and Jonathon Burcham and Anthony Delaney and Coggins, {Andrew R.} and Fatovich, {Daniel M.} and Fraser, {John F.} and Amanda Harley and Peter Jones and Fran Kinnear and Katya May and Sandra Peake and Taylor, {David Mc D.} and Julian Williams and Patricia Williams and {ARISE FLUIDS Study Group}",
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The Australasian Resuscitation In Sepsis Evaluation : FLUid or vasopressors In Emergency Department Sepsis, a multicentre observational study (ARISE FLUIDS observational study): Rationale, methods and analysis plan. / Keijzers, Gerben; Macdonald, Stephen P.J.; Udy, Andrew A.; Arendts, Glenn; Bailey, Michael; Bellomo, Rinaldo; Blecher, Gabriel E.; Burcham, Jonathon; Delaney, Anthony; Coggins, Andrew R.; Fatovich, Daniel M.; Fraser, John F.; Harley, Amanda; Jones, Peter; Kinnear, Fran; May, Katya; Peake, Sandra; Taylor, David Mc D.; Williams, Julian; Williams, Patricia; ARISE FLUIDS Study Group.

In: EMA - Emergency Medicine Australasia, Vol. 31, No. 1, 01.02.2019, p. 90-96.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - The Australasian Resuscitation In Sepsis Evaluation

T2 - FLUid or vasopressors In Emergency Department Sepsis, a multicentre observational study (ARISE FLUIDS observational study): Rationale, methods and analysis plan

AU - Keijzers, Gerben

AU - Macdonald, Stephen P.J.

AU - Udy, Andrew A.

AU - Arendts, Glenn

AU - Bailey, Michael

AU - Bellomo, Rinaldo

AU - Blecher, Gabriel E.

AU - Burcham, Jonathon

AU - Delaney, Anthony

AU - Coggins, Andrew R.

AU - Fatovich, Daniel M.

AU - Fraser, John F.

AU - Harley, Amanda

AU - Jones, Peter

AU - Kinnear, Fran

AU - May, Katya

AU - Peake, Sandra

AU - Taylor, David Mc D.

AU - Williams, Julian

AU - Williams, Patricia

AU - ARISE FLUIDS Study Group

PY - 2019/2/1

Y1 - 2019/2/1

N2 - Objective: There is uncertainty about the optimal i.v. fluid volume and timing of vasopressor commencement in the resuscitation of patients with sepsis and hypotension. We aim to study current resuscitation practices in EDs in Australia and New Zealand (the Australasian Resuscitation In Sepsis Evaluation: FLUid or vasopressors In Emergency Department Sepsis [ARISE FLUIDS] observational study). Methods: ARISE FLUIDS is a prospective, multicentre observational study in 71 hospitals in Australia and New Zealand. It will include adult patients presenting to the ED during a 30 day period with suspected sepsis and hypotension (systolic blood pressure <100 mmHg) despite at least 1000 mL fluid resuscitation. We will obtain data on baseline demographics, clinical and laboratory variables, all i.v. fluid given in the first 24 h, vasopressor use, time to antimicrobial administration, admission to intensive care, organ failure and in-hospital mortality. We will specifically describe (i) the volume of fluid administered at the following time points: when meeting eligibility criteria, in the first 6 h, at 24 h and prior to vasopressor commencement and (ii) the frequency and timing of vasopressor use in the first 6 h and at 24 h. Screening logs will provide reliable estimates of the proportion of ED patients meeting eligibility criteria for a subsequent randomised controlled trial. Discussion: This multicentre, observational study will provide insight into current haemodynamic resuscitation practices in patients with sepsis and hypotension as well as estimates of practice variation and patient outcomes. The results will inform the design and feasibility of a multicentre phase III trial of early haemodynamic resuscitation in patients presenting to ED with sepsis and hypotension.

AB - Objective: There is uncertainty about the optimal i.v. fluid volume and timing of vasopressor commencement in the resuscitation of patients with sepsis and hypotension. We aim to study current resuscitation practices in EDs in Australia and New Zealand (the Australasian Resuscitation In Sepsis Evaluation: FLUid or vasopressors In Emergency Department Sepsis [ARISE FLUIDS] observational study). Methods: ARISE FLUIDS is a prospective, multicentre observational study in 71 hospitals in Australia and New Zealand. It will include adult patients presenting to the ED during a 30 day period with suspected sepsis and hypotension (systolic blood pressure <100 mmHg) despite at least 1000 mL fluid resuscitation. We will obtain data on baseline demographics, clinical and laboratory variables, all i.v. fluid given in the first 24 h, vasopressor use, time to antimicrobial administration, admission to intensive care, organ failure and in-hospital mortality. We will specifically describe (i) the volume of fluid administered at the following time points: when meeting eligibility criteria, in the first 6 h, at 24 h and prior to vasopressor commencement and (ii) the frequency and timing of vasopressor use in the first 6 h and at 24 h. Screening logs will provide reliable estimates of the proportion of ED patients meeting eligibility criteria for a subsequent randomised controlled trial. Discussion: This multicentre, observational study will provide insight into current haemodynamic resuscitation practices in patients with sepsis and hypotension as well as estimates of practice variation and patient outcomes. The results will inform the design and feasibility of a multicentre phase III trial of early haemodynamic resuscitation in patients presenting to ED with sepsis and hypotension.

KW - emergency department

KW - fluid therapy

KW - hypotension

KW - sepsis

KW - vasopressor

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DO - 10.1111/1742-6723.13223

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SP - 90

EP - 96

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JF - EMA - Emergency Medicine Australasia

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