Epinephrine vs Norepinephrine in Fluid Refractory Pediatric Septic Shock- Open labelled randomized trial

This study has been designed to compare the efficacy of epinephrine vs norepinephrine as first line agent in children with fluid refractory septic shock.

Primary objective is to assess and compare hemodynamic status of patients receiving epinephrine (control) vs norepinephrine (intervention group) in fluid refractory septic shock in terms of time taken to achieve reversal of shock at 1st hour.

Sepsis is a leading cause of morbidity, mortality, and healthcare utilization for children worldwide. It is a life-threatening organ dysfunction resulting from a dysregulated host response to infection, leading to systemic inflammation and potential multiorgan failure.In Pediatric populations, sepsis and septic shock pose significant health challenges. The majority of children who die of sepsis suffer from refractory shock and/or multiple organ dysfunction syndrome, with many deaths occurring within the initial 48 to 72 hours of treatment. Hence there is a critical need for timely recognition and intervention to improve outcomes in affected children. Both epinephrine and norepinephrine are recommended as first-line vasoactive agents in pediatric septic shock. There is lack of consensus and limited direct comparative studies in children and hence there is need for robust evidence to guide optimal first-line therapy. Hence this study is designed to compare the effect of the two drugs in reversal of shock within the first hour of initiation of the drugs.