A Comprehensive Systematic Review of The Role of Vasopressors in Early Management of Hemorrhagic Shock

Introduction: The role of vasopressors in the early management of hemorrhagic shock remains controversial, with conflicting evidence from observational studies and randomized controlled trials. This systematic review aims to evaluate the efficacy and safety of early vasopressor administration in adult patients with hemorrhagic shock. Methods: A systematic review was conducted screening studies based on predefined criteria: adult patients with hemorrhagic shock from any cause, evaluation of any vasopressor agent within the first 24 hours, comparative study designs reporting clinically relevant outcomes. Fifty-eight sources were identified including randomized controlled trials, observational studies, and systematic reviews. Data were extracted on patient populations, vasopressor interventions, mortality outcomes, hemodynamic effects, fluid requirements, and adverse events. Results: Randomized controlled trials demonstrated that low-dose norepinephrine (