The role of vasopressin in trauma resuscitation: a protocol of a systematic review and meta-analysis of randomized and observational studies

Abstract Introduction Hemorrhagic shock caused by trauma is one of the most important contributors to mortality in severely injured patients. Management traditionally includes hemorrhage control and aggressive fluid resuscitation. Severe hemorrhagic shock induces a state of antidiuretic hormone (vasopressin) deficiency, which exacerbates vasodilatory shock and refractory hypotension. Recent clinical trials and reviews emphasize the potential benefits of low-dose vasopressin supplementation during trauma resuscitation. Vasopressin can restore vascular tone by acting independently of the adrenergic system, improve renal perfusion, promote hemostasis, and reduce the volume of required blood product transfusions without increasing complications. In this study, we aim to review the effect of AVP in traumatic patients presenting with hemorrhagic shock. Methods This review is formatted according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). Quantitative randomized and observational study designs that evaluated the administration of vasopressin in trauma and hemorrhagic shock will be considered for systematic review. Databases PubMed (NCBI), PubMed Central (NCBI), Embase (Ovid), Scopus (Elsevier), and ClinicalTrials.gov (NLM) were searched for articles from 2000 to September 2025. Cochrane Library (Wiley) is also reviewed for possible systematic reviews on the subject. Further articles are sought through forward and backward citation tracking of the articles with the highest impact, especially randomized trials. Two independent blinded reviewers will screen the remaining articles for eligibility and methodological quality. Two independent authors will extract the data to decrease errors and bias. For statistical analysis, effect sizes will be expressed as risk ratios or ORs for dichotomous data or weighted (or standardized) mean differences and 95% CIs for continuous data. Trial registration CRD420251154486. https://www.crd.york.ac.uk/PROSPERO/view/CRD420251154486