Effectiveness of the MINUTES Bundle for Initial 30-Minute Management of Undifferentiated Circulatory Shock in the Emergency Department

Assiut University

Status: Not yet enrolling

Conditions: Validation of Minute Bundle in Undifferntiated Shock

Treatments: Device: Ultrasound

Study type: Interventional

Funder types: Other

Identifiers

NCT07209735

MINUTES-SHOCK-2025

Details and patient eligibility

About

This study aims to validate the effectiveness of the MINUTES bundle on clinical outcomes in patients presenting with undifferentiated shock.

Full description

Undifferentiated circulatory shock represents a critical challenge in emergency medicine (1), requiring rapid assessment and immediate intervention to prevent organ failure and death. Early goal-directed therapy (EGDT) and time-sensitive bundles have proven beneficial in improving outcomes. While specific shock types (e.g., septic, cardiogenic) have established guidelines (2-6), there is limited structured guidance for the initial 30-minute management "golden half hour" of resuscitation when the cause is unknown.

The MINUTES bundle, proposed in recent expert opinion (7), offers a structured approach to streamline early resuscitation and evaluation steps. It includes:

• Maintain ABCs (airway, breathing, circulation)
• INfuse vasopressors/fluids and INvestigate basic labs
• Ultrasound (POCUS)
• Treat underlying Etiology
• Stabilize systemic perfusion

Enrollment: 202 estimated patients

Sex: All

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• 1. Adults 18-65 years old

  2. Clinical signs of circulatory shock:

  • SBP <90 mmHg or MAP <65 mmHg
  • Signs of hypoperfusion (altered mental status, oliguria, elevated lactate) 3. No clear etiology of shock at time of triage

Exclusion criteria

• 1- Trauma-related shock 2- Known terminal illness- Transferred after prior resuscitation 4- Pregnant patients 5-Patients with cardiac arrest upon arrival

Trial design

Primary purpose: Diagnostic

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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202 participants in 2 patient groups

Participants will receive the Minute Bundle, a structured package of early resuscitation interventio

Experimental group

Treatment:

Device: Ultrasound

Participants will receive standard resuscitation according to current institutional protocols and tr

Active Comparator group

Treatment:

Device: Ultrasound