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PANDA trial: noradrenaline vs adrenaline in shock

Design and rationale of a multicenter paramedic randomized trial of noradrenaline versus adrenaline in the initial management of patients with cardiogenic shock—The PANDA trial
American Heart Journal · Added 23 May 2026

This multicenter RCT protocol tests whether noradrenaline improves outcomes compared with adrenaline for paramedic management of cardiogenic shock, with the PANDA trial aiming to settle the debate on optimal vasopressor choice in the prehospital setting.

Study type

RCT

Design

Protocol for prehospital multicentre open-label RCT

Participants

Planned 1,155 patients with suspected cardiogenic shock (450 recruited to date)

Main finding

Trial randomises paramedic-administered noradrenaline vs adrenaline to target SBP 100 mmHg; primary outcome 28-day all-cause mortality; results not yet available

Caveat

Protocol only — no outcome data yet

Bottom line

Context only

Learning goal

Weigh the evidence for noradrenaline versus adrenaline when supporting blood pressure in prehospital cardiogenic shock.

More

• Topic: Cardiac (non-arrest)
• Daily scan: 23 May 2026

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