PRO STRESS Trial: Proactive Low-Dose Norepinephrine to Reduce Intraoperative Fluid Administration in Patients at High-Risk for Postoperative Pulmonary Complications Undergoing Laparoscopic Abdominal Surgery

Intraoperative hypotension is commonly treated with fluid administration; however, excessive fluid therapy may contribute to postoperative pulmonary complications. This randomized double-blind controlled trial evaluates whether proactive administration of fixed low-dose norepinephrine reduces intraoperative crystalloid administration while maintaining hemodynamic stability in high-risk patients undergoing laparoscopic abdominal surgery. One hundred and thirty patients will be randomized to receive either norepinephrine infusion (0.03 µg/kg/min) or placebo from induction until skin closure within a protocolized hemodynamic strategy guided by mean arterial pressure and pulse pressure variation.

NCT Number	NCT07627360
Lead Sponsor	Suez Canal University
Conditions	Intraoperative Hypotension, Postoperative Pulmonary Complications (PPCs), Fluid Over-load
Enrollment	130 participants
Start Date	2026-07-15
Primary Completion	2026-10 (estimated)
Study Completion	2026-11 (estimated)
Updated on ClinicalTrials.gov	2026-07-13