Journal article
Insertion characteristics of peripheral intravenous catheters used for vasopressor administration in adults who are critically ill: A descriptive exploratory sub-study
Vascular Access, Vol.20(2), pp.43-51
2026
Abstract
Background: Rapid vascular access for patients who are critically ill and in shock is critical, with large bore peripheral intravenous catheters (PIVCs) often used for initial vasopressor administration prior to central access being sought. Emerging evidence supports the safety of short-term peripheral vasopressor infusion, yet little is known of insertion and management practices. This study aimed to describe PIVC device selection, insertion characteristics, and management practices of peripheral vasopressor administration in adults who are critically ill. Methods: This descriptive exploratory sub-study of a randomized feasibility trial examined 40 intensive care unit and emergency department patients (64 PIVCs) receiving peripheral vasopressors between January 2023 and May 2024. Inserter, device, and site characteristics were recorded prospectively. Results: The most frequent PIVC size was 18 gauge (60%). The antecubital fossa was the primary insertion site (70% of first and 71% of second PIVCs). In Queensland (Australia) hospitals, policy dictates that PIVCs inserted at the ACF site, regardless of vein, must be re-sited within 24 hours due to the high risk of infection from this site. Over half remained in situ after 24 hours. Minor complications occurred in 20% of patients (e.g., infiltration, leakage), with no moderate to high level harm as a result of these complications. Conclusion: The antecubital fossa remains a common choice for initial vasopressor PIVC placement, despite international recommendations favouring the distal section of the upper arm. These findings highlight a gap between guideline and clinical practice, suggesting a role for targeted education to promote safer, evidence-aligned practice.
Details
- Title
- Insertion characteristics of peripheral intravenous catheters used for vasopressor administration in adults who are critically ill: A descriptive exploratory sub-study
- Authors
- Alison Craswell (Corresponding Author) - University of the Sunshine CoastStacey Watts - Caboolture Hospital (Australia)April Hatt - Caboolture Hospital (Australia)Frances Lin - Flinders UniversityYogesh Apte - The University of QueenslandThomas Holland - Caboolture Hospital (Australia)Nicole Marsh - Royal Brisbane and Women's HospitalMahesh Ramanan - Queensland University of Technology
- Publication details
- Vascular Access, Vol.20(2), pp.43-51
- Publisher
- Canadian Vascular Access Association (CVAA)
- Date published
- 2026
- DOI
- 10.5737/va.v21.i2.43
- ISSN
- 2563-7193
- Copyright note
- This is an Open Journal Systems article, distributed under the terms of the Creative Commons Attribution Licence CC BY-NC-SA 4.0 (https://creativecommons.org/licenses/by-nc-sa/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited and it is not for commercial purposes.
- Grant note
- The parent feasibility trial was funded by The Common Good Foundation (CKW2022-02), Emergency Medicine Foundation (EMJS-411R372022-HOLLAND), and The University of Queensland Mayne Academy of Critical Care Pilot Study Grant.
- Organisation Unit
- Healthy Ageing Research Cluster; School of Health; School of Health - Nursing
- Language
- English
- Record Identifier
- 991261782202621
- Output Type
- Journal article
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