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Safety and efficacy of peripheral versus centrally administered vasopressor infusion: A single-centre retrospective observational study
Journal article   Peer reviewed

Safety and efficacy of peripheral versus centrally administered vasopressor infusion: A single-centre retrospective observational study

Annaliese Stolz, Rachel Efendy, Yogesh Apte, Alison Craswell, Frances Lin and Mahesh Ramanan
Australian Critical Care, Vol.35(5), pp.506-511
2022
DOI: https://doi.org/10.1016/j.aucc.2021.08.005
PMID: 34600834
url
https://doi.org/10.1016/j.aucc.2021.08.005View
Published Version

Abstract

Patient safety Vasoconstrictor agents Vasopressor Peripheral intravenous cannula Central venous catheter critical illness critical care
Background: Shock affects one-third of patients admitted to intensive care and is associated withincreased mortality. Vasopressor medications are used to maintain blood pressure in shock. Centralvenous catheters are associated with serious complications and pose logistical difficulties for insertion.Delivery of vasopressors via peripheral intravenous cannula may be a safe alternative. Methods: This is a retrospective cohort study comparing safety profile and outcomes of vasopressordelivery via peripheral and central routes in critically ill patients over a 12-month period in a mixedmedical-surgical intensive care unit. Demographics, clinical characteristics, treatments, and safetyoutcome data were extracted from medical records. Patients were classified into three groups: vaso-pressor infusions via peripheral intravenous cannula, combined peripheral intravenous cannula followedby central venous catheter, and central venous catheter only. Groups were compared using the KruskaleWallis test for continuous variables and Fisher's exact test for categorical variables. The impact ofduration of vasopressor infusion on complication rates was assessed using logistic regression. Results: We identified 212 patients who received vasopressor infusion, 39 received via peripheral only(Group 1), 155 via peripheral followed by central (Group 2), and 18 via central only (Group 3). There weresome baseline differences between groups. Group 1 had the lowest median Acute Physiology and ChronicHealth Evaluation III score (64, interquartile range¼44e77), and Group 3, the highest (86, interquartilerange¼57e101). Duration of vasopressor infusion was shortest in Group 1 and longer in Groups 2 and 3.There were no major complications; however, minor complications such as leakage, extravasation, anderythema occurred in 41% of Group 1 and 28% of Group 2 patients. Duration of peripheral vasopressorinfusion was not associated with an increased risk of complications. Conclusions: Administration of vasopressor infusions for short duration in critically ill patients via aperipheral venous cannula may be feasible, with low rates of complications, and offers a safe alternativeto central venous access.

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Critical Care Medicine
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