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Stolz A, Efendy R, Apte Y, et al. Safety and efficacy of peripheral versus centrally administered vasopressor infusion: A single-centre retrospective observational study. Aust Crit Care. 2021;doi: 10.1016/j.aucc.2021.08.005.
Stolz, A., Efendy, R., Apte, Y., Craswell, A., Lin, F., & Ramanan, M. (2021). Safety and efficacy of peripheral versus centrally administered vasopressor infusion: A single-centre retrospective observational study. Australian critical care : official journal of the Confederation of Australian Critical Care Nurses, . https://doi.org/10.1016/j.aucc.2021.08.005
Stolz, Annaliese, et al. "Safety and efficacy of peripheral versus centrally administered vasopressor infusion: A single-centre retrospective observational study." Australian critical care : official journal of the Confederation of Australian Critical Care Nurses vol. (2021). doi: https://doi.org/10.1016/j.aucc.2021.08.005
Stolz A, Efendy R, Apte Y, Craswell A, Lin F, Ramanan M. Safety and efficacy of peripheral versus centrally administered vasopressor infusion: A single-centre retrospective observational study. Aust Crit Care. 2021 Sep 29; doi: 10.1016/j.aucc.2021.08.005. Epub 2021 Sep 29. PMID: 34600834.
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Aust Crit Care. 2021 Sep 29; doi: 10.1016/j.aucc.2021.08.005. Epub 2021 Sep 29.

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

Australian critical care : official journal of the Confederation of Australian Critical Care Nurses

Annaliese Stolz, Rachel Efendy, Yogesh Apte, Alison Craswell, Frances Lin, Mahesh Ramanan

Affiliations

  1. Intensive Care Unit, Caboolture Hospital, Australia; University of Queensland, Australia.
  2. Intensive Care Unit, Caboolture Hospital, Australia.
  3. Intensive Care Unit, Caboolture Hospital, Australia; University of Queensland, Australia. Electronic address: [email protected].
  4. University of the Sunshine Coast, Queensland, Australia.
  5. University of the Sunshine Coast, Sunshine Coast Health Institute, Queensland, Australia.
  6. Intensive Care Unit, Caboolture Hospital, Australia; University of Queensland, Australia; ICU, The Prince Charles Hospital, Australia; The George Institute & University of NSW, Australia.

PMID: 34600834 DOI: 10.1016/j.aucc.2021.08.005

Abstract

BACKGROUND: Shock affects one-third of patients admitted to intensive care and is associated with increased mortality. Vasopressor medications are used to maintain blood pressure in shock. Central venous 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 vasopressor delivery via peripheral and central routes in critically ill patients over a 12-month period in a mixed medical-surgical intensive care unit. Demographics, clinical characteristics, treatments, and safety outcome data were extracted from medical records. Patients were classified into three groups: vasopressor infusions via peripheral intravenous cannula, combined peripheral intravenous cannula followed by central venous catheter, and central venous catheter only. Groups were compared using the Kruskal-Wallis test for continuous variables and Fisher's exact test for categorical variables. The impact of duration 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 were some baseline differences between groups. Group 1 had the lowest median Acute Physiology and Chronic Health Evaluation III score (64, interquartile range = 44-77), and Group 3, the highest (86, interquartile range = 57-101). 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, and erythema occurred in 41% of Group 1 and 28% of Group 2 patients. Duration of peripheral vasopressor infusion was not associated with an increased risk of complications.

CONCLUSIONS: Administration of vasopressor infusions for short duration in critically ill patients via a peripheral venous cannula may be feasible, with low rates of complications, and offers a safe alternative to central venous access.

Crown Copyright © 2021. Published by Elsevier Ltd. All rights reserved.

Keywords: Central venous catheter; Critical care; Critical illness; Patient safety; Peripheral intravenous cannula; Vasoconstrictor agents; Vasopressor

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