Podcast 596: Peripheral Vasopressors

<p><strong>Contributor: Aaron Lessen, MD</strong></p> <p><strong>Educational Pearls:</strong></p> <ul> <li style="font-weight: 400;"><span style= "font-weight: 400;">Traditional teaching has shied away from using vasopressors through peripheral IVs</span></li> <li style="font-weight: 400;"><span style= "font-weight: 400;">Tissue necrosis from extravasation is cited as a risk of use of vasopressors through a peripheral site</span></li> <li style="font-weight: 400;"><span style= "font-weight: 400;">However, risk of extravasation is low (2-4%) and even more rarely results in significant complications</span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">Using an  IV that is more proximal and larger bore with monitoring can further minimize these risks</span></li> <li style="font-weight: 400;"><span style= "font-weight: 400;">Starting with peripheral vasopressors in a critically ill patient appears to be without significant increased cutaneous complications compared to using a central line alone</span></li> </ul> <p><strong>References</strong></p> <p><span style="font-size: 10pt;"><span style= "font-weight: 400;">Loubani OM, Green RS.</span> <a href= "https://pubmed.ncbi.nlm.nih.gov/25669592/"><span style= "font-weight: 400;">A systematic review of extravasation and local tissue injury from administration of vasopressors through peripheral intravenous catheters and central venous catheters.</span></a> <em><span style="font-weight: 400;">J Crit Care</span></em><span style="font-weight: 400;">. 2015;30(3):653.e9-653.e6.53E17. doi:10.1016/j.jcrc.2015.01.014</span></span></p> <p><span style="font-size: 10pt;"><span style= "font-weight: 400;">Cardenas-Garcia J, Schaub KF, Belchikov YG, Narasimhan M, Koenig SJ, Mayo PH.</span> <a href= "https://pubmed.ncbi.nlm.nih.gov/26014852/"><span style= "font-weight: 400;">Safety of peripheral intravenous administration of vasoactive medication.</span></a> <em><span style= "font-weight: 400;">J Hosp Med</span></em><span style= "font-weight: 400;">. 2015;10(9):581-5