Safety and Outcomes of Peripherally Administered Vasopressor Infusion in Patients Admitted with Shock to an Intensive Cardiac Care Unit-A Single-Center Prospective Study.

Abstract

BACKGROUND:

Vasopressors are frequently utilized for blood pressure stabilization in patients with cardiogenic shock (CS), although with a questionable benefit. Obtaining central venous access is time consuming and may be associated with serious complications. Hence, we thought to evaluate whether the administration of vasopressors through a peripheral venous catheter (PVC) is a safe and effective alternative for the management of patients with CS presenting to the intensive cardiovascular care unit (ICCU).

METHODS:

A prospective single-center study was conducted to compare the safety and outcomes of vasopressors administered via a PVC vs. a central venous catheter (CVC) in patients presenting with CS over a 12-month period.

RESULTS:

A total of 1100 patients were included; of them, 139 (12.6%) required a vasopressor treatment due to shock, with 108 (78%) treated via a PVC and 31 (22%) treated via a CVC according to the discretion of the treating physician. The duration of the vasopressor administration was shorter in the PVC group compared with the CVC group (2.5 days vs. 4.2 days, respectively, p < 0.05). Phlebitis and the extravasation of vasopressors occurred at similar rates in the PVC and CVC groups (5.7% vs. 3.3%, respectively, p = 0.33; 0.9% vs. 3.3%, respectively, p = 0.17). Nevertheless, the bleeding rate was higher in the CVC group compared with the PVC group (3% vs. 0%, p = 0.03).

CONCLUSIONS:

The administration of vasopressor infusions via PVC for the management of patients with CS is feasible and safe in patients with cardiogenic shock. Further studies are needed to establish this method of treatment.

• Authors: Elad Asher, Hani Karameh, Hamed Nassar, Chaim Yosefy, David Marmor, Nimrod Perel, Louay Taha, Meir Tabi, Omri Braver, Mony Shuvy, Yonit Wiener-Well, Michael Glikson, Sharon Bruoha, Jerusalem Platelets Thrombosis and Intervention in Cardiology (JUPITER-16) Study Group
• Journal: Journal of clinical medicine (J Clin Med) Vol. 12 Issue 17 (Sep 03 2023) ISSN: 2077-0383 [Print] Switzerland
• PMID: 37685801 (Publication Type: Journal Article)