Vasopressors administration via peripheral intravenous catheter
Extract:
“The use of vasopressors is ubiquitous in the perioperative arena, as well as in the intensive care unit. Vasopressors are often used for the management of intraoperative hypotension, which is associated with postoperative organ injury and is a potentially modifiable cause of surgical morbidity and mortality. Although the exact role of vasopressors in intraoperative arterial pressure management is not well- characterized, they are usually the first-line therapy in many scenarios. In critically ill patients, vasopressors are used commonly for the management of circulatory shock and are recommended as a first-line treatment for septic shock. Vasopressors commonly used during the perioperative period include phenylephrine, ephedrine, norepinephrine, and vasopressin. Of these, phenylephrine and norepinephrine are used commonly as infusions. Whereas phenylephrine is primarily a vasopressor, norepinephrine has both inotropic and vasoconstrictive actions and has been touted as a more appropriate agent to counter the vasodilatory and myocardial depressant effects of anesthetic drugs. Peripheral administration of norepinephrine traditionally has been avoided, given the concerns for extravasation, arterial and venous constriction, tissue necrosis, and limb ischemia.”
Darwish D, Karamchandani K. PRO: Vasopressors Can Be Administered Safely via a Peripheral Intravenous Catheter. J Cardiothorac Vasc Anesth. 2024 Feb 14:S1053-0770(24)00105-8. doi: 10.1053/j.jvca.2024.02.009. Epub ahead of print. PMID: 38453557.