Peripheral Vasopressor Administration in Adults With Sepsis: A Retrospective Study of Guideline Adherence and Complications.

BACKGROUND

Peripheral intravenous catheter (PIVC) vasopressor administration is increasingly used to expedite the treatment of septic shock when central venous access is not immediately available. This shift in practice reflects growing support from national guidelines, which permit short-term peripheral administration of vasopressors in adults. On March 9, 2023, hospitals within 1 health care system implemented guidelines for PIVC vasopressor administration in adult critical care settings, specifically emergency departments and intensive care units.

OBJECTIVE

This study examined adherence to these guidelines for PIVC vasopressor use and to identify associated complications.

METHODS

This retrospective descriptive study included 106 adult patients (68 emergency department and 38 intensive care unit patients) diagnosed with sepsis and receiving peripheral vasopressors.

RESULTS

The majority of patients received norepinephrine through a short PIVC. Overall, 5 patients (4.7%) experienced complications, 4 with thrombophlebitis and 1 with an extravasation. All 5 patients received norepinephrine at the organization's policy-specified concentration via short PIVCs. However, only 1 of these patients met the system's guidelines for minimum PIVC size, quantity, and maximum infusion duration. Overall, only 58% of patients were managed in full compliance with the system's guidelines.

CONCLUSION

These results support the use of standardized protocols to reduce complications associated with short-term peripheral vasopressor administration.