Asher Elad, Karameh Hani, Nassar Hamed, Yosefy Chaim, Marmor David, Perel Nimrod, Taha Louay, Tabi Meir, Braver Omri, Shuvy Mony, Wiener-Well Yonit, Glikson Michael, Bruoha Sharon
Jesselson Integrated Heart Center, Shaare Zedek Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91121, Israel.
Department of Cardiology, Barzilai Medical Center, The Ben-Gurion University of the Negev, Beer-Sheva 84105, Israel.
J Clin Med. 2023 Sep 3;12(17):5734. doi: 10.3390/jcm12175734.
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).
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.
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, < 0.05). Phlebitis and the extravasation of vasopressors occurred at similar rates in the PVC and CVC groups (5.7% vs. 3.3%, respectively, = 0.33; 0.9% vs. 3.3%, respectively, = 0.17). Nevertheless, the bleeding rate was higher in the CVC group compared with the PVC group (3% vs. 0%, = 0.03).
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.
血管升压药常用于心源性休克（CS）患者的血压稳定，但其益处存疑。获得中心静脉通路耗时且可能伴有严重并发症。因此，我们想评估通过外周静脉导管（PVC）给药血管升压药对于入住心血管重症监护病房（ICCU）的CS患者的管理是否是一种安全有效的替代方法。
进行了一项前瞻性单中心研究，比较在12个月期间CS患者中通过PVC与中心静脉导管（CVC）给药血管升压药的安全性和结果。
共纳入1100例患者；其中，139例（12.6%）因休克需要血管升压药治疗，根据治疗医生的判断，108例（78%）通过PVC治疗，31例（22%）通过CVC治疗。PVC组血管升压药给药持续时间短于CVC组（分别为2.5天和4.2天，P<0.05）。PVC组和CVC组静脉炎和血管升压药外渗发生率相似（分别为5.7%和3.3%，P = 0.33；分别为0.9%和3.3%，P = 0.17）。然而，CVC组出血率高于PVC组（3%对0%，P = 0.03）。
对于心源性休克患者，通过PVC输注血管升压药来管理是可行且安全的。需要进一步研究来确立这种治疗方法。
