Zichichi Albert, Wallace Ryan, Daniell Jessica, Rouse Ginger, Ahearn Paul, Ammar Mahmoud
Department of Pharmacy Services, Yale New Haven Hospital, New Haven, CT, USA.
Department of Pharmacy Services, Bridgeport Hospital, Bridgeport, CT, USA.
Ann Pharmacother. 2025 May;59(5):397-405. doi: 10.1177/10600280241284796. Epub 2024 Oct 16.
Sympathomimetic vasopressors may be administered through a peripheral catheter, but there are limited data available on the safety of peripheral use.
The purpose of this study was to analyze the safety of peripherally infused sympathomimetic vasopressors.
A multicenter, retrospective observational study was conducted to evaluate patients who received peripheral vasopressors. The study's primary outcome was to assess the incidence of extravasation during the administration of peripheral vasopressors. Secondary outcomes include avoidance of central venous catheter (CVC) placement and institution protocol deviations.
There were 198 patients included in the study, of which 142 patients received norepinephrine, 48 patients received phenylephrine, and 8 patients received epinephrine peripherally. Extravasation events occurred in 11 (5.6%) patients. Seven patients required a pharmacologic antidote and 10 patients required a warm compress. No significant differences were seen in characteristics of patients who extravasated compared with those who did not. Protocol deviations identified during the study included 24 (12.1%) patients receiving doses above the protocol maximum, 19 (9.6%) with a body mass index above the protocol maximum, and 45 (22.7%) patients receiving peripheral vasopressor over 24 hours. The majority of patients were able to avoid CVC placement (59.1%).
Peripherally infused sympathomimetic vasopressors are safe to administer up to 24 hours with a low incidence of extravasation events while avoiding CVC placement in the majority of patients.
拟交感神经血管加压药可通过外周导管给药，但关于外周使用安全性的数据有限。
本研究旨在分析外周输注拟交感神经血管加压药的安全性。
进行了一项多中心回顾性观察研究，以评估接受外周血管加压药治疗的患者。该研究的主要结局是评估外周血管加压药给药期间外渗的发生率。次要结局包括避免中心静脉导管（CVC）置入和机构方案偏差。
该研究纳入了198例患者，其中142例患者接受去甲肾上腺素治疗，48例患者接受去氧肾上腺素治疗，8例患者接受外周肾上腺素治疗。11例（5.6%）患者发生外渗事件。7例患者需要药物解毒剂，10例患者需要热敷。与未发生外渗的患者相比，发生外渗的患者在特征上无显著差异。研究期间发现的方案偏差包括24例（12.1%）患者接受的剂量高于方案最大值，19例（9.6%）患者的体重指数高于方案最大值，45例（22.7%）患者外周血管加压药给药超过24小时。大多数患者能够避免CVC置入（59.1%）。
外周输注拟交感神经血管加压药给药24小时是安全的，外渗事件发生率低，且大多数患者可避免CVC置入。
