Safety and Outcomes of Peripherally Administered Vasopressor Infusion in Patients Admitted with Shock to an Intensive Cardiac Care Unit—A Single-Center Prospective Study
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 t...
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-09-01
|
| Series: | Journal of Clinical Medicine |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2077-0383/12/17/5734 |
| _version_ | 1797582247387201536 |
|---|---|
| author | 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 |
| author_facet | 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 |
| author_sort | Elad Asher |
| collection | DOAJ |
| description | 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: <b>A</b> 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: <b>A</b> 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, <i>p</i> < 0.05). Phlebitis and the extravasation of vasopressors occurred at similar rates in the PVC and CVC groups (5.7% vs. 3.3%, respectively, <i>p</i> = 0.33; 0.9% vs. 3.3%, respectively, <i>p</i> = 0.17). Nevertheless, the bleeding rate was higher in the CVC group compared with the PVC group (3% vs. 0%, <i>p</i> = 0.03). Conclusions: <b>The administration</b> 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. |
| first_indexed | 2024-03-10T23:19:22Z |
| format | Article |
| id | doaj.art-4a207271a1824507afaaadb398537b22 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T23:19:22Z |
| publishDate | 2023-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-4a207271a1824507afaaadb398537b222023-11-19T08:24:38ZengMDPI AGJournal of Clinical Medicine2077-03832023-09-011217573410.3390/jcm12175734Safety and Outcomes of Peripherally Administered Vasopressor Infusion in Patients Admitted with Shock to an Intensive Cardiac Care Unit—A Single-Center Prospective StudyElad Asher0Hani Karameh1Hamed Nassar2Chaim Yosefy3David Marmor4Nimrod Perel5Louay Taha6Meir Tabi7Omri Braver8Mony Shuvy9Yonit Wiener-Well10Michael Glikson11Sharon Bruoha12Jesselson Integrated Heart Center, Shaare Zedek Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91121, IsraelJesselson Integrated Heart Center, Shaare Zedek Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91121, IsraelJesselson Integrated Heart Center, Shaare Zedek Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91121, IsraelDepartment of Cardiology, Barzilai Medical Center, The Ben-Gurion University of the Negev, Beer-Sheva 84105, IsraelJesselson Integrated Heart Center, Shaare Zedek Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91121, IsraelJesselson Integrated Heart Center, Shaare Zedek Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91121, IsraelJesselson Integrated Heart Center, Shaare Zedek Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91121, IsraelJesselson Integrated Heart Center, Shaare Zedek Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91121, IsraelDepartment of Cardiology, Barzilai Medical Center, The Ben-Gurion University of the Negev, Beer-Sheva 84105, IsraelJesselson Integrated Heart Center, Shaare Zedek Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91121, IsraelInfectious Diseases Unit, Shaare Zedek Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91121, IsraelJesselson Integrated Heart Center, Shaare Zedek Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91121, IsraelDepartment of Cardiology, Barzilai Medical Center, The Ben-Gurion University of the Negev, Beer-Sheva 84105, IsraelBackground: 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: <b>A</b> 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: <b>A</b> 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, <i>p</i> < 0.05). Phlebitis and the extravasation of vasopressors occurred at similar rates in the PVC and CVC groups (5.7% vs. 3.3%, respectively, <i>p</i> = 0.33; 0.9% vs. 3.3%, respectively, <i>p</i> = 0.17). Nevertheless, the bleeding rate was higher in the CVC group compared with the PVC group (3% vs. 0%, <i>p</i> = 0.03). Conclusions: <b>The administration</b> 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.https://www.mdpi.com/2077-0383/12/17/5734cardiogenic shockvasopressorscentral venous catheterperipheral venous catheter |
| spellingShingle | 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 Safety and Outcomes of Peripherally Administered Vasopressor Infusion in Patients Admitted with Shock to an Intensive Cardiac Care Unit—A Single-Center Prospective Study Journal of Clinical Medicine cardiogenic shock vasopressors central venous catheter peripheral venous catheter |
| title | Safety and Outcomes of Peripherally Administered Vasopressor Infusion in Patients Admitted with Shock to an Intensive Cardiac Care Unit—A Single-Center Prospective Study |
| title_full | Safety and Outcomes of Peripherally Administered Vasopressor Infusion in Patients Admitted with Shock to an Intensive Cardiac Care Unit—A Single-Center Prospective Study |
| title_fullStr | Safety and Outcomes of Peripherally Administered Vasopressor Infusion in Patients Admitted with Shock to an Intensive Cardiac Care Unit—A Single-Center Prospective Study |
| title_full_unstemmed | Safety and Outcomes of Peripherally Administered Vasopressor Infusion in Patients Admitted with Shock to an Intensive Cardiac Care Unit—A Single-Center Prospective Study |
| title_short | Safety and Outcomes of Peripherally Administered Vasopressor Infusion in Patients Admitted with Shock to an Intensive Cardiac Care Unit—A Single-Center Prospective Study |
| title_sort | safety and outcomes of peripherally administered vasopressor infusion in patients admitted with shock to an intensive cardiac care unit a single center prospective study |
| topic | cardiogenic shock vasopressors central venous catheter peripheral venous catheter |
| url | https://www.mdpi.com/2077-0383/12/17/5734 |
| work_keys_str_mv | AT eladasher safetyandoutcomesofperipherallyadministeredvasopressorinfusioninpatientsadmittedwithshocktoanintensivecardiaccareunitasinglecenterprospectivestudy AT hanikarameh safetyandoutcomesofperipherallyadministeredvasopressorinfusioninpatientsadmittedwithshocktoanintensivecardiaccareunitasinglecenterprospectivestudy AT hamednassar safetyandoutcomesofperipherallyadministeredvasopressorinfusioninpatientsadmittedwithshocktoanintensivecardiaccareunitasinglecenterprospectivestudy AT chaimyosefy safetyandoutcomesofperipherallyadministeredvasopressorinfusioninpatientsadmittedwithshocktoanintensivecardiaccareunitasinglecenterprospectivestudy AT davidmarmor safetyandoutcomesofperipherallyadministeredvasopressorinfusioninpatientsadmittedwithshocktoanintensivecardiaccareunitasinglecenterprospectivestudy AT nimrodperel safetyandoutcomesofperipherallyadministeredvasopressorinfusioninpatientsadmittedwithshocktoanintensivecardiaccareunitasinglecenterprospectivestudy AT louaytaha safetyandoutcomesofperipherallyadministeredvasopressorinfusioninpatientsadmittedwithshocktoanintensivecardiaccareunitasinglecenterprospectivestudy AT meirtabi safetyandoutcomesofperipherallyadministeredvasopressorinfusioninpatientsadmittedwithshocktoanintensivecardiaccareunitasinglecenterprospectivestudy AT omribraver safetyandoutcomesofperipherallyadministeredvasopressorinfusioninpatientsadmittedwithshocktoanintensivecardiaccareunitasinglecenterprospectivestudy AT monyshuvy safetyandoutcomesofperipherallyadministeredvasopressorinfusioninpatientsadmittedwithshocktoanintensivecardiaccareunitasinglecenterprospectivestudy AT yonitwienerwell safetyandoutcomesofperipherallyadministeredvasopressorinfusioninpatientsadmittedwithshocktoanintensivecardiaccareunitasinglecenterprospectivestudy AT michaelglikson safetyandoutcomesofperipherallyadministeredvasopressorinfusioninpatientsadmittedwithshocktoanintensivecardiaccareunitasinglecenterprospectivestudy AT sharonbruoha safetyandoutcomesofperipherallyadministeredvasopressorinfusioninpatientsadmittedwithshocktoanintensivecardiaccareunitasinglecenterprospectivestudy |