Study of Vasoactive Infusions through Peripheral Line

Varadarajan, Poovazhagi; Kumar, Santosh; Sangareddi, Shanthi

doi:10.7199/ped.oncall.2015.35

Cited by 2 publications

(3 citation statements)

References 9 publications

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“…Tan et al 3 reported that sepsis-related mortality rate is 19% in high-income countries whereas it is as high as 32% in low-income countries. These rates show that sepsis is undoubtedly a socioeconomic disease 4,70–72 and urgent measures are necessary to adapt management guidelines for their use in all these scenarios 51 . Indeed, in resource-poor settings, the use of vasoactive agents through a PVL in PSS is justifiable as it is cost effective and found to be safe without serious adverse effects if experienced and continuous nursing care may be provided.…”

Section: Discussionmentioning

confidence: 99%

“…44,45 Current treatment guidelines suggest the use of PVL for inotropic administration as soon as possible in fluid-refractory PSS patients when a CVL is not already in place. 29,33,34 A growing body of evidence mainly from intensive care units and surgical settings has shown this practice to be safe 36,[46][47][48][49][50][51] ; however, few data are available on the use of PVL for inotropic therapy in resource-poor pediatric emergency departments (PEDs).…”

Section: Introductionmentioning

confidence: 99%

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Use of Inotropics by Peripheral Vascular Line in the First Hour of Treatment of Pediatric Septic Shock: Experience at an Emergency Department

et al. 2020

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Objective: Mortality in pediatric septic shock remains unacceptably high.Delays in vasopressor administration have been associated with an increased risk of mortality. Current treatment guidelines suggest the use of a peripheral vascular line (PVL) for inotropic administration in fluid-refractory septic shock when a central vascular line is not already in place. The aim of this study was to report local adverse effects associated with inotropic drug administration through a PVL at a pediatric emergency department setting in the first hour of treatment of septic shock.Methods: A prospective, descriptive, observational cohort study of patients with septic shock requiring PVL inotropic administration was conducted at the pediatric emergency department of a tertiary care pediatric hospital. For the infusion and postplacement care of the PVL for vasoactive drugs, an institutional nursing protocol was used.Results: We included 49 patients; 51% had an underlying disease.Eighty-four percent of the children included had a clinical "cold shock." The most frequently used vasoactive drug was epinephrine (72%). One patient presented with local complications.Conclusions: At our center, infusion of vasoactive drugs through a PVL was shown to be safe and allowed for adherence to the current guidelines for pediatric septic shock.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Use of Inotropics by Peripheral Vascular Line in the First Hour of Treatment of Pediatric Septic Shock: Experience at an Emergency Department

et al. 2020

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“…Previous similar studies have tended to feature dopamine as the predominant VDI (13–16), whereas in this study, epinephrine is by far the most used drug (used 400 times in 558 children), reflecting current evidence and consensus recommendations (1, 2, 17). A small subgroup of 20 children, mostly with septic shock, received an infusion of peripheral norepinephrine for a median time of 660 minutes without the development of extravasation injury.…”

Section: Discussionmentioning

confidence: 71%

Peripheral and Central/Intraosseous Vasoactive Infusions During and After Pediatric Critical Care Transport: Retrospective Cohort Study of Extravasation Injury*

Peshimam¹,

Bruce-Hickman²,

Crawford³

et al. 2022

Pediatric Critical Care Medicine

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To compare the prevalence of adverse events related to vasoactive drug infusions administered via a peripheral venous catheter versus a central venous or intraosseous catheter.DESIGN: Retrospective observational study. SETTING:A pediatric critical care transport team, and the PICUs and regional hospitals within the North Thames and East Anglia regions of the United Kingdom. PATIENTS:Children (up to 18 yr old) transported by the Children's Acute Transport Service receiving an infusion of a vasoactive drug (epinephrine, dobutamine, dopamine, norepinephrine, and vasopressin). INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS:The medical records of all children transported between April 2017 and May 2020 receiving a vasoactive drug infusion were reviewed and cross-referenced with the service critical incident database. The outcome measure was anatomic catheter-related adverse events (including extravasation) reported during transport or in the first 24 hours on the PICU. During the study period, the service undertook 3,836 transports. Vasoactive drugs were administered during 558 patient transports (14.5%). During 198 of 558 transports (35.5%), vasoactive drugs were administered via a peripheral venous catheter, with seven of 198 (3.5%) adverse events. One extravasation event resulted in tissue necrosis. The median time to injury after the infusion was commenced was 60 minutes (interquartile range, 30-60 min). During 360 of 558 transports (64.5%), vasoactive infusions were administered by central venous or intraosseous catheter, with nine of 360 (2.5%) adverse events. CONCLUSIONS:During pediatric critical care transport, we did not find a difference in prevalence of adverse events following the administration of vasoactive drugs via peripheral venous catheters or via central venous and intraosseous catheters.

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Study of Vasoactive Infusions through Peripheral Line

Cited by 2 publications

References 9 publications

Use of Inotropics by Peripheral Vascular Line in the First Hour of Treatment of Pediatric Septic Shock: Experience at an Emergency Department

Use of Inotropics by Peripheral Vascular Line in the First Hour of Treatment of Pediatric Septic Shock: Experience at an Emergency Department

Peripheral and Central/Intraosseous Vasoactive Infusions During and After Pediatric Critical Care Transport: Retrospective Cohort Study of Extravasation Injury*

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