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Cited by 235Central Venous Catheters and HemodialysisIntravenous Infusion Technology and SafetyChemotherapy-related skin toxicity

A systematic review of extravasation and local tissue injury from administration of vasopressors through peripheral intravenous catheters and central venous catheters

Loubani, Osama M., Green, Robert S.·2015·Journal of Critical Care
DOI 10.1016/j.jcrc.2015.01.014
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Abstract

Purpose The aim of this study was to collect and describe all published reports of local tissue injury or extravasation from vasopressor administration via either peripheral intravenous (IV) or central venous catheter.Methods A systematic search of Medline, Embase, and Cochrane databases was performed from inception through January 2014 for reports of adults who received vasopressor intravenously via peripheral IV or central venous catheter for a therapeutic purpose. We included primary studies or case reports of vasopressor administration that resulted in local tissue injury or extravasation of vasopressor solution.Results Eighty-five articles with 270 patients met all inclusion criteria. A total of 325 separate local tissue injury and extravasation events were identified, with 318 events resulting from peripheral vasopressor administration and 7 events resulting from central administration. There were 204 local tissue injury events from peripheral administration of vasopressors, with an average duration of infusion of 55.9 hours (±68.1), median time of 24 hours, and range of 0.08 to 528 hours. In most of these events (174/204, 85.3%), the infusion site was located distal to the antecubital or popliteal fossae.Conclusions Published data on tissue injury or extravasation from vasopressor administration via peripheral IVs are derived mainly from case reports. Further study is warranted to clarify the safety of vasopressor administration via peripheral IVs.

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  • We identified direct evidence from 14 RCTs (n = 4,499 patients) that assessed use of procalcitonin to guide antimicrobial treatment duration in patients with sepsis.

    “We identified direct evidence from 14 RCTs (n = 4,499 patients) that assessed use of procalcitonin to guide antimicrobial treatment duration in patients with sepsis (two trials included critically ill patients in general) (308-321).”

    From Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. (2021) · cites this paper as [312]

  • Local tissue injury may be more likely with prolonged administration of vasopressors.

    “The occurrence of local tissue injury may be more likely with prolonged administration of vasopressors.”

    From Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 (2021) · cites this paper as [389]

  • Administration of vasopressors for less than 6 hours in a well-placed peripheral catheter proximal to the antecubital fossa is unlikely to cause local tissue injury.

    “Administration of vasopressors for a short period of time (< 6 h) in a well-placed peripheral catheter proximal to the antecubital fossa is unlikely to cause local tissue injury [389].”

    From Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 (2021) · cites this paper as [389]

  • Extravasation may occur more frequently if vasopressors are infused distal to the antecubital fossa; a meta-analysis found 85% of reported extravasation events occurred with a catheter distal to the antecubital fossa.

    “Extravasation may occur more frequently if vasopressors are infused distally to the antecubital fossa; a meta-analysis showed that 85% of reported extravasation events occurred when vasopressors were infused by a catheter that was located distal to the antecubital fossa [389].”

    From Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 (2021) · cites this paper as [389]

  • Most studies reported no need for active treatment of extravasation, and a systematic review concluded most patients with extravasation have no long-term sequelae.

    “Most of the studies reported no need for active treatment of the extravasation, and a systematic review concluded that most patients who experience extravasation events have no long-term sequelae [389].”

    From Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 (2021) · cites this paper as [389]

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Authors
Loubani, O. M., & Green, R. S.
Affiliations
Dalhousie University (CA)
Corresponding author
Loubani, Osama M.
ORCID
Venue
Journal of Critical Care
Publisher
Elsevier BV
Published
2015-06
Volume
30
Issue
3
Pages
653.e9-653.e17
ISSN
0883-9441 (ISSN-L)
DOI
10.1016/j.jcrc.2015.01.014
OpenAlex
W2074225649
Cited by
235
References
95
Citations by year
2026: 14 · 2025: 21 · 2024: 35 · 2023: 26 · 2022: 27 · 2021: 29 · 2020: 24 · 2019: 17 · 2018: 13 · 2017: 16 · 2016: 9 · 2015: 3 · 2013: 1
FWCI
3.25
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Journal of Critical Care (publishedVersion)
  • PubMed (publishedVersion)
Funders
Dalhousie University
Topics
  • Health Sciences › Health Professions › Emergency Medical Services › Central Venous Catheters and Hemodialysis
  • Physical Sciences › Engineering › Biomedical Engineering › Intravenous Infusion Technology and Safety
  • Health Sciences › Medicine › Dermatology › Chemotherapy-related skin toxicity
Keywords
vasopressors, extravasation, local tissue injury, peripheral intravenous catheters, central venous catheters
MeSH terms
Catheterization, Central Venous, Catheterization, Peripheral, Extravasation of Diagnostic and Therapeutic Materials, Humans, Infusions, Intravenous, Necrosis, Vasoconstrictor Agents, Critical Illness, Soft Tissue Injuries, Vascular Access Devices, Central Venous Catheters

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