Montana Fleenor, PharmD
Vanderbilt University Medical Center
Nashville, Tennessee
Disclosure information not submitted.
Sneha Patel, PharmD
Trauma Clinical Pharmacy Specialist
Ascension Saint Thomas Rutherford Hospital
Disclosure information not submitted.
Ryan Dillon, PharmD, BCCCP
Emergency Medicine Clinical Pharmacist Specialist
Vanderbilt University Medical Center, United States
Disclosure information not submitted.
Title: Incidence of Adverse Effects During Peripheral Vasopressin Administration
Introduction: Vasopressors are essential for management of various forms of shock and are preferentially given via central venous catheter (CVC) due to risk of extravasation. CVCs are not without risk and placement can delay timely vasopressor treatment. Various prior studies evaluate the incidence of adverse effects during peripheral administration of adrenergic vasopressor agents, however, there is scarce data exploring vasopressin. The objective of this study was to evaluate the safety of peripheral administration of vasopressin.
Methods: A multi-center retrospective review was conducted in patients who received vasopressin in the emergency department and intensive care units. Patients were excluded if they had a CVC for the entire duration of the infusion or were younger than 18 years. Infusion characteristics and baseline patient demographics were obtained. Infusion related adverse events (IRAEs) were recorded and interventions noted.
Results: A total of 49 patients were included in the analysis. Median patient age was 63 years and majority of patients were managed in the emergency department. Median duration of peripheral infusion was 109 minutes and the most common peripheral venous line sites were cephalic, basilic, and external jugular. The incidence of extravasation was 4%. All of the events were managed via removal of peripheral line; none required pharmacologic or surgical intervention.
Conclusions: In the largest study conducted to date investigating peripheral administration of vasopressin, the incidence of IRAEs related to peripheral vasopressin administration appears to be similar to that of other vasopressor therapies. Thus, its’ use could be considered in patients who require time sensitive therapy.