Complication of vasopressor infusion through peripheral venous catheter: A systematic review and meta-analysis
| Autor: | Brooke Andersen, Gaurika Mester, Ann Matta, Austin Widjaja, Sanketh Andhavarapu, Ali Pourmand, Vera Bzhilyanskaya, Leenah Afridi, Zain Alam, Quincy K. Tran |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Catheterization
Central Venous medicine.medical_specialty Time-to-Treatment law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Catheterization Peripheral medicine Central Venous Catheters Humans Vasoconstrictor Agents Infusions Intravenous Venous Thrombosis business.industry Shock 030208 emergency & critical care medicine General Medicine Guideline Safety guidelines Intensive Care Units Erythema Meta-analysis Shock (circulatory) Practice Guidelines as Topic Emergency medicine Cohort Emergency Medicine Peripheral venous catheter medicine.symptom Emergency Service Hospital Complication business Extravasation of Diagnostic and Therapeutic Materials |
| Zdroj: | The American Journal of Emergency Medicine. 38:2434-2443 |
| ISSN: | 0735-6757 |
| DOI: | 10.1016/j.ajem.2020.09.047 |
| Popis: | Background Vasopressors are mainstay treatment for patients in shock and are usually infused through central venous catheters (CVCs). However, CVCs are associated with risk of infection or delay from the needs of confirmation of placement. Infusing vasopressor through peripheral venous catheter (PIVs) could be an alternative in the Emergency Departments (ED) but data regarding complications is inconclusive. We performed a random-effects meta-analysis to assess literature involving prevalence of complications from infusing vasopressors via PIVs. Methods We searched PubMed, EMBASE and Scopus databases from beginnings to 02/02/2020 to identify relevant randomized control trials, cohort, case-control studies. We excluded case reports. Authors assessed studies' quality with Newcastle-Ottawa Scale and Cochrane Risk of Bias tool. Kappa score was used to assess interrater agreement. Outcome was complications as direct results from infusing vasopressors through PIVs. Results We identified 325 articles and included 9 studies after reviewing 16 full text articles. Our analysis included 1835 patients whose mean age was 63 (Standard Deviation 12) years and 48% was female. There were 122 (7%) complications, of which 117 (96%) were minor. The meta-analysis with random effects showed the pooled prevalence of complications as 0.086 (95%CI 0.031–0.21). Studies reporting infusion safety guidelines had significantly lower prevalence of complications (0.029, 95%CI 0.018–0.045), compared to those not reporting a safety guideline (0.12, 95%CI 0.038–0.30, p = 0.024). Conclusion There was low prevalence of complications as a direct result from infusing vasopressors through PIVs. Studies with safety guidelines were associated with significantly lower prevalence of complications. Further studies are needed to confirm our observations. |
| Databáze: | OpenAIRE |
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