It has been dogmatically believed that prolonged infusion of any vasopressor mandates placement of a central line. However, available evidence doesn’t support this. Diluted solutions of all catecholamines are safe (except Vasopressin) to be administered peripherally via a well functioning 18-20G IV or larger in forearm (no hand/wrist/AC) . No old IVs (>72 hrs) Know how […]
Using the subclavian site for central venous catheterization reduced infections and DVT to a minimum, but tripled the risk of pneumothorax compared to the internal jugular (IJ) position. Using the femoral position eliminated pneumothorax risk, and was comparable to the IJ in infection risk, but significantly increased DVT risk.
Can you give vasopressors via a peripheral IV to save a life before a central line is inserted…YES WE CAN!!
In critically ill patients, with hemodynamic instability, vasopressor infusion through a proximal PIV (antecubital fossa or external jugular vein), for <4hours of duration is unlikely to result in tissue injury and will reduce the time it takes to achieve hemodynamic stability.