Complication of vasopressor infusion through peripheral venous catheter: A systematic review and meta-analysis
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...
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Veröffentlicht in: | The American journal of emergency medicine 2020-11, Vol.38 (11), p.2434-2443 |
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creator | Tran, Quincy K. Mester, Gaurika Bzhilyanskaya, Vera Afridi, Leenah Z. Andhavarapu, Sanketh Alam, Zain Widjaja, Austin Andersen, Brooke Matta, Ann Pourmand, Ali |
description | 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.
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.
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).
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. |
doi_str_mv | 10.1016/j.ajem.2020.09.047 |
format | Article |
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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.
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).
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.</description><identifier>ISSN: 0735-6757</identifier><identifier>EISSN: 1532-8171</identifier><identifier>DOI: 10.1016/j.ajem.2020.09.047</identifier><identifier>PMID: 33039229</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adverse events ; Agreements ; Bias ; Case reports ; Catheterization, Central Venous ; Catheterization, Peripheral ; Catheters ; Central Venous Catheters ; Clinical trials ; Complications ; Emergency medical care ; Emergency Service, Hospital ; Erythema - epidemiology ; Erythema - etiology ; Extravasation of Diagnostic and Therapeutic Materials - epidemiology ; Extravasation of Diagnostic and Therapeutic Materials - etiology ; Health risks ; Humans ; Infusions, Intravenous - adverse effects ; Infusions, Intravenous - methods ; Intensive Care Units ; Medical instruments ; Meta-analysis ; Mortality ; Peripheral intravenous catheters ; Point of care testing ; Practice Guidelines as Topic ; Safety ; Sepsis ; Shock - drug therapy ; Systematic review ; Time-to-Treatment ; Ultrasonic imaging ; Vasoactive medication ; Vasoconstrictor Agents - administration & dosage ; Vasopressors ; Venous Thrombosis - epidemiology ; Venous Thrombosis - etiology</subject><ispartof>The American journal of emergency medicine, 2020-11, Vol.38 (11), p.2434-2443</ispartof><rights>2020 Elsevier Inc.</rights><rights>Copyright © 2020 Elsevier Inc. All rights reserved.</rights><rights>2020. Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c384t-a704472bf2b26eb2934e67684989df55f0a004abe278d98f9f926decb3148b03</citedby><cites>FETCH-LOGICAL-c384t-a704472bf2b26eb2934e67684989df55f0a004abe278d98f9f926decb3148b03</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/2467610616?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,3548,27922,27923,45993,64383,64387,72239</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33039229$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tran, Quincy K.</creatorcontrib><creatorcontrib>Mester, Gaurika</creatorcontrib><creatorcontrib>Bzhilyanskaya, Vera</creatorcontrib><creatorcontrib>Afridi, Leenah Z.</creatorcontrib><creatorcontrib>Andhavarapu, Sanketh</creatorcontrib><creatorcontrib>Alam, Zain</creatorcontrib><creatorcontrib>Widjaja, Austin</creatorcontrib><creatorcontrib>Andersen, Brooke</creatorcontrib><creatorcontrib>Matta, Ann</creatorcontrib><creatorcontrib>Pourmand, Ali</creatorcontrib><title>Complication of vasopressor infusion through peripheral venous catheter: A systematic review and meta-analysis</title><title>The American journal of emergency medicine</title><addtitle>Am J Emerg Med</addtitle><description>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.
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.
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).
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.</description><subject>Adverse events</subject><subject>Agreements</subject><subject>Bias</subject><subject>Case reports</subject><subject>Catheterization, Central Venous</subject><subject>Catheterization, Peripheral</subject><subject>Catheters</subject><subject>Central Venous Catheters</subject><subject>Clinical trials</subject><subject>Complications</subject><subject>Emergency medical care</subject><subject>Emergency Service, Hospital</subject><subject>Erythema - epidemiology</subject><subject>Erythema - etiology</subject><subject>Extravasation of Diagnostic and Therapeutic Materials - epidemiology</subject><subject>Extravasation of Diagnostic and Therapeutic Materials - etiology</subject><subject>Health risks</subject><subject>Humans</subject><subject>Infusions, Intravenous - adverse effects</subject><subject>Infusions, Intravenous - methods</subject><subject>Intensive Care Units</subject><subject>Medical instruments</subject><subject>Meta-analysis</subject><subject>Mortality</subject><subject>Peripheral intravenous catheters</subject><subject>Point of care testing</subject><subject>Practice Guidelines as Topic</subject><subject>Safety</subject><subject>Sepsis</subject><subject>Shock - drug therapy</subject><subject>Systematic review</subject><subject>Time-to-Treatment</subject><subject>Ultrasonic imaging</subject><subject>Vasoactive medication</subject><subject>Vasoconstrictor Agents - administration & dosage</subject><subject>Vasopressors</subject><subject>Venous Thrombosis - epidemiology</subject><subject>Venous Thrombosis - etiology</subject><issn>0735-6757</issn><issn>1532-8171</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kE1r3DAQhkVJaTZp_0AOQZCz3dGHLavkEpY2LQR6yV3I9qgrs7Zcyd6w_75aNukxp4HhfR9mHkJuGJQMWP11KO2AY8mBQwm6BKk-kA2rBC8aptgF2YASVVGrSl2Sq5QGAMZkJT-RSyFAaM71hkzbMM5739nFh4kGRw82hTliSiFSP7k1nfbLLob1z47OGP28w2j39IBTWBPNxR0uGL_RB5qOacExkzoa8eDxhdqppyMutrCT3R-TT5_JR2f3Cb-8zmvy_OP78_Zn8fT78df24anoRCOXwiqQUvHW8ZbX2HItJNaqbqRudO-qyoEFkLZFrppeN047zeseu1Yw2bQgrsndGTvH8HfFtJghrDHfkAyXGcSgZnVO8XOqiyGliM7M0Y82Hg0DczJsBnMybE6GDWiTDefS7St6bUfs_1felObA_TmA-b9sIZrUeZw67H3EbjF98O_x_wEojI5t</recordid><startdate>202011</startdate><enddate>202011</enddate><creator>Tran, Quincy K.</creator><creator>Mester, Gaurika</creator><creator>Bzhilyanskaya, Vera</creator><creator>Afridi, Leenah Z.</creator><creator>Andhavarapu, Sanketh</creator><creator>Alam, Zain</creator><creator>Widjaja, Austin</creator><creator>Andersen, Brooke</creator><creator>Matta, Ann</creator><creator>Pourmand, Ali</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope></search><sort><creationdate>202011</creationdate><title>Complication of vasopressor infusion through peripheral venous catheter: A systematic review and meta-analysis</title><author>Tran, Quincy K. ; Mester, Gaurika ; Bzhilyanskaya, Vera ; Afridi, Leenah Z. ; Andhavarapu, Sanketh ; Alam, Zain ; Widjaja, Austin ; Andersen, Brooke ; Matta, Ann ; Pourmand, Ali</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c384t-a704472bf2b26eb2934e67684989df55f0a004abe278d98f9f926decb3148b03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adverse events</topic><topic>Agreements</topic><topic>Bias</topic><topic>Case reports</topic><topic>Catheterization, Central Venous</topic><topic>Catheterization, Peripheral</topic><topic>Catheters</topic><topic>Central Venous Catheters</topic><topic>Clinical trials</topic><topic>Complications</topic><topic>Emergency medical care</topic><topic>Emergency Service, Hospital</topic><topic>Erythema - epidemiology</topic><topic>Erythema - etiology</topic><topic>Extravasation of Diagnostic and Therapeutic Materials - epidemiology</topic><topic>Extravasation of Diagnostic and Therapeutic Materials - etiology</topic><topic>Health risks</topic><topic>Humans</topic><topic>Infusions, Intravenous - adverse effects</topic><topic>Infusions, Intravenous - methods</topic><topic>Intensive Care Units</topic><topic>Medical instruments</topic><topic>Meta-analysis</topic><topic>Mortality</topic><topic>Peripheral intravenous catheters</topic><topic>Point of care testing</topic><topic>Practice Guidelines as Topic</topic><topic>Safety</topic><topic>Sepsis</topic><topic>Shock - drug therapy</topic><topic>Systematic review</topic><topic>Time-to-Treatment</topic><topic>Ultrasonic imaging</topic><topic>Vasoactive medication</topic><topic>Vasoconstrictor Agents - administration & dosage</topic><topic>Vasopressors</topic><topic>Venous Thrombosis - epidemiology</topic><topic>Venous Thrombosis - etiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tran, Quincy K.</creatorcontrib><creatorcontrib>Mester, Gaurika</creatorcontrib><creatorcontrib>Bzhilyanskaya, Vera</creatorcontrib><creatorcontrib>Afridi, Leenah Z.</creatorcontrib><creatorcontrib>Andhavarapu, Sanketh</creatorcontrib><creatorcontrib>Alam, Zain</creatorcontrib><creatorcontrib>Widjaja, Austin</creatorcontrib><creatorcontrib>Andersen, Brooke</creatorcontrib><creatorcontrib>Matta, Ann</creatorcontrib><creatorcontrib>Pourmand, Ali</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><jtitle>The American journal of emergency medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tran, Quincy K.</au><au>Mester, Gaurika</au><au>Bzhilyanskaya, Vera</au><au>Afridi, Leenah Z.</au><au>Andhavarapu, Sanketh</au><au>Alam, Zain</au><au>Widjaja, Austin</au><au>Andersen, Brooke</au><au>Matta, Ann</au><au>Pourmand, Ali</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Complication of vasopressor infusion through peripheral venous catheter: A systematic review and meta-analysis</atitle><jtitle>The American journal of emergency medicine</jtitle><addtitle>Am J Emerg Med</addtitle><date>2020-11</date><risdate>2020</risdate><volume>38</volume><issue>11</issue><spage>2434</spage><epage>2443</epage><pages>2434-2443</pages><issn>0735-6757</issn><eissn>1532-8171</eissn><abstract>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.
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.
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).
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.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>33039229</pmid><doi>10.1016/j.ajem.2020.09.047</doi><tpages>10</tpages></addata></record> |
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subjects | Adverse events Agreements Bias Case reports Catheterization, Central Venous Catheterization, Peripheral Catheters Central Venous Catheters Clinical trials Complications Emergency medical care Emergency Service, Hospital Erythema - epidemiology Erythema - etiology Extravasation of Diagnostic and Therapeutic Materials - epidemiology Extravasation of Diagnostic and Therapeutic Materials - etiology Health risks Humans Infusions, Intravenous - adverse effects Infusions, Intravenous - methods Intensive Care Units Medical instruments Meta-analysis Mortality Peripheral intravenous catheters Point of care testing Practice Guidelines as Topic Safety Sepsis Shock - drug therapy Systematic review Time-to-Treatment Ultrasonic imaging Vasoactive medication Vasoconstrictor Agents - administration & dosage Vasopressors Venous Thrombosis - epidemiology Venous Thrombosis - etiology |
title | Complication of vasopressor infusion through peripheral venous catheter: A systematic review and meta-analysis |
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