Effect of Peripherally Infused Norepinephrine on Reducing Central Venous Catheter Utilization

Area of Science:

• Critical Care Medicine
• Pharmacology

Background:

• Central venous catheters are often required for vasopressor administration.
• Central venous catheterization carries risks of complications.
• Alternative infusion sites are being explored for vasopressor therapy.

Purpose of the Study:

• To evaluate the safety and efficacy of peripherally administered norepinephrine.
• To determine the rate of avoidance of central venous catheter insertion.
• To assess the economic impact of peripheral norepinephrine infusion.

Main Methods:

• Retrospective study of 124 patients receiving norepinephrine.
• Comparison between peripheral intravenous (IV) and central catheter administration.
• Analysis of primary outcome: need for central venous access.

Main Results:

• 37% of patients on peripheral norepinephrine avoided central catheter placement.
• Peripheral infusion was associated with $8,900 in cost avoidance.
• 82% of patients required peripheral norepinephrine for 12 hours or less.
• No local complications or extravasation occurred with peripheral infusion.

Conclusions:

• Peripherally administered norepinephrine is safe and effective for selected patients.
• Peripheral infusion can reduce the need for central venous access.
• Initial peripheral administration of norepinephrine should be considered to optimize patient care.