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Overview of Peripheral Vasopressor Use in an Academic Health System.

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Peripheral vasopressors are safe and commonly used, especially in community hospitals. Their use was not linked to increased mortality but was associated with shorter hospital stays, despite variable provider utilization.

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Area of Science:

  • Critical Care Medicine
  • Pharmacology
  • Health Services Research

Background:

  • Historical concerns regarding tissue injury from vasopressor extravasation exist.
  • Current evidence suggests peripheral vasopressor administration is safe.
  • Utilization of peripheral vasopressors remains inconsistent across healthcare settings.

Purpose of the Study:

  • To analyze trends in peripheral vasopressor use over time.
  • To identify variations in peripheral vasopressor utilization.
  • To evaluate patient outcomes associated with peripheral vasopressor initiation.

Main Methods:

  • Retrospective cohort study of 9,493 adult patients across 10 Minnesota hospitals (10/2020 - 10/2023).
  • Comparison of patients initiating vasopressors peripherally versus centrally.
  • Assessment of safety, efficacy, and utilization patterns.

Main Results:

  • 3,734 patients initiated vasopressors peripherally; 31 (0.8%) experienced extravasation events.
  • Peripheral initiation was not associated with increased hospital, 90-day, or 1-year mortality.
  • Community hospitals showed higher peripheral vasopressor utilization (50.7%) than academic centers (27.6%).

Conclusions:

  • Peripheral vasopressors are frequently and safely administered within a large health system.
  • Peripheral initiation of vasopressors correlates with decreased hospital length of stay.
  • Significant variability in peripheral vasopressor use exists among hospitals and providers.