Related Experiment Video
Updated: Sep 10, 2025
08:45
Echocardiographic Assessment Using Subxiphoid-Only Examination for Hypotensive Patients
Published on: April 18, 2025
424
Peripheral Vasopressor Use in Early Sepsis-Induced Hypotension
Elizabeth S Munroe1, Ivan N Co1,2, Ivor Douglas3
1Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Michigan, Ann Arbor.
JAMA Network Open
|August 27, 2025
Summary
Peripheral vasopressors are safe and effective for early sepsis resuscitation, showing low complication rates and comparable outcomes to central lines. This supports their feasibility for short-term use.
Area of Science:
- Critical Care Medicine
- Pharmacology
- Clinical Trials
Background:
- Limited generalizability of existing evidence on peripheral vasopressor safety.
- Need to evaluate factors influencing vasopressor route selection in sepsis.
Purpose of the Study:
- Assess safety and clinical outcomes of peripheral vasopressor administration in early sepsis.
- Identify factors associated with vasopressor route selection.
Main Methods:
- Secondary analysis of the CLOVERS trial, a prospective cohort study.
- Included patients receiving vasopressors within 24 hours without central venous access.
- Analyzed vasopressor initiation route, continuation, and complications.
Main Results:
- Peripheral vasopressor initiation was common (84.2%) with low complication rates (0.6%).
- Peripheral vs. central initiation showed comparable 90-day mortality.
- Central venous catheter placement had higher complication rates (3.7%).
Conclusions:
- Peripheral vasopressor administration is feasible and safe for short-term use in early sepsis.
- Findings support expanding the use of peripheral vasopressors in sepsis resuscitation.
- Peripheral vasopressors offer a viable alternative with minimal complications.
Related Concept Videos
01:23Antihypertensive Drugs: Vasodilators
642
Vasodilators, primarily affecting the smooth muscles within arterial and venous walls, are commonly used for hypertension treatment. Medications such as minoxidil and hydralazine primarily target arteries and arterioles, while sodium nitroprusside acts on arterioles and venules. Minoxidil, functioning as a prodrug, is metabolized by hepatic sulfotransferase into its active form, minoxidil sulfate, after oral administration. This metabolite binds to the sulfonylurea receptor (SUR) component of...
642
01:25Cardiopulmonary Resuscitation IV: Pharmacological Management
75
Pharmacologic intervention is crucial in treating cardiac arrest patients during ACLS or Advanced Cardiovascular Life Support. The ACLS algorithms guide the administration of specific drugs based on the patient's cardiac arrest rhythm, which includes pulseless ventricular tachycardia (VT), ventricular fibrillation (VF), asystole, and pulseless electrical activity (PEA).EpinephrineIndication: Epinephrine is the first-line drug for all cardiac arrest rhythms.Mechanism of Action: Epinephrine...
75
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
505
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
505
01:24Blood Pressure Imbalances and Circulatory Shock
998
Disorders affecting blood volume, vascular tone, or vascular function can disrupt vascular homeostasis, including conditions like hypertension, hemorrhage, and shock.
Blood Pressure: Hypertension and Hypotension
Normal blood pressure is 120/80 mm Hg. Elevated blood pressure is 120-129/under 80 mm Hg. Hypertension, warranting treatment at 130/80 mm Hg, is often asymptomatic and can lead to severe cardiovascular events, aneurysms, peripheral arterial disease, chronic renal disease, or cardiac...
Blood Pressure: Hypertension and Hypotension
Normal blood pressure is 120/80 mm Hg. Elevated blood pressure is 120-129/under 80 mm Hg. Hypertension, warranting treatment at 130/80 mm Hg, is often asymptomatic and can lead to severe cardiovascular events, aneurysms, peripheral arterial disease, chronic renal disease, or cardiac...
998
01:30Adrenergic Agonists: Therapeutic Uses
943
Adrenergic agonists have diverse therapeutic uses across various medical conditions and emergencies.
Emergency and Intensive Care Unit (ICU) applications: Pressor agents increase blood pressure, heart rate, and contractility in shock and organ failure situations. Dopamine can induce vasodilation and stimulate adrenoceptors. Endogenous catecholamines are effective in treating cardiogenic shock. α2-agonists like clonidine can reverse anesthesia-induced hypertension.
Allergies and...
Emergency and Intensive Care Unit (ICU) applications: Pressor agents increase blood pressure, heart rate, and contractility in shock and organ failure situations. Dopamine can induce vasodilation and stimulate adrenoceptors. Endogenous catecholamines are effective in treating cardiogenic shock. α2-agonists like clonidine can reverse anesthesia-induced hypertension.
Allergies and...
943