Peripheral Vasopressor Administration: An Evidence-Based Risk-Benefit Analysis

Peripheral vasopressor administration has been heavily researched over the past decade as a way to quickly treat hemodynamically unstable patients. However, current evidence is diverse and limited by quality concerns, including a reliance on retrospective studies, inconsistent criteria, and bias risk. While central venous access devices (CVADs) remain the preferred route for vasopressor administration, use of the peripheral route is necessary when a CVAD is not yet present or contraindicated. Vascular access selection should be tailored to individual patient's needs. Current evidence indicates that using a protocolized approach for peripheral vasopressors appears safe and effective for low-acuity patients requiring short-term therapy (eg, less than 24 hours).