Peripheral versus central venous delivery of medications during CPR

Traditionally drug delivery during cardiopulmonary resuscitation (CPR) has been considered to be equally effective when given through the peripheral venous and central venous routes. Recently, however, these routes of drug administration have undergone reevaluation. During normal flow drug delivery appears to be equally efficient by the peripheral venous and central venous routes. During CPR, however, drug administration by way of the supradiaphragmatic central circulation appears to result in significantly more rapid drug delivery to the central arterial circulation. Data regarding the effect of route of administration on quantitative peak levels are mixed. Changes in cardiac output and the mechanics of blood flow during CPR are thought to be responsible for these route-dependent rates of drug delivery.