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Extravasation injury associated with low-dose dopamine

J L Chen1, M O'Shea

  • 1Pharmacy Department, Montefiore Medical Center, Bronx, NY, USA.

The Annals of Pharmacotherapy
|June 2, 1998
PubMed
Summary

Even low-dose dopamine infusions can cause dangerous extravasation and tissue injury. Healthcare providers should use central venous access or carefully monitor peripheral infusions to prevent complications.

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Area of Science:

  • Cardiology
  • Pharmacology
  • Intensive Care Medicine

Background:

  • Dopamine is used to improve renal blood perfusion and urine output.
  • Peripheral intravenous dopamine infusions are sometimes administered in cardiac intensive care units.
  • Extravasation of dopamine can lead to significant local tissue injury.

Observation:

  • Two patients receiving low-dose peripheral dopamine infusions (< 3 µg/kg/min) experienced extravasation.
  • Both patients developed significant local tissue injury at the infusion site.
  • This highlights a risk previously associated primarily with high-dose dopamine.

Findings:

  • Low-dose dopamine extravasation can cause severe vasoconstriction and ischemic tissue injury.
  • The vasodilatory effects of low-dose dopamine may be overcome by local high concentrations from extravasation.
  • This suggests a potential for tissue necrosis even with therapeutic doses.

Implications:

  • Low-dose dopamine therapy requires precautions similar to high-dose therapy.
  • Central venous access is preferred for dopamine infusions whenever feasible.
  • Close monitoring of peripheral infusion sites and prompt catheter changes are crucial, especially in high-risk patients.

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