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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com

WORLD EMERGENCY MEDICINE SOCIETIES

HEMORRHAGIC SHOCK THE THOR WAY

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martes, 13 de febrero de 2018

Peripheral Vasopressors

R.E.B.E.L.EM - February 12, 2018
"Background: We have discussed the safety of peripheral vasopressors on REBEL EM before. In that review by Loubani et al was a systematic review of 85 articles and 270 patients. 95% of the extravasation events occurred in PIVs with infusions running greater than 4 hours and 85% of extravasation events occurred in PIVs distal to the antecubital fossa. The major limitation of this systematic review is that the majority of the data was derived from case reports and case series and not prospective trials. The authors of this current study sought to determine the incidence of complications of running vasopressors through PIVs in patients with circulatory shock in a prospective, observational trial.
Author Conclusion: “The incidence of complications from the administration of vasopressors through a PVC is small and did not result in significant morbidity in this study. Larger prospective studies are needed to better determine the factors that are associated with these complications, and identify patients in whom this practice is safe.”
Clinical Take Home Point: In patients with shock, use of peripheral vasopressors (Norepinephrine and Dopamine) in a large bore IV (18 – 20g) at a proximal site (antecubital fossa or more proximal) run for ≤4hrs or less is a safe option until more central access can be achieved."