Peripheral Administration of Vasopressin for Catecholamine-Resistant Hypotension Complicated by Skin Necrosis

Bunker, Nick; Higgins, David

doi:10.1097/01.ccm.0000202202.85087.37

Cited by 14 publications

(15 citation statements)

References 3 publications

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“…The κ statistic for agreement between reviewers for the final inclusion of papers based on full references was 0.773. Of the 85 included references, 80 [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][23][24][25][26][27][28][29][30][31][32][33][34][35]66, presented individual data and were made up of case studies and case series, while 5 [22,36,65,67,89] presented aggregate data and included 1 [67] randomized controlled trial and 4 [22,36,65,89] case series. None of these studies directly compared the administration of vasopressors via central or peripheral catheters with rates of tissue ischemia or extravasation.…”

Section: Characteristics Of Study Subjectsmentioning

confidence: 99%

A systematic review of extravasation and local tissue injury from administration of vasopressors through peripheral intravenous catheters and central venous catheters

Loubani

Green

2015

Journal of Critical Care

187

206

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Section: Characteristics Of Study Subjectsmentioning

confidence: 99%

A systematic review of extravasation and local tissue injury from administration of vasopressors through peripheral intravenous catheters and central venous catheters

Loubani

Green

2015

Journal of Critical Care

187

206

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“…Since its resurgence in use for the treatment of septic shock and hepatorenal syndrome, case reports have emerged of extravasation and skin necrosis due to vasopressin. 40 As a result of these reports, the authors of the Surviving Sepsis Campaign have revised their vasopressin recommendations to administer the drug through a central line. 22,40 To date, no published reports have detailed the successful management of vasopressin extravasations.…”

Section: Vasopressinmentioning

confidence: 99%

“…40 As a result of these reports, the authors of the Surviving Sepsis Campaign have revised their vasopressin recommendations to administer the drug through a central line. 22,40 To date, no published reports have detailed the successful management of vasopressin extravasations. Although intravenous vasopressin antagonists exist, such as conivaptan, these agents should not be used until they are further studied for this indication.…”

Section: Vasopressinmentioning

confidence: 99%

Management of Extravasation Injuries: A Focused Evaluation of Noncytotoxic Medications

et al. 2014

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Extravasations are common manifestations of iatrogenic injury that occur in patients requiring intravenous delivery of known vesicants. These injuries can contribute substantially to patient morbidity, cost of therapy, and length of stay. Many different mechanisms are behind the tissue damage during extravasation injuries. In general, extravasations consist of four different subtypes of tissue injury: vasoconstriction, osmotic, pH related, and cytotoxic. Recognition of high-risk patients, appropriate cannulation technique, and monitoring of higher risk materials remain the standard of care for the prevention of extravasation injury. Prompt interdisciplinary action is often necessary for the treatment of extravasation injuries. Knowledge of the mechanism of extravasation-induced tissue injury, agents for reversal, and appropriate nonpharmacologic treatment methods is essential. The best therapeutic agent for treatment of vasopressor extravasation is intradermal phentolamine. Topical vasodilators and intradermal terbutaline may provide relief. Intradermal hyaluronidase has been effective for hyperosmotic extravasations, although its use largely depends on the risk of tissue injury and the severity of extravasation. Among the hyperosmotic agents, calcium extravasation is distinctive because it may present as an acute tissue injury or may possess delayed clinical manifestations. Extravasation of acidic or basic materials can produce significant tissue damage. Phenytoin is the prototypical basic drug that causes a clinical manifestation known as purple glove syndrome (PGS). This syndrome is largely managed through preventive and conservative treatment measures. Promethazine is acidic and can cause a devastating extravasation, particularly if administered inadvertently through the arteriolar route. Systemic heparin therapy remains the accepted treatment option for intraarteriolar administration of promethazine. Overall, the evidence for managing extravasations due to noncytotoxic medications is nonexistent or limited to case reports. More research is needed to improve knowledge of patient risk, prompt recognition of the extravasation, and time course for tissue injury, and to develop prevention and treatment strategies for extravasation injuries.

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“…Evidence is not strong enough to recommend a particular agent. [111][112][113][160][161][162] , and centrally in four. 61,114,159 Djogovic et al…”

Section: (Conditional)mentioning

confidence: 99%

Vasopressor and Inotrope Use in Canadian Emergency Departments: Evidence Based Consensus Guidelines

Djogovic

MacDonald

Wensel

et al. 2015

CJEM

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Peripheral Administration of Vasopressin for Catecholamine-Resistant Hypotension Complicated by Skin Necrosis

Cited by 14 publications

References 3 publications

A systematic review of extravasation and local tissue injury from administration of vasopressors through peripheral intravenous catheters and central venous catheters

A systematic review of extravasation and local tissue injury from administration of vasopressors through peripheral intravenous catheters and central venous catheters

Management of Extravasation Injuries: A Focused Evaluation of Noncytotoxic Medications

Vasopressor and Inotrope Use in Canadian Emergency Departments: Evidence Based Consensus Guidelines

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