A new prospective multicenter cohort of 250 patients with shock examines the safety and outcomes of peripheral vasopressor administration. Extravasation events were rare and clustered only after several days of infusion, while norepinephrine use and simple physiologic markers correlated with survival. In this episode, I translate the findings into bedside guardrails—which sites and gauges to use, how to monitor, and when to pivot to a central line.

The Vasopressor & Inotrope Handbook

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Citation:

Petros A, Melkie A, Kotiso KS, Kebede D, Oljira CF, Assefa Gemechu F, Yusuf H, Abebe S, Ashagre A, Bekele A, Yohannes A, Etesa EK, Bedru M, Gebremariam TH. Peripheral line for vasopressor administration: Prospective multicenter observational cohort study for survival and safety. PLoS One. 2025 Oct 13;20(10):e0333275. doi: 10.1371/journal.pone.0333275. PMID: 41082535; PMCID: PMC12517475.