Abstract Rationale Prior studies have indicated that peripheral administration of vasopressors, particularly norepinephrine, can be considered safe with local complications occurring in 0-1.8% of patients. Our study further explored the local skin complications from peripheral vasopressor administration treated with phentolamine in a large health care system. Methods A retrospective chart review on the patients who received phentolamine for effects of local infiltration of pressors were performed. Data including demographics, diagnostic codes, vasopressor dose and duration of use, peripheral IV (intravenous) characteristics, as well as outcomes such as length of stay and mortality were collected. Additional data was obtained comparing the two subgroups of those patients who did and did not require central venous catheter placement post-extravasation. Results Of 92 patients with infiltrated vasopressor IVs that required phentolamine, the average age was 69, with 65% being female and an average BMI (body mass index) of 28. The shock was predominantly septic in 58% of patients, other types of shock included cardiogenic (14%), hypovolemic (13%), and mixed (12%).The most common sites of intravenous access were the antecubital fossa (33%) and forearm (27%). Mean number of hours prior to extravasation of peripheral vasopressors requiring phentolamine administration was 21 hours. 76% of patients did not any have significant ischemic tissue injury and 24% of patients had only minor bruising and erythema. Two significant reactions occurred including deep vein thrombosis and local skin necrosis. 52% of patients required a subsequent central venous line placement. The average length of stay was 5.4 days in the ICU and 11.8 days in the hospital, and in-patient mortality was 20%. Conclusion In our large cohort of patients with extravasation from peripheral vasopressors managed with local phentolamine administration, severe tissue skin or soft tissue injury was rare. This abstract is funded by: none
Crossland et al. (Fri,) studied this question.