Jurnal Internasional vol.12 issue 2 2022
African Journal of Emergency Medicine
Utilisation of peripheral vasopressor medications and extravasation events among critically ill patients in Rwanda: A prospective cohort study
Dublin Core
Title
Jurnal Internasional vol.12 issue 2 2022
African Journal of Emergency Medicine
Utilisation of peripheral vasopressor medications and extravasation events among critically ill patients in Rwanda: A prospective cohort study
African Journal of Emergency Medicine
Utilisation of peripheral vasopressor medications and extravasation events among critically ill patients in Rwanda: A prospective cohort study
Subject
Rwanda
Vasoactive agents
Peripheral vasopressors
Extravasation
Resuscitation
Global health
Vasoactive agents
Peripheral vasopressors
Extravasation
Resuscitation
Global health
Description
Introduction: In high-income settings, vasopressor administration to treat haemodynamic instability through a
central venous catheter (CVC) is the preferred standard. However, due to lack of availability and potential for
complications, CVCs are not widely used in low- and middle-income countries. This prospective cohort study
evaluated the use of peripheral vasopressors and associated incidence of extravasation events in patients with
haemodynamic instability at the Centre Hospitalier Universitaire Kigali, Rwanda.
Methods: Patients ≥18 years of age receiving peripheral vasopressors in the emergency centre (EC) or intensive
care unit (ICU) for >1 hour were eligible for inclusion. The primary outcome was extravasation events. Patients
were followed hourly until extravasation, medication discontinuation, death, or CVC placement. Extravasation
incidence with 95% confidence intervals (CI) were calculated using Poisson exact tests.
Results: 64 patients were analysed. The median age was 49 (Interquartile Range [IQR]:33-65) and 55% were
female. Distributive shock was the most frequent aetiology (47%). Intravenous (IV) location was most commonly
antecubital fossa/upper arm (31%) and forearm/hand (43%). IV gauges ≤18 were used in 58% of locations. Most
patients were treated with adrenaline (66%) and noradrenaline (41%), and 11% received multiple vasopressors.
The median treatment duration was 19 hours (IQR:8.5-37). Treatment discontinuation was predominantly due
to mortality (41%) or resolution of instability (36%). There were two extravasation events (2.9%), both limited
to soft tissue swelling. Extravasation incidence was 0.8 events per 1000 patient-hours (95% CI:0.2-2.2).
Conclusion: Extravasation incidence with peripheral vasopressors was low, even with long use durations, sug-
gesting peripheral infusions may be an acceptable approach when barriers exist to CVC placement.
central venous catheter (CVC) is the preferred standard. However, due to lack of availability and potential for
complications, CVCs are not widely used in low- and middle-income countries. This prospective cohort study
evaluated the use of peripheral vasopressors and associated incidence of extravasation events in patients with
haemodynamic instability at the Centre Hospitalier Universitaire Kigali, Rwanda.
Methods: Patients ≥18 years of age receiving peripheral vasopressors in the emergency centre (EC) or intensive
care unit (ICU) for >1 hour were eligible for inclusion. The primary outcome was extravasation events. Patients
were followed hourly until extravasation, medication discontinuation, death, or CVC placement. Extravasation
incidence with 95% confidence intervals (CI) were calculated using Poisson exact tests.
Results: 64 patients were analysed. The median age was 49 (Interquartile Range [IQR]:33-65) and 55% were
female. Distributive shock was the most frequent aetiology (47%). Intravenous (IV) location was most commonly
antecubital fossa/upper arm (31%) and forearm/hand (43%). IV gauges ≤18 were used in 58% of locations. Most
patients were treated with adrenaline (66%) and noradrenaline (41%), and 11% received multiple vasopressors.
The median treatment duration was 19 hours (IQR:8.5-37). Treatment discontinuation was predominantly due
to mortality (41%) or resolution of instability (36%). There were two extravasation events (2.9%), both limited
to soft tissue swelling. Extravasation incidence was 0.8 events per 1000 patient-hours (95% CI:0.2-2.2).
Conclusion: Extravasation incidence with peripheral vasopressors was low, even with long use durations, sug-
gesting peripheral infusions may be an acceptable approach when barriers exist to CVC placement.
Creator
Catalina G. Marques , Lucien Mwemerashyak, Kyle Martin, Oliver Tang, Chantal Uwamahoro , Vincent Ndebwaniman, Doris Uwamahoro , Katelyn Moretti , Vinay Sharma, Sonya Naganathan, Ling Jing, Stephanie C. Garbern, Menelas Nkeshiman, Adam C. Levine, Adam R. Aluisio
Source
https://doi.org/10.1016/j.afjem.2022.03.006
Date
28 March 2022
Contributor
peri irawan
Format
pdf
Language
english
Type
text
Files
Citation
Catalina G. Marques , Lucien Mwemerashyak, Kyle Martin, Oliver Tang, Chantal Uwamahoro , Vincent Ndebwaniman, Doris Uwamahoro , Katelyn Moretti , Vinay Sharma, Sonya Naganathan, Ling Jing, Stephanie C. Garbern, Menelas Nkeshiman, Adam C. Levine, Adam R. Aluisio, “Jurnal Internasional vol.12 issue 2 2022
African Journal of Emergency Medicine
Utilisation of peripheral vasopressor medications and extravasation events among critically ill patients in Rwanda: A prospective cohort study,” Repository Horizon University Indonesia, accessed April 26, 2025, https://repository.horizon.ac.id/items/show/1892.
African Journal of Emergency Medicine
Utilisation of peripheral vasopressor medications and extravasation events among critically ill patients in Rwanda: A prospective cohort study,” Repository Horizon University Indonesia, accessed April 26, 2025, https://repository.horizon.ac.id/items/show/1892.