JMIR Publications

ABSTRACT

Background:

The infusion of vasopressors is a standard treatment for shock, and international guidelines recommend administering these medications through central venous catheters (CVCs) due to concerns for potential extravasation and local tissue injury with peripheral intravenous (PIV) administration. However, CVCs are often unavailable in resource-variable settings due to lack of human and material resources. Previous studies have assessed the safety of vasopressor infusion through PIVs but have considered only limited patient population, a short infusion time, or have used retrospective designs that may have failed to capture mild complications.

Objective:

The primary objective of this study is to observe and describe the incidence of complications among patients receiving vasopressor infusion via PIV. The secondary objective is to assess whether the safety of PIV vasopressor administration via PIVs is non-inferior to the safety of administration via CVC.

Methods:

This prospective, observational study is being conducted at AIC Kijabe Hospital, a 360-bed tertiary care teaching hospital in rural Kenya. All patients (adult, obstetric, pediatric) receiving intravenous vasopressor infusions who are admitted to the intensive care unit or high-dependency unit will be included. Patients will be followed twice daily from the start of vasopressor infusion through 72 hours after vasopressor discontinuation or death, whichever occurs first. Demographic, physiologic, laboratory, therapeutic, and outcome data will be collected.

Results:

Consecutive enrollment began in October 2023 and is ongoing. As of July 2025, we have enrolled 190 patients. We anticipate that the time to enroll the number of patients required to reach our power goal will take 24 months.

Conclusions:

This study in a resource-variable setting will allow for more accurate and comprehensive data collection on vasopressor administration and potential complications as they arise, while most previous studies have been retrospective in nature. In addition, this is the first study of its kind to include both adult and pediatric patients within a mixed-ICU population with broad etiologies of shock, which could improve generalizability.