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Multiple studies and the 2021 Surviving Sepsis Campaign have established the safety of starting vasopressors peripherally. Prior systematic reviews identified low complication rates but didn’t distinguish between individual vasopressors or include data on midline catheters. In a new meta-analysis, the largest to date, researchers took a more detailed look at adverse events with peripheral intravenous (IV) vasopressors in critically ill adults. Roughly 50 studies and 33,000 peripheral IV catheters were included.
Minor adverse events were rare, regardless of which vasopressor was used (pooled incidence, 2.3%). Hematoma, extravasation, and skin discoloration were most common.
Major adverse events essentially were absent with sh…