scholarly journals Safety of Early Norepinephrine Infusion Through Peripheral Vascular Access During Transport of Critically ill Children

2020 ◽  
Author(s):  
Ramy CHARBEL ◽  
Vincent OLLIER ◽  
Sebastien JULLIAND ◽  
Gilles JOURDAIN ◽  
Noëlla LODE ◽  
...  
Keyword(s):  
Critically Ill ◽  
Vascular Access ◽  
Central Venous Access ◽  
Venous Access ◽  
Critically Ill Children ◽  
Urban Region ◽  
Peripheral Vascular ◽  
Short Delay ◽  
Norepinephrine Infusion ◽  
Peripheral Catheter

Abstract BackgroundReversal of hypotension is a priority in the management of a collapsed child. The pediatric Surviving Sepsis Campaign advocates for the rapid use of epinephrine or norepinephrine for sepsis related myocardial or vascular dysfunction following 40-60ml/kg of fluid resuscitation. Vasoactive drugs should be started within the first hour after sepsis recognition in a patient with shock. In such a short delay, central venous access can be difficult to obtain, and infusion may be initially started through a peripheral catheter. Hereby, we reported the safety of norepinephrine infusion through a peripheral catheter in retrieved shocked patients.MethodsMulticentric retrospective analysis of medical pediatric retrieval teams experience of vasopressors infusion through a peripheral vascular access. Medical pediatric retrieval teams (SMUR) and Pediatric Intensive care units (PICU) of the Paris urban region. Children 0 to 18 years necessitating norepinephrine infusion during retrieval. Modalities of infusion (drip concentration, duration, site of infusion), incidence of complication and outcome at PICU discharge were reviewed.ResultsThirty-seven children in shock received a norepinephrine infusion for a median time of 4 hours. No local adverse event was noted. One patient had transient blanching of the skin which improved after appropriate care. The overall mortality was 10.8% with one death (2.7%) during transport and 3 (8.1%) in PICU. ConclusionsDuring transport of critically ill patients requiring vasopressor infusion by a specialized pediatric retrieval team, the use of norepinephrine on a non-central catheter was safe among all patients.

1337: ULTRASOUND FOR PERIPHERAL VASCULAR ACCESS IMPROVES OUTCOMES AND SAFETY FOR CRITICALLY ILL CHILDREN

2018 ◽  
Vol 46 (1) ◽  
pp. 652-652 ◽  
Author(s):  
Erik Su ◽  
Julianna Amorese ◽  
Traci Antes ◽  
Nathaniel Bohn ◽  
Jennifer Snider ◽  
...  
Keyword(s):  
Critically Ill ◽  
Vascular Access ◽  
Critically Ill Children ◽  
Peripheral Vascular

scholarly journals Peripheral Inotropes in Critically Ill Children: Is It Safe?

2021 ◽  
Vol 8 ◽  
pp. 2333794X2110222
Author(s):  
Ravi K. Mooli ◽  
Kalaimaran Sadasivam
Keyword(s):  
Central Venous Access ◽  
Pediatric Intensive Care ◽  
Venous Access ◽  
Critically Ill Children ◽  
Middle Income ◽  
Central Lines ◽  
Middle Income Countries ◽  
Peripheral Venous Access ◽  
Vasoactive Medications

Many children needing pediatric intensive care units care require inotropes, which are started peripherally prior to securing a central venous access. However, many hospitals in low- and middle-income countries (LMIC) may not have access to central lines and the vasoactive medications are frequently given through a peripheral venous access. Aim: The aim of our study was to describe the role of peripheral vasoactive inotropes in children. Methods: Children requiring peripheral vasoactive medications were included in this study. We retrospectively collected data at 2 time points on use and complications of peripheral vasoactive medications. Results: Eighty-four children (51 pre-COVID era and 33 COVID pandemic) received peripheral vasoactive medications. Only 3% of children (3/84) developed extravasation injury, all of whom recovered completely. Conclusions: Results from our study suggest that extravasation injury due to peripheral inotrope infusion is very low (3%) and it may be safely administered in children at a diluted concentration.

scholarly journals PERIPHERAL INOTROPES IN CRITICALLY ILL CHILDREN - IS IT SAFE?

2021 ◽  
Author(s):  
Ravi K Mooli ◽  
K Sadasivam
Keyword(s):  
Central Venous Access ◽  
Venous Access ◽  
Critically Ill Children ◽  
Central Venous ◽  
Middle Income ◽  
Central Lines ◽  
Middle Income Countries ◽  
Peripheral Venous Access ◽  
Vasoactive Medications ◽  
Paediatric Intensive Care Units

ABSTRACTMany children needing paediatric intensive care units care require inotropes, which are started peripherally prior to securing a central venous access. However, many hospitals in low- and middle-income countries may not have access to central lines and the vasoactive medications are frequently given through a peripheral venous access.AimThe aim of our study was to estimate the safety of peripheral vasoactive inotropes in children.MethodsChildren requiring peripheral vasoactive medications were included in this study. We retrospectively collected data at two time points on use and complications of peripheral vasoactive medications.ResultsEighty-four children (51 pre-COVID era and 33 COVID pandemic) received peripheral vasoactive medications. Only 3% of children (3/84) developed extravasation injury, all of whom recovered completely.ConclusionsResults from our study suggest that extravasation injury due to peripheral inotrope infusion is very low (3%) and it can be safely administered in children at a diluted concentration.

Advanced vascular access

2019 ◽  
pp. 177-190
Author(s):  
Richard Craig
Keyword(s):  
Vascular Access ◽  
Central Venous Access ◽  
Venous Access ◽  
Central Venous ◽  
Short Term ◽  
Central Lines ◽  
Venous Access Devices

In this chapter, the use of ultrasound to facilitate cannulation of a vessel is described in detail, including commentaries on equipment, preparation, scanning, and needling technique. Equipment and techniques for the insertion of short-term non-tunnelled central lines, long-term central venous access devices, arterial lines, and intraosseous needles are presented.

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