Peripheral vasopressors

Peripheral vasopressor administration has evolved from a restricted practice to a safe, efficient strategy for managing septic shock. Historically, concerns regarding catastrophic tissue necrosis mandated central venous access, but modern clinical data, including findings from the CLOVER trial, demonstrate that peripheral administration is both common and safe when performed with proper technique. With an adverse event rate of approximately 0.6% in large prospective cohorts, peripheral lines offer a viable alternative that facilitates timely resuscitation while avoiding central line-associated bloodstream infections. Successful implementation relies on selecting secure, large-bore peripheral access, maintaining consistent monitoring, and having established protocols for managing potential extravasation with agents like phentolamine. Dr. Elizabeth Munroe, an expert in critical care research, emphasizes that clinician training and institutional protocols are more critical to patient safety than the specific route of administration.