Noradrenaline Use Through PIVCs: How Much Is Safe?

Peripheral IV catheters (PIVCs) are sometimes used to deliver noradrenaline in emergency and ICU settings when central access is delayed. This study investigated the relationship between noradrenaline dose and phlebitis risk using a time-dependent model.

Study Overview
Data from 1,351 ICU patients and 3,410 PIVCs across 22 Japanese hospitals was analyzed using a multilevel Cox regression model. The focus was to identify a safe dosage threshold for noradrenaline when administered through PIVCs.

Key Findings

• No consistent dose-response trend was found across the full cohort.
• However, phlebitis risk increased significantly when the total dose exceeded 6 mg.
• Findings support the use of PIVCs for noradrenaline in emergencies—with dosage monitoring.

Conclusion
Administering noradrenaline via PIVCs can be safe when kept under 6 mg total. These findings support short-term use in critical settings, providing clinicians with guidance while waiting for central access.

Read more: https://onlinelibrary.wiley.com/doi/10.1155/emmi/4457109 

Authors: Hideto Yasuda, Claire M. Rickard, Jessica A. Schults, Nicole Marsh, Masahiro Kashiura, Yuki Kishihara, Yutaro Shinzato, Shunsuke Amagasa, Takashi Moriya, Yuki Kotani, Natsuki Kondo, Kosuke Sekine, Nobuaki Shime, Keita Morikane, Takayuki Abe, AMOR-VENUS Study Group