Grant: Master's Award: Canada Graduate Scholarships

The use of medications to increase blood pressure called vasopressors are invaluable in the treatment of patients who have difficulty maintaining a stable blood pressure. Vasopressors are usually infused through a central venous catheter (CVC), which is a flexible tube placed in the large vein of the neck, arm or groin. CVCs require a skilled clinician and often with an ultrasound to prevent complications such as a collapsed lung or bleeding. These complications can cause significant harm and may occur in up to 15% of patients. Alternatively, the infusion of vasopressors through a peripheral venous catheter (PVC), a thin tube placed in the smaller veins of the arm or hand, have been avoided due to the risk of extravasation, which is the leakage of fluid to surrounding tissues. This can lead to potential tissue death requiring surgery. However, emerging research shows the safety of infusing vasopressors through a PVC, referred to as peripheral vasopressors. There is a growing interest in peripheral vasopressors for two main reasons: to expedite vasopressor initiation in patients with refractory shock and to potentially avoid CVC placement and its complications. However, a standardized protocol for administration is lacking and many clinicians still avoid peripheral vasopressors due to lack of high quality evidence. We will examine the effectiveness of implementing a peripheral vasopressor protocol by conducting a feasibility study and assess outcomes such as safety of peripheral vasopressors and acceptability rate by healthcare providers. By conducting this study, we hope to provide the framework to conduct larger, multi-center trials and to provide high quality data for the future use of a standardized peripheral vasopressor protocol.