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dc.contributor.authorDelaney, Anthony
dc.contributor.authorFinnis, Mark
dc.contributor.authorBellomo, Rinaldo
dc.contributor.authorUdy, Andrew
dc.contributor.authorJones, Daryl
dc.contributor.authorKeijzers, Gerben
dc.contributor.authorMacdonald, Stephen
dc.contributor.authorPeake, Sandra
dc.description.abstractObjective: To assess whether the initiation of vasopressor infusions via peripheral venous catheters (PVC) compared to central venous catheters (CVC) in ED patients with early septic shock was associated with differences in processes of care and outcomes. Methods: We conducted a post‐hoc analysis of the ARISE trial. We compared participants who had a vasopressor infusion first commenced via a PVC versus a CVC. The primary outcome was 90 day mortality. Results: We studied 937 participants. Of these, 389 (42%) had early vasopressor infusion commenced via a PVC and 548 (58%) via a CVC. Trial participants who received a vasopressor infusion via a PVC were more severely ill, with higher median (interquartile range [IQR]) Acute Physiology And Chronic Health Evaluation (APACHE II) scores (17 [13–23] versus 16 [12–21], P = 0.003), and higher median (IQR) lactate (mmol/L) (3.6 [1.9–5.8] versus 2.5 [1.5–4.5], P < 0.001). After adjusting for baseline covariates, the estimated odds ratio for mortality for PVC‐treated patients was 1.26 (95% confidence interval 0.95–1.67, P = 0.11). Trial participants who had vasopressors commenced via PVC had a shorter median (IQR) time to commencement of antimicrobials (55 [32–96] versus 71.5 [39–119] min, P < 0.001) and a shorter median (IQR) time to commencement of vasopressors (2.4 [1.3–3.9] versus 4.9 [3.5–6.6] h, P < 0.001). Conclusion: The practice of commencing a vasopressor infusion via a PVC was common in the ARISE trial and more frequent in trial participants with higher severity of illness. Commencement of a vasopressor infusion via a PVC was associated with some improvements in processes of care and, after adjustment, was not associated with an increased risk of death.
dc.publisherWiley-Blackwell Publishing Asia
dc.relation.ispartofjournalEmergency Medicine Australasia
dc.subject.fieldofresearchClinical sciences
dc.subject.fieldofresearchHealth services and systems
dc.subject.fieldofresearchPublic health
dc.titleInitiation of vasopressor infusions via peripheral versus central access in patients with early septic shock: A retrospective cohort study
dc.typeJournal article
dc.type.descriptionC1 - Articles
dcterms.bibliographicCitationDelaney, A; Finnis, M; Bellomo, R; Udy, A; Jones, D; Keijzers, G; Macdonald, S; Peake, S, Initiation of vasopressor infusions via peripheral versus central access in patients with early septic shock: A retrospective cohort study, Emergency Medicine Australasia, 2019
gro.description.notepublicThis publication has been entered into Griffith Research Online as an Advanced Online Version.
gro.hasfulltextNo Full Text
gro.griffith.authorKeijzers, Gerben

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