Singh O, Juneja D. Navigating the veins: A comprehensive review of vasoactive agent infusion via peripheral routes. World J Crit Care Med 2026; 15(2): 118811 [DOI: 10.5492/wjccm.v15.i2.118811]
Corresponding Author of This Article
Deven Juneja, MD, Director, Institute of Critical Care Medicine, Max Super Speciality Hospital, Saket, 1 Press Enclave Road, New Delhi 110017, India. devenjuneja@gmail.com
Research Domain of This Article
Critical Care Medicine
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
Share the Article
Singh O, Juneja D. Navigating the veins: A comprehensive review of vasoactive agent infusion via peripheral routes. World J Crit Care Med 2026; 15(2): 118811 [DOI: 10.5492/wjccm.v15.i2.118811]
World J Crit Care Med. Jun 9, 2026; 15(2): 118811 Published online Jun 9, 2026. doi: 10.5492/wjccm.v15.i2.118811
Navigating the veins: A comprehensive review of vasoactive agent infusion via peripheral routes
Omender Singh, Deven Juneja
Omender Singh, Deven Juneja, Institute of Critical Care Medicine, Max Super Speciality Hospital, New Delhi 110017, India
Author contributions: Singh O and Juneja D contributed to conceptualization of the review, data accusation, writing, and reviewing the manuscript; both the authors have read and approved the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Deven Juneja, MD, Director, Institute of Critical Care Medicine, Max Super Speciality Hospital, Saket, 1 Press Enclave Road, New Delhi 110017, India. devenjuneja@gmail.com
Received: January 12, 2026 Revised: January 17, 2026 Accepted: February 9, 2026 Published online: June 9, 2026 Processing time: 129 Days and 22.6 Hours
Abstract
Peripheral venous catheters (PVCs) are almost always present in patients in the intensive care unit. Still, they are seldom used to administer vesicant or irritant drugs, including vasoactive agents, due to concerns about extravasation and local tissue injury. However, emerging evidence indicates that PVCs are safe and effective for this purpose, offering distinct clinical advantages and obviating the need for more invasive central venous catheter insertion. Implementing a standardized protocol to ensure the appropriate size and placement of PVC, optimizing the dosage and duration of vasopressors, and establishing vigilant nursing monitoring can facilitate the safe administration of vasopressors via PVC, with substantial implications for the early management of shock, particularly in resource-constrained settings.
Core Tip: Central venous catheters (CVCs) are traditionally used to transfuse vasopressors. However, their insertion is costly, time-consuming, requires expertise and may be associated with serious complications like bleeding and pneumothorax. Emerging evidence suggests that peripheral venous catheters (PVCs) can be safely and effectively used to administer vasopressors. Even though this may help with the rapid initiation of vasopressors and sometimes avoid the need for CVC insertion, the use of PVCs may also lead to minor complications from extravasation of vasopressors. By adopting a safety protocol that includes measures such as careful selection of insertion site and PVC size, limiting the dose and duration of vasopressors, and vigilant monitoring of the infusion site, complications may be further reduced. Safe use of vasopressors via PVCs may have far-reaching clinical implications for managing early septic shock, especially in resource-limited settings.
