{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T19:11:45Z","timestamp":1793128305524,"version":"4.5.0"},"reference-count":81,"publisher":"American Medical Association (AMA)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Peripheral intravenous (PIV) vasopressors are increasingly used but remain associated with adverse events (AEs). Quantifying the incidence of these AEs is essential to guide clinical decision-making regarding PIV vasopressor use.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To assess the incidence of AEs and avoidance of central venous catheter (CVC) placement after PIV vasopressor administration in adults with hypotension, shock, or critical illness.<\/jats:p>\n <\/jats:sec>\n \n Data Sources<\/jats:title>\n PubMed, Embase, and the Cochrane Central Register of Controlled Trials were searched from inception to December 13, 2025, using medical subject headings and keywords related to peripheral vasopressors.<\/jats:p>\n <\/jats:sec>\n \n Study Selection<\/jats:title>\n Eligible studies included critically ill adults receiving vasopressors via PIV catheters and reported AEs and\/or CVC avoidance.<\/jats:p>\n <\/jats:sec>\n \n Data Extraction and Synthesis<\/jats:title>\n Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, 2 investigators independently extracted data and assessed risk of bias. A random-effects model was used, and proportions were pooled using a generalized linear mixed model.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n The primary end point was the pooled incidence of AEs as the proportion among total catheters, and the secondary end point was the pooled proportion of CVC avoidance.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Forty-nine studies including 33\u202f060 catheters were analyzed. The pooled minor AE incidence was 2.6% (95% CI, 1.4%-4.7%) for norepinephrine, 0.0% (95% CI, 0.0%-24.6%) for epinephrine, 2.9% (95% CI, 1.8%-4.8%) for phenylephrine, 1.4% (95% CI, 0.3%-5.9%) for dopamine, 0.5% (95% CI, 0.1%-1.8%) for vasopressin, and 0.9% (95% CI, 0.1%-11.5%) for metaraminol. When considering all vasopressors collectively, the pooled minor AE incidence was 2.3% (95% CI, 1.5%-3.7%). Regarding major AEs, 30 venous thromboembolism events occurred, all in the 4 studies (8.1%) using midline catheters (1126 total catheters), with a pooled incidence of 1.4% (95% CI, 0.4%-5.4%). In contrast, only 1 major AE (a tissue necrosis event) was reported in 43 studies (87.8%) using short PIV catheters (29\u202f596 total catheters), with a pooled incidence of 0.0% (95% CI, 0.0%-0.0%). CVC avoidance ranged from 0% to 100%, with a pooled proportion of 59.7% (95% CI, 46.4%-71.7%) in 38 studies (77.6%) including 15\u202f371 catheters.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this systematic review and meta-analysis of adult patients, AE incidence was low after short-term vasopressor administration through PIV catheters, particularly short catheters. These findings suggest that PIV administration might reduce the need for CVC placement with appropriate monitoring.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2026.0710","type":"journal-article","created":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T15:30:34Z","timestamp":1773675034000},"page":"e260710","source":"Crossref","is-referenced-by-count":4,"title":["Incidence of Adverse Events in Peripheral Intravenous Vasopressor Use"],"prefix":"10.1001","volume":"9","author":[{"given":"Shang-Jun","family":"ZhangJian","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kuang-Yu","family":"Niu","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, 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