{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T19:07:10Z","timestamp":1782846430725,"version":"3.54.5"},"reference-count":25,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Res Protoc"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec sec-type=\"background\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The infusion of vasopressors is a standard treatment for shock, and international guidelines recommend administering these medications through central venous catheters (CVCs) due to concerns about potential extravasation and local tissue injury with peripheral intravenous (PIV) administration. However, CVCs are often unavailable in resource-variable settings due to lack of human and material resources. Previous studies have assessed the safety of vasopressor infusion through PIV catheters but have considered only limited patient populations or a short infusion time or have used retrospective designs that may have failed to capture mild complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"objective\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The primary objective of this study is to observe and describe the incidence of complications among patients receiving vasopressor infusion via PIV administration. The secondary objective is to assess whether the safety of PIV vasopressor administration is noninferior to the safety of administration via CVC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective observational study is being conducted at African Inland Church (AIC) Kijabe Hospital, a 360-bed tertiary care teaching hospital in rural Kenya. All patients (adult, obstetric, and pediatric) receiving intravenous vasopressor infusions who are admitted to the intensive care unit or high-dependency unit will be included. Patients will be followed up on twice daily from the start of vasopressor infusion to 72 hours after vasopressor discontinuation or death, whichever occurs first. Demographic, physiological, laboratory, therapeutic, and outcome data will be collected.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Consecutive enrollment began in October 2023 and is ongoing. As of July 2025, we have enrolled 190 patients. We anticipate that the time to enroll the number of patients required to reach our power goal will be 24 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study in a resource-variable setting will allow for more accurate and comprehensive data collection on vasopressor administration and potential complications as they arise, whereas most previous studies have been retrospective in nature. In addition, this is the first study of its kind to include both adult and pediatric patients within a mixed intensive care unit population with broad etiologies of shock, which could improve generalizability.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2196\/81794","type":"journal-article","created":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T15:45:09Z","timestamp":1768491909000},"page":"e81794-e81794","source":"Crossref","is-referenced-by-count":0,"title":["Safety of Administration of Vasopressors Through Peripheral Compared to Central Venous Catheters in a Rural Kenyan Hospital: Protocol for a Prospective Observational Cohort Study"],"prefix":"10.2196","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-2687-3621","authenticated-orcid":false,"given":"Grace Hezi","family":"Gao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-4970-867X","authenticated-orcid":false,"given":"Brian","family":"Kimani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3437-8878","authenticated-orcid":false,"given":"Linette","family":"Lepore","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7138-8172","authenticated-orcid":false,"given":"Zahra","family":"Aghababa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-7578-7223","authenticated-orcid":false,"given":"Hannah","family":"Gitura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1849-8710","authenticated-orcid":false,"given":"Michael","family":"Kinuthia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6172-1495","authenticated-orcid":false,"given":"Jack","family":"Musau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3254-4517","authenticated-orcid":false,"given":"Judy","family":"Muthoki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-3063-1185","authenticated-orcid":false,"given":"Alice","family":"Mwonge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5703-7504","authenticated-orcid":false,"given":"Fredrick","family":"Ndibaru","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3960-6514","authenticated-orcid":false,"given":"Ann Viola","family":"Ndubi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-9186-2761","authenticated-orcid":false,"given":"Juliah","family":"Ndungu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-4918-1852","authenticated-orcid":false,"given":"Kinzi","family":"Nixon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5361-5629","authenticated-orcid":false,"given":"Moses","family":"Odhiambo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2120-5914","authenticated-orcid":false,"given":"Winslet","family":"Okari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-4377-0538","authenticated-orcid":false,"given":"Benjamin","family":"Thairu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-3082-9825","authenticated-orcid":false,"given":"Lilian","family":"Vihenda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5252-2052","authenticated-orcid":false,"given":"Rachel M","family":"Wojcik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1144-6107","authenticated-orcid":false,"given":"B Jason","family":"Brotherton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6695-8401","authenticated-orcid":false,"given":"Kristina E","family":"Rudd","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,3,5]]},"reference":[{"issue":"2","key":"R1","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1016\/j.mpmed.2012.11.012","article-title":"Circulatory shock","volume":"41","author":"Soong","journal-title":"Medicine"},{"issue":"2","key":"R2","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1097\/ACO.0000000000000958","article-title":"Epidemiology of sepsis and septic shock","volume":"34","author":"Chiu","journal-title":"Curr Opin Anaesthesiol"},{"issue":"1","key":"R3","doi-asserted-by":"publisher","DOI":"10.1186\/s13613-019-0498-7","article-title":"Current use of vasopressors in septic shock","volume":"9","author":"Scheeren","journal-title":"Ann Intensive Care"},{"issue":"11","key":"R4","doi-asserted-by":"publisher","first-page":"1181","DOI":"10.1007\/s00134-021-06506-y","article-title":"Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021","volume":"47","author":"Evans","journal-title":"Intensive Care Med"},{"issue":"1","key":"R5","doi-asserted-by":"publisher","DOI":"10.1186\/cc9410","article-title":"Availability of critical care resources to treat patients with severe sepsis or septic shock in Africa: a self-reported, continent-wide survey of anaesthesia providers","volume":"15","author":"Baelani","journal-title":"Crit Care"},{"issue":"9","key":"R6","doi-asserted-by":"publisher","first-page":"581","DOI":"10.1002\/jhm.2394","article-title":"Safety of peripheral intravenous administration of vasoactive medication","volume":"10","author":"Cardenas-Garcia","journal-title":"J Hosp Med"},{"issue":"1","key":"R7","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1016\/j.jemermed.2017.09.007","article-title":"Complications from administration of vasopressors through peripheral venous catheters: an observational study","volume":"54","author":"Medlej","journal-title":"J Emerg Med"},{"issue":"1","key":"R8","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1177\/0885066616686035","article-title":"Safety of the peripheral administration of vasopressor agents","volume":"34","author":"Lewis","journal-title":"J Intensive Care Med"},{"issue":"5","key":"R9","doi-asserted-by":"publisher","first-page":"506","DOI":"10.1016\/j.aucc.2021.08.005","article-title":"Safety and efficacy of peripheral versus centrally administered vasopressor infusion: a single-centre retrospective observational study","volume":"35","author":"Stolz","journal-title":"Aust Crit Care"},{"issue":"4","key":"R10","doi-asserted-by":"publisher","first-page":"210","DOI":"10.2478\/jccm-2020-0030","article-title":"Feasibility and safety of peripheral intravenous administration of vasopressor agents in resource-limited settings","volume":"6","author":"Padmanaban","journal-title":"J Crit Care Med"},{"key":"R11","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/6160563","article-title":"Safety of vasopressor medications through peripheral line in pediatric patients in PICU in a resource-limited setting","volume":"2022","author":"Abrar","journal-title":"Crit Care Res Pract"},{"issue":"10","key":"R12","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0333275","article-title":"Peripheral line for vasopressor administration: prospective multicenter observational cohort study for survival and safety","volume":"20","author":"Petros","journal-title":"PLoS ONE"},{"issue":"13","key":"R13","doi-asserted-by":"publisher","first-page":"1220","DOI":"10.1056\/NEJMoa1500964","article-title":"Intravascular complications of central venous catheterization by insertion site","volume":"373","author":"Parienti","journal-title":"N Engl J Med"},{"issue":"5","key":"R14","doi-asserted-by":"publisher","first-page":"390","DOI":"10.1308\/rcsann.2017.0022","article-title":"Mechanical complications of central venous catheterisation in trauma patients","volume":"99","author":"Odendaal","journal-title":"Ann R Coll Surg Engl"},{"issue":"5","key":"R15","doi-asserted-by":"publisher","first-page":"474","DOI":"10.1001\/jamainternmed.2023.8232","article-title":"Complication rates of central venous catheters: a systematic review and meta-analysis","volume":"184","author":"Teja","journal-title":"JAMA Intern Med"},{"issue":"5","key":"R16","doi-asserted-by":"publisher","first-page":"e1331","DOI":"10.1542\/peds.2015-1507","article-title":"Complications of central venous access devices: a systematic review","volume":"136","author":"Ullman","journal-title":"Pediatrics"},{"issue":"6","key":"R17","doi-asserted-by":"publisher","first-page":"628","DOI":"10.1097\/PCC.0b013e318207124a","article-title":"Incidence and risk factors associated with venous thrombotic events in pediatric intensive care unit patients","volume":"12","author":"Higgerson","journal-title":"Pediatr Crit Care Med"},{"issue":"3","key":"R18","doi-asserted-by":"publisher","first-page":"316","DOI":"10.1016\/j.bja.2019.04.055","article-title":"Incidence of and risk factors for venous thrombosis in children with percutaneous non-tunnelled central venous catheters","volume":"123","author":"\u00d6stlund","journal-title":"Br J Anaesth"},{"issue":"5","key":"R19","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-014-0532-y","article-title":"Early versus delayed administration of norepinephrine in patients with septic shock","volume":"18","author":"Bai","journal-title":"Crit Care"},{"issue":"11","key":"R20","doi-asserted-by":"publisher","first-page":"2434","DOI":"10.1016\/j.ajem.2020.09.047","article-title":"Complication of vasopressor infusion through peripheral venous catheter: a systematic review and meta-analysis","volume":"38","author":"Tran","journal-title":"Am J Emerg Med"},{"issue":"1","key":"R21","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-021-03553-1","article-title":"Adverse events associated with administration of vasopressor medications through a peripheral intravenous catheter: a systematic review and meta-analysis","volume":"25","author":"Owen","journal-title":"Crit Care"},{"issue":"3","key":"R22","doi-asserted-by":"publisher","first-page":"653.e9","DOI":"10.1016\/j.jcrc.2015.01.014","article-title":"A systematic review of extravasation and local tissue injury from administration of vasopressors through peripheral intravenous catheters and central venous catheters","volume":"30","author":"Loubani","journal-title":"J Crit Care"},{"issue":"8","key":"R23","doi-asserted-by":"publisher","first-page":"2419","DOI":"10.1007\/s11739-023-03419-0","article-title":"The Crystalloid Liberal or Vasopressors Early Resuscitation in Sepsis (CLOVERS) randomized clinical trial","volume":"18","author":"Bartoli","journal-title":"Intern Emerg Med"},{"issue":"8","key":"R24","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2025.29148","article-title":"Peripheral vasopressor use in early sepsis-induced hypotension","volume":"8","author":"Munroe","journal-title":"JAMA Netw Open"},{"issue":"5","key":"R25","doi-asserted-by":"publisher","first-page":"551","DOI":"10.1007\/s00383-020-04640-0","article-title":"Long-term vascular access in differently resourced settings: a review of indications, devices, techniques, and complications","volume":"36","author":"Milford","journal-title":"Pediatr Surg Int"}],"container-title":["JMIR Research Protocols"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.researchprotocols.org\/2026\/1\/e81794","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T18:15:40Z","timestamp":1782843340000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.researchprotocols.org\/2026\/1\/e81794"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,5]]},"references-count":25,"URL":"https:\/\/doi.org\/10.2196\/81794","relation":{},"ISSN":["1929-0748"],"issn-type":[{"value":"1929-0748","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,5]]},"article-number":"v15i2e81794"}}