Peripheral Norepinephrine Administration in Critically Ill Adults: A Rapid Review of Administration Practices and Reported Local Adverse Events
Year: 2026
Type: article
Study design: Systematic Review
Abstract: Background: Peripheral norepinephrine enables timely vasopressor initiation, but local safety remains uncertain. This rapid review mapped administration practices and local adverse events in critically ill adults. Methods: Following Joanna Briggs Institute and Cochrane rapid review guidance and PRISMA 2020 (OSF: 10.17605/OSF.IO/6VH9E), PubMed, MEDLINE Complete and CINAHL Complete were searched through 22 August 2026 (PubMed re-run with corrected syntax within this limit). Included syntheses were citation-searched. Short peripheral intravenous and midline catheters were analysed separately; peripherally inserted central catheters were classified as central access. Results: Thirty-nine sources were included (27 primary studies, seven syntheses, five normative documents); three reports were unavailable. In 14 norepinephrine-specific reports using short peripheral catheters, source-defined extravasation or infiltration occurred in 0–5.6% of patients or infusions, and with midline catheters in one of 472 episodes; composite local events were analysed separately. Serious injury was inconsistently assessed; one fasciotomy occurred among 3734 patients in a mixed-agent cohort. Confidence was low to very low for all outcomes. Conclusions: Observational evidence suggests that peripheral norepinephrine is feasible in selected critically ill adults under structured monitoring and extravasation-response protocols, with infrequent, mostly minor events, but does not establish comparative safety or universal concentration, dose or duration limits.
Source: Emergency Care and Medicine
DOI: 10.3390/ecm3040037
Institution: Atlântica Instituto Universitário
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,207
OpenAlex ID: W7225323979