Study on Ward-Based Practice of Vasopressor Administration for Patients with Sepsis, in National Hospital of Sri Lanka (NHSL)

Background: Vasopressors are administrated peripherally in hemodynamically unstable patients with sepsis in the initial period. International guidelines are available for peripheral administration of vasopressors, including Surviving Sepsis guidelines 2021.
Objective: Assess the ward-based practice regarding peripheral administration of vasopressors in patients with sepsis, in NHSL.
Methods: A prospective cross-sectional study, during a period of six weeks in 2022, setting of Medical and surgical wards in NHSL, in a group of 52 patients.
Results: Noradrenaline was the vasopressor used for all patients with septic shock. 93% of patients had peripheral noradrenaline infusions for a medium duration of 77.7 hours. Peripheral cannula for noradrenaline was sited in the forearm at 46% and in the dorsum of the hand at 34%. Only 7% had a central line for vasopressors. Other infusions along with noradrenaline in the same cannula were given in 75%. Approximately 90% were monitored hourly during the infusion of vasopressors. ICU referral was done only in 5.7% of patients. Adverse reactions were noted in 38% of patients, all minor complications.
Conclusion: Peripheral administration of vasopressors was prolonged compared to standard. Adverse reactions were identified, but all were minor complications.