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- Nafeesa Alibhai, Michael Detsky, Hannah Wunsch, and Bijan Teja.
- From the Department of Integrated Sciences: Genetics, Physiology, Neuroscience, University of British Columbia, Vancouver, British Columbia, Canada.
- A A Pract. 2021 May 14; 15 (5): e01479.
AbstractRecent studies have demonstrated that vasopressors can be delivered safely through peripheral intravenous lines. While norepinephrine is usually delivered at a concentration of 16 to 32 μg/mL, out of concern for extravasation and interstitial necrosis, some patients receive more dilute norepinephrine solutions through peripheral intravenous catheters. We describe a case of severe hyponatremia and seizure resulting from administration of norepinephrine concentrated at 4 μg/mL in dextrose 5% in water. After the incident, the institutional policy changed to recommend normal saline as the default diluent for peripheral norepinephrine, with a more concentrated option available. The incident also informed similar guidelines at other hospitals.Copyright © 2021 International Anesthesia Research Society.
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