The PULSE Study - Peripheral Use of Low-dose Vasopressors for Safety and Efficacy in the Intensive Care Unit: a Pilot Feasibility Study

What this Trial Is About

Researchers are evaluating the use of vasopressors, medications that raise blood pressure, in critically ill patients with shock who need help maintaining stable blood pressure. Typically, vasopressors are given through a central venous catheter (CVC), a tube placed in a large vein, but this approach requires skilled clinicians and can cause serious complications. This study explores the safety and feasibility of using peripheral venous catheters (PVCs), thinner tubes placed in smaller veins, to deliver vasopressors, aiming to provide high-quality data to support a standardized peripheral vasopressor protocol. The study involves randomly assigning patients to receive vasopressors either through a peripheral venous catheter at varying dose levels or through a central venous catheter. Patients in the peripheral group may be switched to a central line if they require high doses or multiple vasopressors. The investigators will adapt and implement a peripheral vasopressor protocol with ICU pharmacists to determine appropriate dosages and concentrations. This pilot feasibility study will recruit about 25 patients per group to assess protocol feasibility, safety outcomes, and healthcare provider acceptance. Participants will be monitored for safety issues such as leakage of medication into surrounding tissues, lung collapse, arterial puncture, and blood clots. Researchers will also track outcomes like avoidance of central line placement, infection rates, survival, and length of ICU and hospital stay. The study includes collecting data on recruitment success, data capture, and staff acceptance over a one-week period. The overall study period extends until June 2026, with ongoing assessments to inform future larger trials.

Pulse Study: Peripheral Use of Low-dose Vasopressors for Safety and Efficacy in the Intensive Care Unit