Until recently I believed that prolonged vasopressor administration requires a central line, to avoid extravasation. I lumped together all vasopressors, treating them all as equal. I used the occurrence of an extravasation reaction from one vasopressor as evidence that all vasopressors could cause extravasation reactions (the fallacy of inappropriate generalization). Upon closer examination, these beliefs aren’t supported by evidence. Traditional wisdom was that all patients on a vasopressor for more than a few hours require a central line. This has been disproven by Cardenas-Garcia 2015, Delgado 2016, and Putland 2006. However, there still isn’t enough evidence to reach a universal answer.

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