What is a major concern when administering IV dopamine?

Administering IV dopamine comes with several risks, but one major concern is the potential for infiltration leading to tissue necrosis. When dopamine is given via an intravenous line, if the solution infiltrates into the surrounding tissue rather than remaining within the blood vessel, it can cause local tissue damage. This is particularly concerning because dopamine, especially in higher concentrations, is a potent vasoconstrictor. This vasoconstriction can lead to ischemia and subsequently necrosis of the tissues if not addressed promptly.

Infiltration can often occur with peripheral IV access, particularly if the catheter is not properly placed or if it becomes dislodged. Therefore, continuous monitoring of the IV site is critical during dopamine administration to identify any signs of infiltration early, such as swelling or discoloration in the tissue surrounding the IV site.

While allergic reactions, increased heart rate, and fluid overload are also considerations in ICU settings, they do not carry the same immediate risk of tissue damage associated with infiltration as the primary concern during dopamine administration.