PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Infusions, Intraosseous”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 73 records · Page 4Linked to original sources
PubMedDate not supplied

Preliminary report: the development of an intraosseous infusion technique for neonatal foals.

Six normal foals between the ages of 2 and 7 days were used in this study to develop a technique for intraosseous infusion in equine neonates. A 14-gauge 1/2-inch needle was placed intraosseously in the right proximal medial one-third aspect of the radius and tibia of each foal. A maximum of 1 L of isotonic fluids was administered intraosseously at these sites. Radiographs were taken at the time of intraosseous needle placement, and at days 10, 30, and 60 following the procedure. The mean time for needle placement was 33 seconds for the tibia and 63 seconds for the radius. The mean fluid flow rates for the tibia were 47 mL/min and for the radius 27 mL/min. Minimal technical difficulties were encountered with the intraosseous site in the tibia, but subperiosteal and/or subcutaneous fluid leakage and needle displacement or occlusion were commonly seen in the radius. The local soft tissue swellings and periosteal reactions seen following the procedure had resolved by 2 months. Intraosseous infusion offers a safe, practical, and effective alternative to vascular access for fluid administration in neonatal foals.

Animals↗
PubMed1997

Intraosseous infusion performed in the prehospital setting: South Carolina's six-year experience.

Our data do not demonstrate that a prehospital intraosseous infusion protocol will improve the outcome of prehospital pediatric patients with cardiac arrest. The number of patients in our study is too small to allow us to draw a conclusion as to the effect of intraosseous infusion on altering survivability of pediatric cardiac arrest in the prehospital setting. More study is necessary to determine whether there might be a group of pediatric patients with cardiac arrest or hypovolemic shock who could potentially benefit in a prehospital setting from this procedure.

Allied Health Personnel↗
PubMed2005

Cadaver testing to validate design criteria of an adult intraosseous infusion system.

INTRODUCTION: The FAST 1 intraosseous (IO) infusion system was designed to deliver fluids and medications into the adult sternum in the prehospital and battlefield environments. OBJECTIVE: To test the prototype in 106 cadavers and excised sterna and compare it with other IO devices. RESULTS: The insertion force was similar to that of other IO devices (mean, 8.5 kg; range, 2.3-19.6 kg). In 39 of 39 trials, the depth-control mechanism inserted the portal within 1.0 mm of a predetermined distance below the anterior surface of the cortical bone. If misplaced, underpenetration was more likely than overpenetration (mean displacement, -0.3 mm; SD, 0.5 mm). After release, the portal could not be advanced further into the manubrium. Marrow was accessed in 75 of 77 trials. Mean flow rates were 109 mL/min for normal saline solution and 102 mL/min for hypertonic saline/dextran, similar to the Cook Sur-Fast device. CONCLUSION: The cadaver and bench tests demonstrated the reliability and safety of the FAST 1 system at the design/prototype stage.

Aged↗
PubMed1996

Compartment syndrome after intraosseous infusion: an experimental study in dogs.

An experimental study was designed to investigate the development of compartment syndrome with the use of an intraosseous line in dogs. We used an open technique for insertion of a 20-gauge spinal needle to the tibia. The needle was secured to the tibia with bone cement. Throughout the intraosseous infusion of saline with radio-opaque dye (rate, 480 mL/h), serial radiographic examination and pressure monitoring of the anterolateral compartment of the leg was performed. Although there was no change up to approximately 350 mL of fluid infusion, the radio-opaque dye was detected in the soft tissues and compartment pressure increased to more than 35 mm Hg. Compartment pressure continued to increase in direct proportion to the amount of dye infused. In the present study, the possible technical errors, which may cause compartment syndrome, have been eliminated. However, compartment syndrome developed because of the failure of microvasculature within a muscle adjacent to bone. We suggest that there is a need for a dose-and time-dependent scale for safe intraosseous infusion.

Animals↗
PubMedDate not supplied

Intraosseous infusions in adults.

Intraosseous (IO) access in adults via the distal tibia has never been a widely accepted technique. Yet there have been occasional reports of the successful use of this procedure. This study was done to demonstrate the utility of IO infusions in the adult patient, including those patients in cardiac arrest. Twenty-two patients, aged 36 through 84 (mean 65.1 years), who arrived in the emergency department (ED) in cardiac arrest from nonhypovolemic causes and in whom an intravenous line was not established prior to arrival or was found to be inadequate (nonfunctioning or poorly functioning) upon arrival in the ED, had an IO needle (13-gauge Kormed/Jamshidi, Pharmaseal Division, Baxter Healthcare Corp., Valencia, CA) placed above the medial malleolus. The IO needle was then connected to a standard IV tubing, with a pressure bag or pressure device delivering 300 mm Hg to the solution bag. The resultant flow rate through the IV line ranged from 5 to 12 mL/min. The IO needle was placed and flow established in under one minute in all patients. Temporally related pharmacologic effects were observed after the IO administration of sodium bicarbonate, lidocaine, atropine, and vasopressors. This study shows that I.O. access can be quickly and easily obtained in adults in the medial supramalleolar position during cardiac arrest. This method of drug administration appears to hold promise as another useful modality for adults and older children during nontraumatic resuscitations.

Adult↗
PubMedDate not supplied

A new system for sternal intraosseous infusion in adults.

BACKGROUND: Intraosseous (IO) infusion provides an alternative route for the administration of fluids and medications when difficulty with peripheral or central lines is encountered during resuscitation of critically ill and injured patients. OBJECTIVE: To report the first 50 uses of a new system for emergency IO infusion into the sternum in adults, the Pyng F.A.S.T.1 IO infusion system. METHODS: Six emergency departments and five prehospital emergency medical services (EMS) sites in Canada and the United States provided clinical and/or research data on their use of the IO system in a pilot study of success rates, insertion times, and complications. Indications for use included adult patient, urgent need for fluids or medications, and unacceptable delay or inability to achieve standard vascular access. A basic data set was standardized for all sites, and some sites collected additional data. RESULTS: The overall success rate for achieving vascular access with the system was 84%. Success rates were 74% for first-time users, and 95% for experienced users. Failure to achieve vascular access occurred most frequently in patients (5 of 9) described subjectively by the user as "very obese," in whom there was a thick layer of tissue overlying the sternum. Mean time to achieve vascular access was 77 seconds. Flow rates of up to 80 mL/min were reported for gravity drip, and more than 150 mL/min by syringe bolus. Pressure cuffs were also used successfully, although fluid rate was controlled by clamping the line. Further research on flow rates is needed. No complications or complaints were reported at two-month follow-up. CONCLUSION: These early data indicate that sternal IO infusion using the new F.A.S.T.1 IO system may provide rapid, safe vascular access and may be a useful technique for reducing unacceptable delays in the provision of emergency treatment.

Adolescent↗
PubMed1999

Methylene blue by intraosseous infusion for methemoglobinemia.

Intraosseous administration of methylene blue may be an emergency alternative to intravascular administration. A 6-week-old female infant (3 kg) presented to the emergency department after a 1-week illness and appeared cyanotic and listless. Oxygen saturation by oximetry was 86% while the patient was receiving oxygen. Vital signs were blood pressure, 107/80 mm Hg; pulse, 190; respirations, 47; temperature, 39.0 degreesC. A metabolic acidosis and a methemoglobin level of 29.3% were present. After several unsuccessful attempts to establish intravenous access, an intraosseous needle was placed in the infant's left tibia. Methylene blue, 1 mg/kg, normal saline solution, and sodium bicarbonate were given intraosseously. The patient's oxygen saturation rose to 98% to 100%, and her cyanosis improved. Three hours later, her methemoglobin level was 8.2%. The child recovered uneventfully and was sent home after 3 days. Intraosseous administration of standard intravenous doses of methylene blue rapidly terminated the effects of acquired methemoglobinemia.

Antidotes↗
PubMedDate not supplied

Intraosseous infusion: a re-discovered procedure as an alternative for pediatric vascular access.

The intraosseous infusion has numerous advantages over other techniques that provide vascular access during emergencies. It is a rapid and safe alternate route for fluid and certain drug administration in the infant or child. Few contra-indications or restrictions exist and the success rate for the technique is very high, even when performed by paramedical personnel, and the rate of complications is very low. At this time the technique should be reserved for children in crisis such as cardiac arrest, shock, trauma, life threatening status epilepticus, or any situation in which the potential benefit of rapid venous access outweighs the low incidence of complication. Intraosseous infusion is intended only for emergency resuscitation and stabilization, after which another route of vascular access should be sought. The technique may offer even more promise for those who rarely care for critically ill children, because this skill is easily mastered with even limited opportunity for practice.

Bone Marrow↗
PubMedDate not supplied

Intraosseous infusion.

Establishing vascular access is vital in the resuscitation of critically-ill children and adults. Intraosseous infusion (IOI) is a viable route for providing vascular access when traditional intravenous methods cannot be accomplished. IOI is relatively easy to perform and is a standard recommended intervention for the resuscitation of both adults and children. The authors review the history, anatomy, technique, and clinical application of IOI. They also highlight the use of IOI in the prehospital setting.

Advanced Cardiac Life Support↗
PubMed1994

Resuscitation from hypovolemia in swine with intraosseous infusion of a saturated salt-dextran solution.

Prehospital fluid resuscitation of traumatic injury is limited by difficulty in delivering large volumes of fluid in the field and time delays associated with gaining vascular access. We addressed these limitations in 14 anesthetized swine by evaluating a highly efficient volume expander, a near-saturated salt-dextran solution (SSD) administered through a new device, which gains vascular access via intraosseous (IO) infusion into the sternal bone marrow. After a steady-state baseline was achieved, all animals were hemorrhaged to 45 mm Hg for one hour. Half of the hemorrhaged animals were infused intraosseously with either normal saline (NS) or SSD until cardiac output was restored to the baseline value. No further infusion was given and animals were monitored for 2 hours. Both regimens were able to restore cardiac output to the baseline value, but only 1.3 +/- 0.1 mL/kg of SSD was required vs. 31.6 +/- 6.3 mL/kg for NS. In addition, cardiac output was better sustained after 2 hours with SSD than with NS. No deleterious effects of IO infusion of SSD were observed. From the improvement in cardiovascular variables and the lack of significant sternal or pulmonary pathologic perturbations, these data suggest that IO infusion of SSD can effectively treat hypovolemia and may allow field treatment when logistic considerations make conventional resuscitation impractical.

Animals↗
PubMed1994

Scintigraphic findings of osteomyelitis after intraosseous infusion in a child.

A case of unilateral tibial osteomyelitis in a 20-month-old child after bilateral intraosseous infusion (IOI) needle placement is presented. A review of the indications, potential complications, and scan findings is discussed. This case also shows the lack of significant uptake in the noninfected side, suggesting that a three-phase bone scan is of value in differentiating reactive bone from infected bone in patients with IOI.

Female↗