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intraosseous infusion

Megan Johnson, Kenji Inaba, Saskya Byerly, Erika Falsgraf, Lydia Lam, Elizabeth Benjamin, Aaron Strumwasser, Jean-Stephane David, Demetrios Demetriades
Intraosseous (IO) needle placement is an alternative for patients with difficult venous access. The purpose of this retrospective study was to examine indications and outcomes associated with IO use at a Level 1 trauma center (January 2008-May 2015). Data points included demographics, time to insertion, intravenous (IV) access points, indications, infusions, hospital and intensive care unit length of stay, and mortality. Of 68 patients with IO insertion analyzed (63.2% blunt trauma, 29.4% penetrating trauma, and 7...
October 2016: American Surgeon
Carol H Miao
Current treatment of hemophilia A (HemA) patients with repeated infusions of factor VIII (FVIII; abbreviated as F8 in constructs) is costly, inconvenient, and incompletely effective. In addition, approximately 25 % of treated patients develop anti-factor VIII immune responses. Gene therapy that can achieve long-term phenotypic correction without the complication of anti-factor VIII antibody formation is highly desired. Lentiviral vector (LV)-mediated gene transfer into hematopoietic stem cells (HSCs) results in stable integration of FVIII gene into the host genome, leading to persistent therapeutic effect...
2016: Thrombosis Journal
Yi Liu, Jiawei Wang, Doudou Ma, Fang Lv, Xiaojie Xu, Weibo Xia, Yan Jiang, Ou Wang, Xiaoping Xing, Peiran Zhou, Jianyi Wang, Wei Yu, Mei Li
INTRODUCTION: Osteogenesis imperfecta (OI) type V is a rare inherited disease characterized by multiple fractures, intraosseous membrane calcification, and hypercallus formation. We investigate the causative gene, phenotype and also observe the effects of zoledronic acid in Chinese OI type V patients. METHODS: The clinical phenotype and causative gene mutation was investigated in eleven patients with type V OI. Patients were given a dose of zoledronic acid 5mg intravenously...
November 1, 2016: Clinica Chimica Acta; International Journal of Clinical Chemistry
A Marinosci, C Doit, B Koehl, K Belhacel, P Mariani Kurkdjian, I Melki, A Renaud, C Lemaitre, N Ammar Khodja, A Blachier, S Bonacorsi, A Faye, M Lorrot
: Rotavirus is the most common cause of gastroenteritis in children requiring hospitalization. It is a very resistant and contagious virus causing nosocomial gastroenteritis. In France, the vaccine against rotavirus has been available since 2006, but the vaccine is not recommended for infant vaccination. The aim of this retrospective study was to describe nosocomial rotavirus gastroenteritis (NRGE) and to assess its impact on children hospitalized in the General Pediatrics Department of Robert-Debré Hospital (Paris) between 1 January 2009 and 31 December 2013...
September 15, 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Matthew C Phipps, Felipe Monte, Manav Mehta, Harry K W Kim
Osteonecrosis of the femoral head (ONFH) is a debilitating hip disorder, which often produces a permanent femoral head deformity and osteoarthritis. The local delivery of biological agents capable of stimulating bone healing offer potential new treatment options for patients with ONFH. Previous studies from our laboratory have shown that a local intraosseous infusion of bone morphogenic protein-2 (BMP-2) was effective in stimulating new bone formation in a piglet model of ischemic ONFH. However, infusion of BMP-2 solution was associated with unwanted dissemination of BMP-2 out of the femoral head and produced heterotopic ossification in the hip capsule...
July 11, 2016: Biomacromolecules
Stacy L Muir, Lance B Sheppard, Anne Maika-Wilson, James M Burgert, Jose Garcia-Blanco, Arthur D Johnson, Jennifer L Coyner
UNLABELLED: Introduction Obtaining intravenous (IV) access in patients in hemorrhagic shock is often difficult and prolonged. Failed IV attempts delay life-saving treatment. Intraosseous (IO) access may often be obtained faster than IV access. Albumin (5%) is an option for prehospital volume expansion because of the absence of interference with coagulation and platelet function. Hypothesis/Problem There are limited data comparing the performance of IO and IV administered 5% albumin. The aims of this study were to compare the effects of tibial IO (TIO) and IV administration of 500 mL of 5% albumin on infusion time and hemodynamic measurements of heart rate (HR), mean arterial pressure (MAP), cardiac output (CO), and stroke volume (SV) in a swine model of hemorrhagic shock...
August 2016: Prehospital and Disaster Medicine
Nabeel I Uwaydah, Stephen L Hoskins, Stephen P Bruttig, Henry Farrar, Nick C Copper, Donald J Deyo, Michael A Dubick, George C Kramer
OBJECTIVE: Exposure to nerve agents requires prompt treatment. We hypothesized that intraosseous (IO) injections of drug antidotes into the vascularized bone marrow will provide a more rapid and effective means to treat exposure to nerve agents than standard intramuscular (IM) injections. We compared the pharmacokinetics of IM and IO administration of pralidoxime chloride (2-PAM Cl) during normovolemia and hypovolemia, as well as their combined administration during normovolemia in swine...
July 2016: Prehospital Emergency Care
Yonatan Y Greenstein, Seth J Koenig, Paul H Mayo, Mangala Narasimhan
OBJECTIVE: Current guidelines recommend the use of intraosseous access when IV access is not readily attainable. The pediatric literature reports an excellent safety profile, whereas only small prospective studies exist in the adult literature. We report a case of vasopressor extravasation and threatened limb perfusion related to intraosseous access use and our management of the complication. We further report our subsequent systematic review of intraosseous access in the adult population...
September 2016: Critical Care Medicine
Hong Huang, Jiejie Liu, Haojie Hao, Chuan Tong, Dongdong Ti, Huiling Liu, Haijing Song, Chaoguang Jiang, Xiaobing Fu, Weidong Han
OBJECTIVE: To evaluate the therapeutic effects of G-CSF administration after intraosseous (IO) resuscitation in hemorrhagic shock (HS) combined with cutaneous injury rats. METHODS: The rats were randomly divided into four groups: (1) HS with resuscitation (blank), (2) HS with resuscitation + G-CSF (G-CSF, 200 μg/kg body weight, subcutaneous injection), (3) HS with resuscitation + normal saline solution injection (normal saline), and (4) HS + G-CSF injection without resuscitation (Unres/G-CSF)...
2016: BioMed Research International
H J G M Derikx, B M Gerritse, R Gans, N J M van der Meer
INTRODUCTION: Intraosseous access is recommended in vitally compromised patients if an intravenous access cannot be easily obtained. Intraosseous infusion can be initiated by various healthcare providers. Currently, there are two mechanical intraosseous devices approved by the U.S. Food and Drug Administration (FDA) for use in adults and children. A comparison is made in this study of the theoretical and practical performance by anesthesiologists and registered nurses of anesthesia (RNAs) in the use of the battery-powered device (device A) versus the spring-loaded needle device (device B)...
October 2014: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Sandra Lange, Anne Steder, Änne Glass, Doreen Killian, Susanne Wittmann, Christoph Machka, Juliane Werner, Stephanie Schäfer, Catrin Roolf, Christian Junghanss
The canine hematopoietic stem cell transplantation (HSCT) model has become accepted in recent decades as a good preclinical model for the development of new transplantation strategies. Information on factors associated with outcome after allogeneic HSCT are a prerequisite for designing new risk-adapted transplantation protocols. Here we report a retrospective analysis aimed at identifying risk factors for allograft rejection in the canine HSCT model. A total of 75 dog leukocyte antigen-identical sibling HSCTs were performed since 2003 on 10 different protocols...
April 2016: Biology of Blood and Marrow Transplantation
Niels Hammer, Robert Möbius, André Gries, Björn Hossfeld, Ingo Bechmann, Michael Bernhard
INTRODUCTION: Intraosseous infusion is recommended if peripheral venous access fails for cardiopulmonary resuscitation or other medical emergencies. The aim of this study, using body donors, was to compare a semi-automatic (EZ-IO®) device at two insertion sites and a sternal intraosseous infusion device (FASTR™). METHODS: Twenty-seven medical students being inexperienced first-time users were randomized into three groups using EZ-IO and FASTR. The following data were evaluated: attempts required for successful placement, insertion time and flow rates with and without external pressure to the infusion...
2015: PloS One
N a Efimenko, V V Valevskii, V V Lyutov, A I Makhnovskii, S I Sorokin, I V Blinda
The kit is designed in accordance with the list of the first medical aid procedures and syndromic standards of emergency medical care providing. The kit contains modern local hemostatic agents, vent tubes, cricothyrotomy, needles to eliminate pneumothorax, portable oxygen machine, sets for intravenous and intraosseous infusion therapy, collapsible plastic tires, anti-shock pelvic girdle, and other medical products and pharmaceuticals. As containers used backpack and trolley bag on wheels camouflage colours...
June 2015: Voenno-medit︠s︡inskiĭ Zhurnal
Matthew J Douma, Gurpaul S Bara, Domhnall O'Dochartaigh, Peter G Brindley
INTRODUCTION: Resuscitation can be delayed, or impaired, by insufficient vascular access. This study examines whether dual-intraosseous needles, inserted into a single porcine humerus, can facilitate rapid and concomitant fluid and medication delivery. METHODS: After inserting one- and then two-intraosseous needles into the same porcine humerus, we determined the rate of fluid administration using (i) an infusion pump set to 999mL/h, and (ii) a standard pressure-bag set to 300mmHg...
November 2015: Injury
G Benson
In many emergency situations rapid vascular access is a priority, particularly in cases involving haemodynamic compromise. Traditional vascular access through the use of an intravenous cannula, although the preferred first line method, can in certain circumstances have a high rate of failure. A study by Minville et al (2006) showed that the success rate of first attempt venous cannulation can be as low as 76%. Repeated attempts at venous cannulation in patients with difficult vascular access wastes valuable time which in some situations could prove fatal...
July 2015: Journal of Perioperative Practice
P K Suominen, E Nurmi, K Lauerma
Gaining vascular access in a neonate during cardiopulmonary resuscitation is crucial and challenging. Intraosseous (IO) access can offer a fast and reliable method for achieving emergency access for fluids and drugs when venous access fails in a critically ill child. IO access can however result in rare, but serious adverse events including compartment syndrome and amputation. We describe a case resulting in leg amputation due to IO infusion in a neonate after resuscitation and therapeutic hypothermia. We compared 10 tibia X-rays in three age groups...
November 2015: Acta Anaesthesiologica Scandinavica
Mats Eriksson, Gunnar Strandberg, Miklós Lipcsey, Anders Larsson
BACKGROUND: Determination of troponin I may be important in the management of the critically ill patient. In medical emergencies, especially when vascular access is difficult to achieve, the use of intraosseous (10) needles is recommended. We aimed to perform a descriptive study, aiming to elucidate whether IO needles can be used to evaluate troponin I in a porcine model of human shock. METHODS: Eight pigs were anesthetized and challenged with a 6 hours continuous intravenous infusion of E...
2015: Clinical Laboratory
Nkhensani Mogale, Albert-Neels van Schoor, Marius C Bosman
BACKGROUND: Studies have shown that the venous system tends to collapse during hypovolemic shock. The use of the bone marrow space for infusions is an effective alternative, with the tibial insertion site being the norm. OBJECTIVES: This study was conducted to determine a quick intraosseous infusion method that could be an alternative to the tibial route in neonates during emergency situations. METHOD: A sample of 30 neonatal cadavers was dissected to explore a possible alternative to the tibial insertion site...
2015: African Journal of Primary Health Care & Family Medicine
Raúl J Gazmuri, Kasen Whitehouse, Karla Whittinghill, Alvin Baetiong, Jeejabai Radhakrishnan
INTRODUCTION: Current management of hemorrhagic shock (HS) in the battlefield and civilian settings favors small-volume fluid resuscitation before controlling the source of bleeding. We investigated in a swine model of HS the effects of vasopressin infusion along with small-volume fluid resuscitation; with erythropoietin (EPO) and HS severity as additional factors. METHODS: HS was induced in 24 male domestic pigs (36 to 41 kg) by blood withdrawal (BW) through a right atrial cannula modeling spontaneous bleeding by a mono-exponential decay function...
2015: PloS One
Don Johnson, Christian Penaranda, Kent Phillips, Daniel Rice, Lauren Vanderhoek, Brian Gegel, James Burgert, Jose Blanco
OBJECTIVE: Disasters may cause traumatic injuries leading to hemorrhage. Hemorrhage is the leading cause of death for military and civilian trauma casualties. The US Army's Tactical Combat Casualty Care guidelines recommend administering a 500 mL Hextend bolus via the intravenous (IV) or intraosseous (IO) routes for patients in hypovolemic shock. The purposes of this study were to compare administration time of Hextend and the effects on hemodynamics when Hextend is administered by the sternal IO (SIO) and IV routes in a swine model of hemorrhagic shock...
2015: American Journal of Disaster Medicine
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