Intraosseous Pressure Tracings Mimics Arterial Pressure Tracings in Timing and Contour

Frascone, R.J.; Salzman, Joshua G.; Bliss, P.; Adams, Alexander B.; Wewerka, Sandi S.; Dries, David J.

doi:10.1016/j.annemergmed.2013.07.318

Cited by 3 publications

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“…showed a similar result in a model of rabbits. In a preliminary report Frascone and colleagues show the pulsatile waveforms associated with IOP may mimic the arterial pressure waveform. In a separate abstract, they show a relationship with respiratory variation and volume status .…”

Section: Discussionmentioning

confidence: 99%

“…As early as the 1950s it was observed that a pulsatile waveform could be measured in the IO space, and it was seemingly in phase with the systemic arterial pressure . More recently, Frascone and colleagues in two preliminary reports showed the pulsatile waveforms associated with IO pressure (IOP) may mimic the arterial pressure waveform and are associated with respiratory variation and volume status. The IOP is reported generally to be a fraction of systemic arterial pressure, usually in the range of 10% to 30%.…”

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Relationships of Intraosseous and Systemic Pressure Waveforms in a Swine Model

et al. 2014

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Section: Discussionmentioning

confidence: 99%

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Relationships of Intraosseous and Systemic Pressure Waveforms in a Swine Model

et al. 2014

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Use of an intraosseous device for invasive pressure monitoring in the ED

Frascone

Salzman

Ernest

et al. 2014

The American Journal of Emergency Medicine

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Factors affecting intraosseous pressure measurement

Beverly

Murray

2018

J Orthop Surg Res

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BackgroundAlthough a raised intraosseous pressure (IOP) has been found in osteoarthritis and osteonecrosis, the normal physiology of subchondral circulation is poorly understood. We developed an animal model and explored the physiology of normal subchondral perfusion and IOP.MethodsIn 21 anaesthetised rabbits, 44 intraosseous needles were placed in the subchondral bone of the femoral head (n = 6), femoral condyle (n = 7) or proximal tibia (n = 31). Needles were connected to pressure transducers and a chart recorder. In 14 subjects, the proximal femoral artery and vein were clamped alternately. In five subjects, arterial pressure was measured simultaneously in the opposite femoral artery.ResultsThe average IOP at all 44 sites was 24.5 mmHg with variability within SD 6.8 and between subjects SD 11.5. IOP was not significantly influenced by gender, weight, site or size of a needle. Needle clearance by flushing caused a prolonged drop in IOP whereas after clearance by aspiration, recovery was rapid. IOP recordings exhibited wave patterns synchronous with the arterial pulse, with respiration and with drug circulation time. There was a correlation between IOP and blood pressure (13 sites in 5 subjects, Pearson correlation 0.829, p < 0.0005). There was a correlation between IOP and the associated pulse pressure (PP) in 44 sites among 21 subjects (Pearson correlation 0.788, p < 0.001). In 14 subjects (31 sites), arterial occlusion caused a significant reduction in IOP and loss of PP (p < 0.0001). Venous occlusion significantly raised IOP with preservation of the PP (p < 0.012).ConclusionOur study shows that subchondral cancellous bone behaves as a perfused tissue and that IOP is mainly a reflection of arterial supply. A single measure of IOP is variable and reflects only perfusion at the needle tip rather than being a measure of venous back pressure. Alternate proximal vessel clamping offers a new means of exploring the physiology of subchondral perfusion. We describe a model that will allow further study of IOP such as during loading.

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Intraosseous Pressure Tracings Mimics Arterial Pressure Tracings in Timing and Contour

Cited by 3 publications

References 0 publications

Relationships of Intraosseous and Systemic Pressure Waveforms in a Swine Model

Relationships of Intraosseous and Systemic Pressure Waveforms in a Swine Model

Use of an intraosseous device for invasive pressure monitoring in the ED

Factors affecting intraosseous pressure measurement

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