The use of intraosseous infusions in the operating room

Intraosseous Line Use, Complications, and Outcomes Among a Population-Based Cohort of Children Presenting to California Hospitals

“…In 2005, the American Heart Association published guidelines regarding the care of critically ill children 1 in which IO line access is described as a class IIa recommendation for emergent vascular access in children when intravenous access cannot be established quickly. Intraosseous line use has been described in the prehospital setting 2Y6 and emergency department (ED) setting, 7Y10 with limited reports of IO line use in trauma patients, 11,12 burn patients, 13 in the patients in the operating room, 14 and in all ages of pediatric patients including neonates. 15,16 However, there are no studies utilizing populationbased data describing the incidence of IO line use, characteristics of patients and hospitals in which it is used, mortality of patients in whom an IO line is placed, or complication rates from the procedure.…”

Semi‐elective intraosseous infusion after failed intravenous access in pediatric anesthesia1

“…Although the IO infusion is well established in pediatric emergency medicine, pediatric anesthetists still have strong reservations using this technique even in life-threatening situations in the operating theatre (1). Only a few authors have so far reported on or recommend IO access when peripheral IV access had failed in the perioperative setting (5,7,(12)(13)(14)(15)(16).…”

“…Only a very limited number of case reports have been published on IO access in pediatric anesthetic emergencies or on its use following failed peripheral IV access in elective routine patients (5–7). We report on a series of fourteen children in whom semi‐elective IO infusion was successfully performed as alternative measure, after peripheral IV access had failed repeatedly under inhalational induction of anaesthesia.…”

Intraosseous infusion in elective and emergency pediatric anesthesia

“…Therefore, there are more and more case reports and recommendations for its use not only in the prehospital emergency situation but also for perioperative pediatric anesthesia care [14,22,29,31,32,34,[39][40][41][42][43][44][45][46]. As a consequence of these reports and in order to provide a structured approach, the German Scientific Working Group for Pediatric Anesthesia published working guidelines in 2011 for the use of intraosseous infusion in the pediatric perioperative setting [37].…”