Tibial Fracture as a Complication of Intraosseous Infusion During Pediatric Resuscitation

Bowley, Douglas M.; Loveland, Jerome; Pitcher, Graeme

doi:10.1097/01.ta.0000100170.61381.63

Cited by 41 publications

(17 citation statements)

References 15 publications

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“…Previously used sites for IO access should not be used for one to two days, and repeated attempts at the same site are discouraged. Bowley et al [28] describe an iatrogenic fracture associated with IO access in a two-yearold trauma patient after IO access placement was attempted unsuccessfully with an 18-gauge bone BIG at the left proximal tibia followed by two manual attempts with the same needle at the same site. In addition to fracture, repeated long-bone puncture attempts can result in extravasation of subsequently administered resuscitation agents, with the risk of tissue necrosis or compartment syndrome.…”

Section: Discussionmentioning

confidence: 97%

The use of intraosseous infusions in the operating room

Joseph¹,

Tobias²

2008

Journal of Clinical Anesthesia

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Section: Discussionmentioning

confidence: 97%

The use of intraosseous infusions in the operating room

Joseph¹,

Tobias²

2008

Journal of Clinical Anesthesia

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“…The risk of bone injury should also be considered. Although case reports of iatragenic fractures from intraosseous insertion in pediatric patients exist, these are often a result of excessive force using a manually inserted needle [25]. In addition, a recent prospective pediatric study demonstrated that there are no long-term changes in a variety of radiographic bone measurements after a mean follow-up period of 29.2 months [26].…”

Section: Discussionmentioning

confidence: 98%

The versatility of intraosseous vascular access in perioperative medicine: a case series

Anson

Sinz

Swick

2015

Journal of Clinical Anesthesia

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“…Their primary diseases were cerebral palsy (5 patients), congenital heart disease (3 patients), Prader Willi syndrome (1 patient) and acute lymphoblastic leukemia (1 patient), while 3 patients were previously healthy. The etiologies of shock in these IOI administered patients were septic shock (6), cardiogenic shock (2), acute gastroenteritis (1), hemorrhagic shock and encephalopathy syndrome (4).…”

Section: Resultsmentioning

confidence: 99%

“…Thereafter intraosseous (IO) infusions are indicated in life-threatening situations in which vascular access is essential for treatment and routine intravenous infusion is not readily available (1). Common clinical indications for IO infusion include cardiopulmonary arrest, shock, major trauma, extensive burns, status epilepticus and overhelming sepsis (2)(3)(4)(5)(6).…”

mentioning

confidence: 99%

A life-saving line in resuscitation and shock management of the critically ill child: intraosseous infusion Kritik olarak hasta olan çocuğun canlandırılması ve şok tedavisindeyaşam kurtarıcı bir yol:

Kendirli¹

2005

Ankara Üniversitesi Tıp Fakültesi Mecmuası

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Aim: Intraosseous infusion (IOI) is an alternative method of vascular access which is considered when peripheral intravenous line cannot be achieved rapidly. Epinephrine, adenosine, crystalloids, colloids and blood products can be administered effectively using this route during resuscitation and shock management. Material and Methods:We retrospectively evaluated the medical records of Pediatric Intensive Care Unit (PICU) patients who had required IOI administration, and the complications of this method are searched. Results: Medical records of 332 patients who had been followed in our PICU were examined and 13 patients (3.9%) were detected to have IOI administered. Our patients' median age was 8 months, and male:female ratio was 2,5. The primary diagnoses of our IOI administered patients were septic shock (6), cardiogenic shock (2), acute gastroenteritis (1), hemorrhagic shock and encephalopathy syndrome (4). IOI were performed 2 of 13 patients during resuscitation. We performed IOI by spinal needle in 10 (76.9%) patients and by bone marrow aspiration needle in three patients. Eight (61.64%) patients were inpatient. The sites for placement of IO line were right proximal tibia in 12 patients, left proximal tibia in 2 patients, and right distal femur in one patient. The median time of IOI was 20 hours (3 hours-9 days) , and 11 patients survived in the first 24 hours. The only complication was extravasation, seen in a patient. Conclusion: IOI is indicated in life-threatening situations in which vascular access is essential for treatment, and should be kept in mind for being an easily achieved vascular access.Key words: intraosseous infusion, shock, resuscitation, emergency treatment Amaç: Kemik içi (Kİ) infüzyon acil durumlarda damaryolu açılamadığında ilâç ve sıvı tedavisi için alternatif bir yoldur. Bu yolla canlandırma sırasında ve şokta epinefrin, adenozin, kristaloid, kolloid ve kan ürünleri etkin bir şekilde uygulanabilir. Gereç ve Yöntem: Yoğun bakım ünitesinde yatmış ve Kİ infüzyon tedavisi uygulanmış olan hastaların dosyaları retrospektif olarak incelenerek, bu tedavinin yapıldığı hastalar ve komplikasyonlar değerlendirildi. Bulgular: Yoğun bakım ünitemizde yatan 332 hastadan 13 (3.9%)'üne Kİ infüzyon tedavisi uygulandı. Hastalarımızda median yaş 8 ay, erkek kız oranı 2.5 bulundu. Kİ infüzyon tedavisi uygulanan hastaların tanıları septik şok (6), kardiyojenik şok (2), akut gastroenterit (1), hemorajik şok ve ensefalopati sendromu (4) idi. Kİ infüzyonu 13 hastadan 2'sine canlandırma sırasında uygulandı. On (76.9%) hastaya spinal iğne, 3 hastaya ise kemik iliği aspirasyon iğnesi ile Kİ infüzyonu yapıldı. Sekiz (61.64%) hasta daha önceden hastanede yatmaktaydı. Kemik içi infüzyon tedavisi 12 hastada sağ proksimal tibia, 2 hastada sol proksimal tibia ve bir hastada sağ distal femurdan uygulandı. Kemik içi uygulanan iğneler ortalama 20 saat (3 saat-9 gün) kaldı ve 11 hasta 24 saatten uzun süre yaşadı. Hastalardan sadece birisinde 1 kez görülen ilâç ekstravazasyonu, tek komplikasyon idi. Sonuç: Kemik içi infüzy...

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Tibial Fracture as a Complication of Intraosseous Infusion During Pediatric Resuscitation

Cited by 41 publications

References 15 publications

The use of intraosseous infusions in the operating room

The use of intraosseous infusions in the operating room

The versatility of intraosseous vascular access in perioperative medicine: a case series

A life-saving line in resuscitation and shock management of the critically ill child: intraosseous infusion Kritik olarak hasta olan çocuğun canlandırılması ve şok tedavisindeyaşam kurtarıcı bir yol:

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