Comparison of intraosseous and intravenous delivery of hypertonic saline/dextran in anesthetized, euvolemic pigs.

STUDY OBJECTIVES With renewed interest in intraosseous (IO) infusion, the present study examined if sternal IO infusion provided vascular entry of 7.5% NaCl/6% dextran-70 (HSD) as efficiently as IV infusion. DESIGN, SETTING, TYPE OF PARTICIPANTS, INTERVENTIONS: Twelve anesthetized pigs were catheterized for measurement of cardiovascular parameters. Six pigs were given a 4-mL/kg IO infusion of HSD under pressure over two to six minutes; each pig was paired with another that had been given HSD IV over the same time course. Rapid arterial blood sampling was used to evaluate vascular entry of NaCl and dextran with monitoring continued for two hours after infusion. MEASUREMENTS AND MAIN RESULTS Complete vascular entry of infused sodium and dextran was generally complete within one minute after infusion in all experiments. Increases in mean arterial pressure, cardiac output, and other cardiovascular parameters were indistinguishable between IO and IV infusions. Plasma volume expansion was about 20% above baseline in both groups of pigs. Histologic examination showed minimum pathology to the sternum and no significant pulmonary complications. CONCLUSION 1O vascular delivery of HSD is a viable alternative in emergency scenarios in which vascular access is compromised.