PRACTICAL PROBLEMS AND THE EFFICACY OF INTRAOSSEOUS INFUSION: SOLVING THE PROBLEMS BY EMPLOYING AN ANIMAL MODEL

In critically ill infants and children, intravascular (IV) access is sometimes very difficult. In such cases intraosseous (IO) infusion should be used as the method of choice. However, in practice, different problems are experienced with this procedure. To overcome the practical problems and to confirm the efficacy of IO infusion in reversing hypovolemic shock, an animal model was used by employing three rabbits. In rabbit I, after insertion of a 14-gauge bone marrow aspiration needle in the proximal tibia, the flow rate of normal saline was very slow by gravity, but pressure infusion devices including manual pushing with a syringe, blood pressure cuffs, or infusion pumps all increased the flow rate remarkably. In rabbit II, the circulation time of a dye given by IO route was very short therefore drugs are expected to appear in the systemic circulation shortly after IO injection. In rabbit III, hypovolemic shock was induced by withdrawing blood and then, rapidly and successfully treated by IO infusion of normal saline.