A prospective evaluation of tibial insertion sites for intraosseous needles to gain vascular access in Asian neonates.


Journal

Journal of perinatology : official journal of the California Perinatal Association
ISSN: 1476-5543
Titre abrégé: J Perinatol
Pays: United States
ID NLM: 8501884

Informations de publication

Date de publication:
06 Jun 2024
Historique:
received: 15 04 2024
accepted: 23 05 2024
revised: 22 05 2024
medline: 7 6 2024
pubmed: 7 6 2024
entrez: 6 6 2024
Statut: aheadofprint

Résumé

To determine the appropriate intraosseous (IO) needle insertion site, optimal depth and success using a drill-assisted device (DAD) versus a manually inserted needle (MIN). Computed tomography scans of neonatal cadavers were analyzed. Success was based on tibial needle tip placement within the marrow cavity and contrast media distribution. Nineteen cadavers (38 tibiae) were included. The overall success rate was comparable between DAD and MIN needles, but reduced in very-low birthweight (VLBW) infants. The insertion site was consistent across birth weight groups. Contrast leakage occurred overall in 15.8% and 41.7% in VLBW infants and was insignificantly greater in DAD versus MIN needles. Minimum and maximum puncture depth was adjusted for higher BW groups. IO needles should be placed 2 cm below and 1-2 cm medial to the tibial tuberosity. MIN needles are preferred to minimize leakage. IO depth should be modified by birth weight.

Identifiants

pubmed: 38844519
doi: 10.1038/s41372-024-02018-x
pii: 10.1038/s41372-024-02018-x
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024. The Author(s).

Références

Yangthara B, Horrasith S, Paes B, Kitsommart R. Predictive factors for intensive birth resuscitation in a developing-country: a 5-year, single-center study. J Matern Fetal Neonatal Med. 2020;33:570–6.
doi: 10.1080/14767058.2018.1497602 pubmed: 29973079
Kapadia VS, Wyckoff MH. Drugs during delivery room resuscitation-what, when and why? Semin Fetal Neonatal Med. 2013;18:357–61.
doi: 10.1016/j.siny.2013.08.001 pubmed: 23994199
American Academy of Pediatrics and American Heart Association. Textbook of neonatal resuscitation, 8th edn. Itasca, IL: American Academy of Pediatrics; 2021.
Sapien R, Stein H, Padbury JF, Thio S, Hodge D. Intraosseous versus intravenous epinephrine infusions in lambs: pharmacokinetics and pharmacodynamics. Pediatr Emerg Care. 1992;8:179–83.
doi: 10.1097/00006565-199208000-00002 pubmed: 1513725
Boon JM, Gorry DL, Meiring JH. Finding an ideal site for intraosseous infusion of the tibia: an anatomical study. Clin Anat. 2003;16:15–8.
doi: 10.1002/ca.10071 pubmed: 12486733
Suominen PK, Nurmi E, Lauerma K. Intraosseous access in neonates and infants: risk of severe complications—a case report. Acta Anaesthesiol Scand. 2015;59:1389–93.
doi: 10.1111/aas.12602 pubmed: 26300243
Ellemunter H, Simma B, Trawöger R, Maurer H. Intraosseous lines in preterm and full term neonates. Arch Dis Child Fetal Neonatal Ed. 1999;80:F74–5.
doi: 10.1136/fn.80.1.F74 pubmed: 10325819 pmcid: 1720869
Marete I, Ekhaguere O, Bann CM, Bucher SL, Nyongesa P, Patel AB, et al. Regional trends in birth weight in low- and middle-income countries 2013–2018. Reprod Health. 2020;17:176.
doi: 10.1186/s12978-020-01026-2 pubmed: 33334365 pmcid: 7745347
Incorporated T Vascular access: Arrow, EZ-IO intraosseous vascular access system for military use. 2024. [cited 2024 18th March]. Available from: https://www.teleflex.com/usa/en/product-areas/military-federal/intraosseous-access/ez-io-system-for-military-use/#
Acufirm. Cannulaes - sternal puncture. [cited 2024 25th March]. Available from: https://www.acufirm.de/index.php?seite=273
Fuchs Z, Scaal M, Haverkamp H, Koerber F, Persigehl T, Eifinger F. Anatomical investigations on intraosseous access in stillborns - comparison of different devices and techniques. Resuscitation. 2018;127:79–82.
doi: 10.1016/j.resuscitation.2018.04.003 pubmed: 29627398
Catalano PM, Drago NM, Amini SB. Factors affecting fetal growth and body composition. Am J Obstet Gynecol. 1995;172:1459–63.
doi: 10.1016/0002-9378(95)90478-6 pubmed: 7755054
Rodríguez JI, Palacios J, Rodríguez S. Transverse bone growth and cortical bone mass in the human prenatal period. Biol Neonate. 1992;62:23–31.
doi: 10.1159/000243849 pubmed: 1391272
Schwindt EM, Häcker T, Stockenhuber R, Patsch JM, Mehany SN, Berger A, et al. Finding the most suitable puncture site for intraosseous access in term and preterm neonates: an ultrasound-based anatomical pilot study. Eur J Pediatr. 2023;182:3083–91.
doi: 10.1007/s00431-023-04972-8 pubmed: 37074459 pmcid: 10354146
Orlowski JP. Emergency alternatives to intravenous access. Intraosseous, intratracheal, sublingual, and other-site drug administration. Pediatr Clin North Am. 1994;41:1183–99.
doi: 10.1016/S0031-3955(16)38868-X pubmed: 7984381
Wei W, Michu Q, Wenjuan D, Jianrong W, Zhibing H, Ming Y, et al. Histological changes in human skin 32 days after death and the potential forensic significance. Sci Rep. 2020;10:18753.
doi: 10.1038/s41598-020-76040-2 pubmed: 33128004 pmcid: 7599219

Auteurs

Chutima Sengasai (C)

Division of Neonatology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Preeyacha Pacharn (P)

Division of Diagnostic Radiology, Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Bosco Paes (B)

Division of Neonatology, Department of Pediatrics, McMaster University, Hamilton, ON, Canada.

Ratchada Kitsommart (R)

Division of Neonatology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand. rkitsommart@hotmail.com.

Classifications MeSH