Effects of intraosseous transfusion of whole blood on hemolysis and transfusion time in a swine model of hemorrhagic shock: a pilot study.

ABSTRACT

This prospective, experimental, mixed study determined whether there were differences in intraosseous (IO) and intravenous (IV) whole blood transfusion relative to hemolysis and transfusion time. Swine were assigned to the IV group (n = 6) with an 18-gauge catheter in the auricular vein or the IO group (n = 7) with a 15-gauge 10 needle in the proximal humerus. Following baseline specimen collection, 900 mL of blood was collected from each animal. The collected blood was autologously transfused by the IV or IO route using a pressure infusion bag inflated to 300 mm Hg, with immediate posttransfusion specimen collection. Hemolysis was defined by the amount of plasma free hemoglobin. Multivariate analysis of variance revealed no significant differences between groups relative to posttransfusion free hemoglobin or transfusion time (P = .065). The IV group's mean free hemoglobin level was 10.23 +/- 10.52 micromol/L; the IO group, 7.2 +/- 5.82 micromol/L. The IV group's mean transfusion time was 13.48 +/- 4.1 minutes; the IO group, 28.70 +/- 19.51 minutes. Intraosseous transfusion does not significantly increase hemolysis or transfusion time compared with IV transfusion. Clinically, it can take up to twice as long to transfuse 900 mL of blood IO compared with IV.