A Pilot Study of Four Intraosseous Blood Transfusion Strategies.
J Spec Oper Med
; 18(3): 50-56, 2018.
Article
en En
| MEDLINE
| ID: mdl-30222837
ABSTRACT
BACKGROUND:
Intraosseous (IO) access is used by military first responders administering fluids, blood, and medications. Current IO transfusion strategies include gravity, pressure bags, rapid transfusion devices, and manual push-pull through a three-way stopcock. In a swine model of hemorrhagic shock, we compared flow rates among four different IO blood transfusion strategies.METHODS:
Nine Yorkshire swine were placed under general anesthesia. We removed 20 to 25mL/kg of each animal's estimated blood volume using flow of gravity. IO access was obtained in the proximal humerus. We then autologously infused 10 to 15mL/kg of the animal's estimated blood volume through one of four randomly assigned treatment arms.RESULTS:
The average weight of the swine was 77.3kg (interquartile range, 72.7kg-88.8kg). Infusion rates were as follows gravity, 5mL/min; Belmont rapid infuser, 31mL/min; single-site pressure bag, 78mL/min; double-site pressure bag, 103mL/min; and push-pull technique, 109mL/min. No pulmonary arterial fat emboli were noted.CONCLUSION:
The optimal IO transfusion strategy for injured Servicemembers appears to be single-site transfusion with a 10mL to 20mL flush of normal saline, followed immediately by transfusion under a pressure bag. Further study, powered to detect differences in flow rate and clinical complications. is required.
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Choque Hemorrágico
/
Transfusión Sanguínea
Tipo de estudio:
Guideline
Límite:
Animals
Idioma:
En
Revista:
J Spec Oper Med
Asunto de la revista:
MEDICINA MILITAR
Año:
2018
Tipo del documento:
Article