ABSTRACT
The study aimed to compare the effects of intraosseous infusion of lactated Ringer's and 0.9% sodium chloride solutions on the electrolytes and acid-base balance in pigeons submitted to humerus osteosynthesis. Eighteen pigeons were undergoing to isoflurane anesthesia by an avalvular circuit system. They were randomly assigned into two groups (n=9) receiving lactated Ringer's solution (LR) or 0.9% sodium chloride (SC), in a continuous infusion rate of 20mL/kg/h, by using an intraosseous catheter into the tibiotarsus during 60-minute anesthetic procedure. Heart rate (HR), and respiratory rate (RR) were measured every 10 min. Venous blood samples were collected at 0, 30 and 60 minutes to analyze blood pH, PvCO2, HCO3 -, Na+ and K+. Blood gases and electrolytes showed respiratory acidosis in both groups during induction, under physical restraint. This acidosis was evidenced by a decrease of pH since 0 min, associated with a compensatory response, observed by increasing of HCO3 - concentration, at 30 and 60 min. It was not observed any changes on Na+ and K+ serum concentrations. According to the results, there is no reason for choosing one of the two solutions, and it could be concluded that both fluid therapy solutions do not promote any impact on acid-base balance and electrolyte concentrations in pigeons submitted to humerus osteosynthesis...
O presente estudo avaliou os efeitos da infusão das soluções de Ringer lactato ou cloreto de sódio 0,9%, no equilíbrio ácido-base e hidroeletrolítico de pombos submetidos à osteossíntese de úmero. Foram utilizados 18 animais, os quais foram submetidos à anestesia por isofluorano, e mantidos em circuito avalvular durante o período anestésico (60 min). Os animais foram distribuídos aleatoriamente em dois grupos (n=9) recebendo Ringer lactato (LR) ou cloreto de sódio 0,9% (SC), administradas na taxa de 20mL/kg/h pela via intraóssea (tibiotarso). Foram monitoradas as frequências cardíaca e respiratória a cada 10 minutos e colhidas amostras sanguíneas venosas aos 0, 30 e 60 min de anestesia, obtendo-se a partir destas, valores de pH sanguíneo, bicarbonato (HCO3), pressão venosa de CO2 (PvCO2), sódio (Na+) e potássio (K+). Os valores referentes ao equilíbrio ácido-base indicam que houve acidose respiratória em ambos os grupos, a qual foi decorrente do processo de indução sob contenção física, caracterizada por diminuição no pH desde o 0 min, associado ao aumento compensatório nos valores de HCO3 -, nos momentos 30 e 60 min. No entanto, no que se refere aos valores obtidos de Na+ e K+ séricos, durante a infusão de ambos os fluidos, não foram observadas alterações que justifiquem a predileção por alguma destas soluções. Diante destes resultados conclui-se que a escolha entre uma das soluções avaliadas não promoveu impacto sob o equilíbrio ácido-base e hidroeletrolítico de pombos submetidos a osteossíntese de úmero...
Subject(s)
Animals , Acid-Base Equilibrium , Sodium Chloride/therapeutic use , Columbidae/surgery , Fracture Fixation, Internal/veterinary , Humeral Fractures/veterinary , Water-Electrolyte Balance , Anesthesia, Inhalation/veterinary , Isoflurane/administration & dosageABSTRACT
PURPOSE: Gaining vascular access is difficult and time-consuming in critically ill children, so nowdays, in many countries, intraosseous vascular access is frequently used for rapid vascular access in critically ill children. Its pharmacokinetics is close to that of the peripheral intravenous route, but its infusion flow rate is faster. The purpose of this study was to determine how widely the intraosseous infusion technique was being used in Korean emergency departments. METHODS: We telephoned forty-two (42) randomly selected university-affiliated hospitals. We asked physicians if they use the intraosseous infusion technique. Responders were emergency and pediatric residents and emergency faculty. If they responded that they were not using the intraosseous infusion technique, we asked the reason. Also, we asked about their experiences with the intraosseous infusion technique. RESULTS: Forty-two (42) hospitals were enrolled in this study. No hospital used the intraosseous infusion technique on a regular basis. However, 8 hospitals used the intraosseous infusion technique occasionally. None of the responders had experience with the intraosseous infusion technique. CONCLUSION: The intraosseous infusion technique is currently underrepresented at emergency departments in Korea.
Subject(s)
Child , Humans , Critical Illness , Emergencies , Emergency Service, Hospital , Infusions, Intraosseous , Korea , PharmacokineticsABSTRACT
El establecimiento de un acceso en la circulación es un componente crítico en la resucitación. La infusión intraósea fue descrita por primera vez en 1922 y utilizada para la administración de drogas en 1940, permitiendo un rápido acceso intravascular en pacientes críticamente enfermos, con el objetivo de demostrar sus beneficios en la reanimación infantil en situaciones emergentes. Se realizó una investigación longitudinal, prospectiva y descriptiva en el servicio de cuidados intensivos pediátricos del Hospital General Docente Comandante Pinares, San Cristóbal. Pinar del Río. Cuba. En la etapa comprendida entre enero-1999 a diciembre-2001. Se estudiaron 11 pacientes menores de 5 años que necesitaron medidas de reanimación, realizándose una encuesta que contaba con las siguientes variables: edad, diagnóstico al ingreso, tiempo de obtención de la vía y mantenimiento, drogas, fluidos administrados y complicaciones, se le aplicó el método de estadística descriptivo, distribución de frecuencia y test de proporción. Se concluyó que el 28,2 % (11) de la muestra requirió canalización intraósea, los lactantes (menores de 6 meses) con deshidratación severa necesitaron esta vía en el 54,5% (6), se logró obtener en un tiempo menor de un minuto en 81,8% (7) de los pacientes y se mantuvo hasta 4 horas en el 90,9% de los casos estudiados, las drogas y fluidos mayormente administrados fueron las catecolaminas y la solución salina fisiológica en el 63,6% y el 100% respectivamente, es una técnica con muy raras complicaciones reportándose solo un 9,1%.
The establishment of an access in Circulation is a very important component in resuscitation. The intraosseous infusion was described for the first time in 1922 and use to administer medications in 1940 allowing a fast intravascular access in critically ill patients. A longitudinal, prospective and descriptive research was carried out at Intensive Care Pediatric Unit belonging to Comandante Pinares General Hospital, San Cristobal, Pinar del Rio aimed at showing its benefits in child resuscitation mainly in emergent situations. During January 1999 to December 2001 eleven patients under 5 years old needing resuscitation measures were studied. A survey taking into account age, diagnosis at admission, time obtained for route and maintenance, drugs, administration of fluids and complications was conducted. Descriptive method, frequency distribution and proportion test were statistically used. Concluding that 28.2 % (11) of the sample required intraosseous infusions, infants (under 6 months) suffering from severe dehydration needed this via (54.5 %) (6), it was obtained (less than a minute) the 81.8 % (7) of the patients and the maintenance was 4 hours in the 90.9 % of the cases studied, drugs and fluids having a greater administration were catecholamines and hypertonic saline solution in 63.6 % and in 100 % of the cases respectively, this technique provoked scarcely complications, only 9.1 % could be reported.
ABSTRACT
As a conventional alternative of intravenous infusion, intraosseous infusion becomes attractive again. This paper introduces a novel apparatus for intraosseous infusion. With precise location on the bone surface and self-designed depth control framework adopted, this apparatus can be applied to quick, simple and safe intraosseous infusion.
ABSTRACT
A 1 ½ year old girl presented with cardio-vascular collapsing after watery diarrhea for 2 days. At emergency room, the replacement fluid was not able to be administered because the anaesthetists couldn’t open any intravenous line even by cut down. Twenty minutes after the admission, the patient became cyanosed, bradypnoeic and nearly arrested. As a result, the intraosseous infusion was done successfully within 15 seconds. After resuscitation with replacement fluid through intraosseous route and supplement oxygenation, the girl became pink and conscious. Four days later, she was discharged uneventfully.