Establishing intraosseous access and central intravenous line placement in critically ill patients: a randomized controlled study / 中华急诊医学杂志

ABSTRACT

Objective To compare the time consumed for the procedure done,satisfaction and safety of the establishment of intraosseous (IO) access and central intravenous line placement (CVL) in critically ill patients using a randomized controlled trial.Methods The patients were randomly divided into the IO access group versus CVL group according to the inclusion criteria.The IO access and CVL were established,respectively for medicine or fluid administration.The success rates at the first attempt,time required for procedure completed,satisfaction and complications were recorded.Results During the study period,24 patients were enrolled,and divided equally and randomly into IO group (n=12) and CVL group (n=12).There were no significant differences in age,gender,BMI between the two groups.The patients with shock and cardiac arrest accounted for 83.3 ％ in IO group and 58.3 ％ in CVL group,respectively.The success rates at the first attempt was 91.7 ％ in IO access group versus 66.7 ％ in CVL group (P=0.158).the time required for procedure done was significantly shorter in IO access group (74.9 ±43.7)s compared with CVL group (944.0 s±491.5 s) (P＜0.01).The satisfaction of operators at the instruments used was 8.0±1.1 for IO access group versus 7.2±0.8 for CVL group (P==0.053).The overall satisfaction of the operators at the entire course of procedure was 3.7 + 0.7 in IO access group versus 3.9±0.3 in CVL group (P=0.377).Complications were not observed during the study period in the two groups.Conclusions The success rate at the first attempt was significantly higher in IO access group compared with CVL grouThe mean time consumed for procedure completed in IO group was much shorter than that in CVL group,and the operation was simple and practicable.During the emergency care of critical patients,if the peripheral intravenous line placement was difficult to establish,and IO access could be a choice of alternative used as a bridging procedure to rapidly establish the vascular access and win the rescue opportunity.