دورية أكاديمية
Single Versus Double Anatomic Site Intraosseous Blood Transfusion in a Swine Model of Hemorrhagic Shock.
| العنوان: | Single Versus Double Anatomic Site Intraosseous Blood Transfusion in a Swine Model of Hemorrhagic Shock. |
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| المؤلفون: | Sulava E; Department of Emergency Medicine, Naval Medical Center Portsmouth, Portsmouth, Virginia; Naval Medical Center Portsmouth, Combat Trauma Research Group, Clinical Investigation Department, Portsmouth, Virginia. Electronic address: eric.f.sulava.mil@mail.mil., Bianchi W; Department of Emergency Medicine, Naval Medical Center San Diego, San Diego, California; Naval Medical Center Portsmouth, Combat Trauma Research Group, Clinical Investigation Department, Portsmouth, Virginia., McEvoy CS; Department of General Surgery, Naval Medical Center Portsmouth, Portsmouth, Virginia; Naval Medical Center Portsmouth, Combat Trauma Research Group, Clinical Investigation Department, Portsmouth, Virginia., Roszko PJ; Department of Emergency Medicine, Naval Medical Center Portsmouth, Portsmouth, Virginia; Naval Medical Center Portsmouth, Combat Trauma Research Group, Clinical Investigation Department, Portsmouth, Virginia., Zarow GJ; Naval Medical Center Portsmouth, Combat Trauma Research Group, Clinical Investigation Department, Portsmouth, Virginia., Gaspary MJ; Department of Emergency Medicine, Naval Medical Center Portsmouth, Portsmouth, Virginia; Naval Medical Center Portsmouth, Combat Trauma Research Group, Clinical Investigation Department, Portsmouth, Virginia., Natarajan R; Department of Emergency Medicine, Naval Medical Center Portsmouth, Portsmouth, Virginia; Naval Medical Center Portsmouth, Combat Trauma Research Group, Clinical Investigation Department, Portsmouth, Virginia., Auten JD; Department of Emergency Medicine, Naval Medical Center San Diego, San Diego, California; Naval Medical Center Portsmouth, Combat Trauma Research Group, Clinical Investigation Department, Portsmouth, Virginia. |
| المصدر: | The Journal of surgical research [J Surg Res] 2021 Nov; Vol. 267, pp. 172-181. Date of Electronic Publication: 2021 Jun 18. |
| نوع المنشور: | Journal Article; Research Support, Non-U.S. Gov't |
| اللغة: | English |
| بيانات الدورية: | Publisher: Academic Press Country of Publication: United States NLM ID: 0376340 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1095-8673 (Electronic) Linking ISSN: 00224804 NLM ISO Abbreviation: J Surg Res Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: New York, NY : Academic Press Original Publication: Philadelphia [etc.] |
| مواضيع طبية MeSH: | Shock, Hemorrhagic*/therapy, Animals ; Humans ; Blood Transfusion ; Hemolysis ; Humerus ; Infusions, Intraosseous ; Swine |
| مستخلص: | Background: Blood transfusion via single site intraosseous access is a critical modality when caring for a trauma victim that lacks intravascular access. Flow rates and potential clinical complications when utilizing two sites of intraosseous access are not well known. Materials and Methods: Anesthetized adult female Yorkshire swine (Sus scrofa; n = 48; 76.7 ± 1.75kg; range 66-90kg) were cannulated and then bled approximately 30% total blood volume. Swine were randomly assigned to treatment groups: single sited humerus, single sited sternum, dual sited humerus or dual sited humerus and sternum. Flow rates, hemolysis, physiologic measurements, biochemical variables, and pulmonary histologic inflammation and occlusion were contrasted between groups. Results: Dual sited intraosseous transfusion flow rates (128ml/min, 95% CI 123-132) were double the flow rates of single sites (65ml/min, 95% CI 60-70), P < .0001.Single sited humeral flow rates were greater than sternal flow rates, with respective averages of 74ml/min and 55ml/min, though not reaching statistical significance (P < 0.17). There was no significant elevation of plasma free hemoglobin in any group after transfusion as compared to baseline (P = 0.7). Groups did not significantly differ in vitals or biochemical variables. Most pulmonary specimens had some intraparenchymal fat embolism, however no animals had evidence of occlusive intra-arterial fat embolism. Conclusions: Dual anatomic site, pressure bag driven, intraosseous blood transfusion approximately doubles flow rates without evidence of clinical complications or hemolysis. Further research using a survivability model is needed to characterize long-term complications from pressurized IO transfusions. (Published by Elsevier Inc.) |
| فهرسة مساهمة: | Keywords: Blood transfusion; Hemorrhagic shock; Intraosseous infusion; Intraosseous transfusion; Operational medicine |
| تواريخ الأحداث: | Date Created: 20210621 Date Completed: 20230927 Latest Revision: 20230927 |
| رمز التحديث: | 20240628 |
| DOI: | 10.1016/j.jss.2021.04.035 |
| PMID: | 34153560 |
| قاعدة البيانات: | MEDLINE |
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