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Comparison of intraosseous versus central venous vascular access in adults under resuscitation in the emergency department with inaccessible peripheral veins
Resuscitation, 09/07/2011
Leidel BA et al. – Intraosseous (IO) vascular access is a reliable bridging method to gain vascular access for in–hospital adult patients under resuscitation with difficult peripheral veins. Moreover, IO access is more efficacious with a higher success rate on first attempt and a lower procedure time compared to landmark–based central venous catheterisation (CVC).
Methods- In this prospective observational study the authors investigated success rates on first attempt and procedure times of IO access versus central venous catheterisation (CVC) in adults (≥18years of age) with inaccessible peripheral veins under trauma or medical resuscitation in a level I trauma centre emergency department.
- Forty consecutive adults patients under resuscitation were analysed, each receiving IO access and CVC simultaneously.
- Success rates on first attempt were significantly higher for IO cannulation than CVC (85% versus 60%, p=0.024) and procedure times were significantly lower for IO access compared to CVC (2.0 versus 8.0 min, p<0.001).
- As for complications, failure of IO access was observed in 6 patients, while 2 or more attempts of CVC were necessary in 16 patients.
- No other relevant complications like infection, bleeding or pneumothorax were observed.