Establishing intraosseous access and central intravenous line placement in critically ill patients: a randomized controlled study
10.3760/cma.j.issn.1671-0282.2018.08.016
- VernacularTitle:危重症患者建立骨髓腔内通路和中心静脉通路随机对照研究
- Author:
Yanyan LIU
1
;
Yupeng WANG
;
Lingyun ZU
;
Kang ZHENG
;
Nan LI
;
Yiming ZHAO
;
Yaan ZHENG
;
Wei GAO
Author Information
1. 100191北京,北京大学第三医院心内科,卫生部心血管分子生物学与调节肽重点实验室分子心血管学教育部重点实验室
- Keywords:
Intraosseous vascular access;
Central venous catheterization;
Critical disease;
Blood vessel;
Success rates on first attempt;
Procedure time;
Satisfaction;
Complications
- From:
Chinese Journal of Emergency Medicine
2018;27(8):901-904
- CountryChina
- Language:Chinese
-
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.
