Elsevier

The Journal of Pediatrics

Volume 116, Issue 2, February 1990, Pages 312-315
The Journal of Pediatrics

Plasma epinephrine concentrations after intraosseous and central venous injection during cardiopulmonary resuscitation in the lamb*

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  • Cardiopulmonary Resuscitation

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  • Overview of Drug Delivery Methods in Exotics, Including Their Anatomic and Physiologic Considerations

    2018, Veterinary Clinics of North America - Exotic Animal Practice
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    Immature bones with active growth plates, hyperostotic bones in avian reproductive females, or diseased bones are not suitable for IO catheter placement.27 Drugs delivered through the IV and IO routes are considered to have a similar onset of action and peak blood levels.69–73 Unless immediate access is required for cardiopulmonary resuscitation, the IO catheter site preparation and placement should be performed under aseptic conditions to minimize the risk of osteomyelitis.1,4

  • Cardiopulmonary Resuscitation

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  • The effects of proximal and distal routes of intraosseous epinephrine administration on short-term resuscitative outcome measures in an adult swine model of ventricular fibrillation: A randomized controlled study

    2016, American Journal of Emergency Medicine
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    The results of these studies were inconsistent. The first study found epinephrine concentrations were greater in the central IV group (377 × baseline) than the TIO group (196 × baseline) but plasma concentrations were sufficient to raise heart rate and MAP in both groups and no dosage changes were recommended [20]. The second study reported 0.01 mg/kg epinephrine given TIO increased plasma concentration but not MAP or DBP.

  • Pharmacokinetics of intraosseous and central venous drug delivery during cardiopulmonary resuscitation

    2012, Resuscitation
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    The authors determined that the maximum arterial plasma adrenaline concentrations were similar between central venous and tibial IO delivery. However, they noted reduced appearance time, after central venous administration compared to tibial IO injection after adrenaline injection.36 Our measurements of appearance times and doses delivered, coupled with an additional one or more minutes for establishing a peripheral IV, suggest that even when using the slower tibial IO route, one would effectively deliver drugs into the arterial circulation during CPR in a shorter time than the time needed to successfully start a peripheral IV.

  • Intraosseous access

    2010, Journal of Emergency Medicine
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    Intraosseous access also may be used in obese patients with urgent conditions in whom multiple attempts at intravenous access have failed. Intraosseous infusions achieve onset of action and drug concentrations similar to those provided by intravenous administration (7,16,17). Hence, it is recommended that the dose used for intravenous fluids and medications remain unchanged when the intraosseous route is used (13–15).

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Supported by grant No. HL35518 from the National Heart, Lung, and Blood Institute.

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