Intraosseous lines in preterm and full term neonates

Ellemunter, Helmut; Simma, B.; Trawöger, Rudolf; Maurer, Heiner

doi:10.1136/fn.80.1.f74

Cited by 130 publications

(69 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Multiple clinical series and case reports suggest that fluids and medications can be successfully delivered by the intraosseous route during resuscitation of neonates when equipment or personnel skilled in establishing venous access are not available or if other vascular access sites (especially intravenous) cannot be successfully established within several minutes (LOE 4 119,120 ).…”

Section: Consensus On Sciencementioning

confidence: 99%

Part 11: Neonatal Resuscitation

Perlman¹,

Wyllie²,

Kattwinkel³

et al. 2010

Circulation

561

358

View full text Add to dashboard Cite

Section: Consensus On Sciencementioning

confidence: 99%

Part 11: Neonatal Resuscitation

Perlman¹,

Wyllie²,

Kattwinkel³

et al. 2010

Circulation

561

358

View full text Add to dashboard Cite

“…Intraosseous access has been shown to be useful in the neonate and older infant when vascular access is difficult to achieve. 82 Intraosseous access can be used as an alternative route for medication/volume expansion if umbilical or other direct venous access is not readily attainable (Class IIb, LOE 5).…”

Section: Routes Of Medication Administrationmentioning

confidence: 99%

International Guidelines for Neonatal Resuscitation: An Excerpt From the Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care: International Consensus on Science

2000

Pediatrics

414

View full text Add to dashboard Cite

The International Guidelines 2000 Conference on Cardiopulmonary Resuscitation (CPR) and Emergency Cardiac Care (ECC) formulated new evidenced-based recommendations for neonatal resuscitation. These guidelines comprehensively update the last recommendations, published in 1992 after the Fifth National Conference on CPR and ECC. As a result of the evidence evaluation process, significant changes occurred in the recommended management routines for: • Meconium-stained amniotic fluid: If the newly born infant has absent or depressed respirations, heart rate <100 beats per minute (bpm), or poor muscle tone, direct tracheal suctioning should be performed to remove meconium from the airway. • Preventing heat loss: Hyperthermia should be avoided. • Oxygenation and ventilation: 100% oxygen is recommended for assisted ventilation; however, if supplemental oxygen is unavailable, positive-pressure ventilation should be initiated with room air. The laryngeal mask airway may serve as an effective alternative for establishing an airway if bag-mask ventilation is ineffective or attempts at intubation have failed. Exhaled CO2 detection can be useful in the secondary confirmation of endotracheal intubation. • Chest compressions: Compressions should be administered if the heart rate is absent or remains <60 bpm despite adequate assisted ventilation for 30 seconds. The 2-thumb, encircling-hands method of chest compression is preferred, with a depth of compression one third the anterior-posterior diameter of the chest and sufficient to generate a palpable pulse. • Medications, volume expansion, and vascular access: Epinephrine in a dose of 0.01–0.03 mg/kg (0.1–0.3 mL/kg of 1:10,000 solution) should be administered if the heart rate remains <60 bpm after a minimum of 30 seconds of adequate ventilation and chest compressions. Emergency volume expansion may be accomplished with an isotonic crystalloid solution or O-negative red blood cells; albumin-containing solutions are no longer the fluid of choice for initial volume expansion. Intraosseous access can serve as an alternative route for medications/volume expansion if umbilical or other direct venous access is not readily available. • Noninitiation and discontinuation of resuscitation: There are circumstances (relating to gestational age, birth weight, known underlying condition, lack of response to interventions) in which noninitiation or discontinuation of resuscitation in the delivery room may be appropriate.

show abstract

“…It cannot be placed in cases of fractured bones, overlying vascular injuries, osteogenesis imperfecta, osteopetrosis or repeated placement of lines in the same bone. If the technique is performed with careful asepsis, the complication rate in most studies is less than 2% and include osteomyelitis, skin infection, skin necrosis, subcutaneous abscess, fat embolism, fractures, compartment syndrome or leakage through the foramina of the nutrient vessels [5]. The technique is easy, but precaution should be taken to prevent damage to the epiphyseal plate with proper size and type of needle, which is ideally an intraosseous needle (Fig 2) or a Jamshidi needle for bone marrow aspiration.…”

Section: Discussionmentioning

confidence: 99%