Therapeutic effect of intraosseous norepinephrine infusion in a minipig model of septic shock

Abstract

Background Studies have indicated that not every drug can achieve the same therapeutic effect or prognosis as intravenous injection when administered via intraosseous (IO) access. The purpose of this study was to establish an experimental minipig model of septic shock to compare the differences in the efficacy for the treatment of hypotension and survival time of IO and central venous catheter (CVC) infusions of norepinephrine. Methods Experimental minipigs were chosen for this study and were randomly divided into IO and CVC groups (n = 4 for each group). Cecal ligation and puncture was performed to establish the septic shock model. Immediately after the septic shock model was established, the IO group received norepinephrine via tibial IO infusion, whereas the CVC group received norepinephrine via internal jugular vein. The vital signs, blood pressure recovery time, post-septic shock survival time and total survival time were recorded. Results There was no significant difference in blood pressure recovery time between IO and CVC groups [40 (20–60) vs 30 (20–60) minutes, P = 0.686]. The cumulative norepinephrine dose during the period of blood pressure recovery time did not differ significantly between IO and CVC groups [10.0 (3.0–21.0) vs 6.5 (3.0–21.0) µg/Kg, P = 0.686]. There were no significant differences in the post-septic shock survival time [7.75 (6.50–10.00) vs 8.75 (6.50–14.00) hours, P = 0.686] and total survival time [21.25 (16.50–35.50) vs 25.75 (19.50–26.50) hours, P = 0.686] between IO and CVC groups. Conclusion These results suggest that tibial IO and CVC infusion of norepinephrine achieved same therapeutic effect on hypotension and survival time.