Clinical Medicine
Establishing intraosseous access and central intravenous line placement in critically ill patients: a randomized controlled study
Yanyan Liu, Yupeng Wang, Lingyun Zu, Kang Zheng, Nan Li, Yiming Zhao, Yaan Zheng, Wei Gao
Published 2018-08-10
Cite as Chin J Emerg Med, 2018, 27(8): 901-904. DOI: 10.3760/cma.j.issn.1671-0282.2018.08.016
Abstract
ObjectiveTo 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.
MethodsThe 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.
ResultsDuring 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.
ConclusionsThe 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.
Key words:
Intraosseous vascular access; Central venous catheterization; Critical disease; Blood vessel; Success rates on first attempt; Procedure time; Satisfaction; Complications
Contributor Information
Yanyan Liu
Department of Cardiology, Peking University Third Hospital, Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Ministry of Health, Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing 100191, China
Yupeng Wang
Department of Cardiology, Peking University Third Hospital, Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Ministry of Health, Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing 100191, China
Lingyun Zu
Department of Cardiology, Peking University Third Hospital, Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Ministry of Health, Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing 100191, China
Kang Zheng
Department of Emergency, Peking University Third Hospital, Beijing 100191, China
Nan Li
Clinical epidemiology research center of Peking University Third Hospital, Beijing 100191, China
Yiming Zhao
Clinical epidemiology research center of Peking University Third Hospital, Beijing 100191, China
Yaan Zheng
Department of Emergency, Peking University Third Hospital, Beijing 100191, China
Wei Gao
Department of Cardiology, Peking University Third Hospital, Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Ministry of Health, Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing 100191, China
