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Intravenous and Intraosseous Blood Transfusion With Three Different Pediatric Pressure Transfusion Strategies in an Immature Swine (Sus scrofa) Model of Hemorrhagic Shock: A Pilot Study.

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  • معلومة اضافية
    • المصدر:
      Publisher: Oxford University Press Country of Publication: England NLM ID: 2984771R Publication Model: Print Cited Medium: Internet ISSN: 1930-613X (Electronic) Linking ISSN: 00264075 NLM ISO Abbreviation: Mil Med Subsets: MEDLINE
    • بيانات النشر:
      Publication: 2018- : Oxford : Oxford University Press
      Original Publication: Washington, D.C. : Association of Military Surgeons, United States, 1955-
    • الموضوع:
      Blood Transfusion/*methods ; Shock, Hemorrhagic/*prevention & control; Administration, Intravenous/instrumentation ; Administration, Intravenous/methods ; Analysis of Variance ; Animals ; Blood Transfusion/instrumentation ; Blood Transfusion/statistics & numerical data ; Disease Models, Animal ; Infusions, Intraosseous/instrumentation ; Infusions, Intraosseous/methods ; Pilot Projects ; Shock, Hemorrhagic/drug therapy ; Shock, Hemorrhagic/physiopathology ; Swine/blood ; Swine/injuries
    • نبذة مختصرة :
      Introduction: Exsanguination remains the leading cause of preventable death in military conflicts, and pediatric casualties are common. Transfusion is crucial to preserve life, but vascular access is challenging in children, so intraosseous (IO) access is often required. However, the optimal transfusion method is unclear. There was therefore the need for feasibility testing of a model for contrasting the efficacy of blood infusion devices via intravenous (IV) and IO access in immature swine with bone densities similar to children.
      Materials and Methods: Eighteen immature swine (21 ± 1 kg) were bled 31% of estimated blood volume and then received autologous blood delivered by pressure bag, push-pull (PP), or LifeFlow Rapid Infuser via IO (15-gauge IO needle placed in the humeral head) or IV (auricular 20-gauge), with monitoring for 60 minutes.
      Results: Flow rates for LifeFlow (172 ± 28 mL/kg) were 4-fold higher than pressure bag (44 ± 13 mL/kg, P < 0.001) and 80% higher than PP (95 ± 28 mL/kg, P < 0.02). However, higher hemolysis was evident in the IV LifeFlow condition, with 6-fold more plasma-free hemoglobin than other conditions (P < 0.0001).
      Conclusions: IV LifeFlow conferred higher flows, but higher hemolysis in this pilot study demonstrates the feasibility of an immature swine model toward determining optimal methods for resuscitating children with hemorrhagic shock.
      (Published by Oxford University Press on behalf of the Association of Military Surgeons of the United States 2020.)
    • الموضوع:
      Date Created: 20200220 Date Completed: 20201124 Latest Revision: 20201124
    • الموضوع:
      20250114
    • الرقم المعرف:
      10.1093/milmed/usz200
    • الرقم المعرف:
      32074308