Search
IVTEAM

Intraosseous access in term and preterm neonates – Full Text

"Intraosseous access is a feasible option for emergency administration of vital drugs and fluids in newborns undergoing resuscitation when an umbilical venous catheter is impossible to place" Schwindt et al (2023).

"Intraosseous access is a feasible option for emergency administration of vital drugs and fluids in newborns undergoing resuscitation when an umbilical venous catheter is impossible to place" Schwindt et al (2023).

ReTweet
Intraosseous access in term and preterm neonates

Abstract:

The purpose of this prospective ultrasound-based pilot study was to identify the most suitable tibial puncture site for intraosseous (IO) access in term and preterm neonates, describe tibial dimensions at this site, and provide anatomical landmarks for rapid localization. We measured the tibial dimensions and distances to anatomical landmarks at puncture sites A (proximal: 10 mm distal to the tibial tuberosity; distal: 10 mm proximal to the malleolus medialis) and B (chosen by palpation of the pediatrician), in 40 newborns in four weight groups (< 1000 g; 1000-2000 g, 2000-3000 g, and 3000-4000 g). Sites were rejected if they fell short of the assumed safety distance to the tibial growth plate of 10 mm. If both A and B were rejected, puncture site C was determined sonographically at the maximum tibial diameter while maintaining the safety distance. Puncture site A violated the safety distance in 53% and 85% (proximally and distally, respectively) and puncture site B in 38% and 33%. In newborns weighing 3000-4000 g, at median (IQR), the most suitable puncture site at the proximal tibia was 13.0 mm (12.0-15.8) distal to the tuberosity and 6.0 mm (4.0-8.0) medial to the anterior rim of the tibia. The median (IQR) diameters at this site were 8.3 mm (7.9-9.1) (transverse) and 9.2 mm (8.9-9.8) (anterior-posterior). The diameters increased significantly with increasing weight. Conclusion: This study adds concise, practical information on the implementation of IO access in neonatal patients: the tibial dimensions in newborns in four different weight groups and initial data on anatomical landmarks to easily locate the IO puncture site. The results may help implement IO access in newborns more safely.

What is Known:

  • Intraosseous access is a feasible option for emergency administration of vital drugs and fluids in newborns undergoing resuscitation when an umbilical venous catheter is impossible to place.
  • Severe complications of IO access due to malpositioned IO needles have been reported in neonates.

    • What is New:

  • This study reports the most suitable tibial puncture sites for IO access and the tibial dimensions, in newborns of four weight groups.
  • The results can help to implement safe IO access in newborns.
    • Reference:

    Schwindt EM, Häcker T, Stockenhuber R, Patsch JM, Mehany SN, Berger A, Schwindt JC. Finding the most suitable puncture site for intraosseous access in term and preterm neonates: an ultrasound-based anatomical pilot study. Eur J Pediatr. 2023 Apr 19. doi: 10.1007/s00431-023-04972-8. Epub ahead of print. PMID: 37074459.

    Full Text
    Facebook Twitter Linkedin Rss Envelope

    About IVTEAM citation library

    IVTEAM has established itself as a core global resource for infusion and vascular access practitioners. Each day 6K users have access thousands of pages of easy to access relevant intravenous news and updates. IVTEAM offers its visitors a premier service that has no financial or subscriber based restrictions. The editorial stance of IVTEAM is to ensure no editorial restrictions exist; content remains unbiased and independent.

    It is crucial that IVTEAM stays up-to-date and offers visitors regular, current updates. Each day news feeds are analysed, websites searched and various additional sources of information visited. This results in large amounts of data being sifted through for relevant information every day. Only a small amount of data is relevant to IV practice and makes it onto IVTEAM.

    Read more
    Copyright 2024 © IVTEAM. All rights Reserved.