Intraosseous infusion in burn patients
Abstract:
According to research, shock, the most common complication of extremely severe burns, is also the leading cause of mortality among patients with such burns. The case fatality rate reaches 83.45% when the total burn area exceeds 90%. The American Heart Association in 2020 recommended the intraosseous route after the peripheral route and prior to the central venous route when venous cannulation is either difficult or delayed. The use and experience with intraosseous infusion (IO) in extremely severe burns are still limited. We report efficacy and safety results from nineteen burn patients treated with IO between June 2020 and December 2022 . In these patients, the mean injury time of burns was 1.55 ± 1.10 h, the mean burn surface area was 86.24% ± 11.33%, the mean catheterization time was 49.68 ± 10.11 s, and the mean emergency retention time was 2.75 ± 1.74 h, the mean actual fluid supplement amount was 5533.68 ± 3077.19 ml, the mean hourly urine volume of the patient was 93.31 ± 60.94 ml, the mean emergency detention time was 4.16 ± 2.97 h, and the mean duration of hospitalization was 34.50 ± 25.38 d. The results demonstrated a clinically meaningful improvement and higher response rate vs peripheral venous cannulation and an acceptable safety profile in those patients.
Reference:
Wang Y, Zhou S, Wang L, Fang J, Zhang Y, Shi L, Lin G, Zhang M, Wang S. The use of intraosseous infusion in the early resuscitation of patients with extremely severe burns. J Burn Care Res. 2024 Jan 5:irad202. doi: 10.1093/jbcr/irad202. Epub ahead of print. PMID: 38180502.