Register for citation alerts

Vascular Access Conversation - IVUPDATE Podcast from IVTEAM

"Within this surveillance study, IO access in neonates was feasible and safe. IO access is an important alternative for vascular access in neonates" Schwindt et al (2022).
Safety of intraosseous access in neonates

Abstract:

Background: This was a prospective surveillance study to investigate reports on the safety and frequency of use of intraosseous (IO) access in neonates.

Methods: Over a two-year period, paediatric hospitals in Germany were asked to report all cases of IO access to the nationwide Surveillance Unit for Rare Paediatric Diseases (ESPED). Hospitals reporting a case submitted responses via an anonymised electronic questionnaire, providing details on indication, success rate, system used, location, duration to first successful IO access, complications, alternative access attempts and short-term outcome. We present a subset of data for IO use in infants of less than 28 days.

Results: A total of 161 neonates (145 term and 16 preterm born infants) with 206 IO access attempts were reported. In 146 neonates (91%), IO access was successfully established, and success was achieved with the first attempt in 109 neonates (75%). There was no significant impact of gestational age or provider’s educational level on success rates. In 71 infants with successful IO access (79%), the estimated duration of placement was less than 3 min. The proximal tibia was the predominant site used. A semiautomatic battery-driven device was used in 162 attempts (88%). The most often applied medications via IO access were crystalloid fluid and adrenaline. Potentially severe complications occurred in 9 patients (6%).

Conclusion: Within this surveillance study, IO access in neonates was feasible and safe. IO access is an important alternative for vascular access in neonates.

Reference:

Schwindt E, Pfeiffer D, Gomes D, Brenner S, Schwindt JC, Hoffmann F, Olivieri M. Intraosseous access in neonates is feasible and safe – An analysis of a prospective nationwide surveillance study in Germany. Front Pediatr. 2022 Jul 26;10:952632. doi: 10.3389/fped.2022.952632. PMID: 35958173; PMCID: PMC9361041.