Application of intraosseous access in adult patients with hemorrhagic shock

doi:10.3877/cma.j.issn.2095-9133.2021.03.003

Abstract

Abstract:

Objective

To compare the application effect of venous access and intracavitary access in emergency treatment of patients with traumatic hemorrhagic shock.

Methods

From November 2017 to may 2019, 60 patients with traumatic hemorrhagic shock were selected, including 48 males and 12 females, aged (45.6±15.2) years. 30 cases received intravenous access treatment, 30 cases received intracerebral access treatment. The first puncture success rate and puncture time of two groups were recorded. The infusion time, SBP, DBP and map were recorded before infusion (T₀) and 10 minutes after infusion (T_1-10).

Results

There were no significant differences in gender, age, body mass index (BMI) and map at T₀ between the two groups. Compared with the venous access group, the infusion time was shorter and the infusion speed was higher in the intramedullary access group (P<0.05). Compared with T₀, SBP, DBP and map increased at T_1-10 (P<0.05); Compared with the venous access group, the success rate of the first puncture was higher and the puncture time was shorter in the Endomedullary access group (P<0.05); SBP, DBP and map increased at T_1-10 (P<0.05).

Conclusions

The therapeutic effect of intracavitary access in adult patients with traumatic hemorrhagic shock is better than that of intravenous access.

Key words: intraosseous vascular access, intravenous transfusion, hemorrhagic shock

Hao Wu, Zhongjie Yu. Application of intraosseous access in adult patients with hemorrhagic shock[J]. Chinese Journal of Hygiene Rescue(Electronic Edition), 2021, 07(03): 137-140.

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Figures/Tables 3

References 13

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组别	例数	性别(男/女)	年龄(岁)	BMI(kg/m²)	穿刺时间(s)	输液时间(min)	输液速度(mL/min)
Ⅳ组	30	23/7	45.8±17.0	23.0±3.1	128.8±68.2	34.6±2.5	39.6±4.2
IO组	30	25/5	45.3±13.4	23.7±3.5	86.2±15.1	12.5±1.8	148.9±10.1
t值			-0.13	0.67	-51.01	-21.58	203.70
P值		>0.05	>0.05	>0.05	<0.05	<0.05	<0.05

组别	例数	性别(男/女)	年龄(岁)	BMI(kg/m²)	穿刺时间(s)	输液时间(min)	输液速度(mL/min)
Ⅳ组	30	23/7	45.8±17.0	23.0±3.1	128.8±68.2	34.6±2.5	39.6±4.2
IO组	30	25/5	45.3±13.4	23.7±3.5	86.2±15.1	12.5±1.8	148.9±10.1
t值			-0.13	0.67	-51.01	-21.58	203.70
P值		>0.05	>0.05	>0.05	<0.05	<0.05	<0.05

组别	例数	第一次穿刺成功例数	第一次穿刺失败例数	穿刺成功率(%)
Ⅳ组	30	19	11	63.3
IO组	30	27	3	90.0
χ²值				5.96
P值				<0.05

组别	例数	第一次穿刺成功例数	第一次穿刺失败例数	穿刺成功率(%)
Ⅳ组	30	19	11	63.3
IO组	30	27	3	90.0
χ²值				5.96
P值				<0.05

组别	例数	SBP(mmHg)
组别	例数	T₀	T₁	T₂	T₃	T₄	T₅	T₆	T₇	T₈	T₉	T₁₀
Ⅳ组	30	84.7±6.4	90.2±6.2^a	93.4±5.8^a	98.9±5.4^a	104.5±5.4^a	108.8±5.3^a	111.3±4.9^a	113.7±4.8^a	116.2±4.7^a	118.3±4.5^a	120.7±4.3^a
IO组	30	85.5±7.1	94.2±6.0^a	98.7±5.2^a	103.4±4.0^a	113.5±3.7^a	118.2±3.5^a	120.9±3.5^a	123.2±3.6^a	125.3±3.9^a	127.6±4.3^a	129.8±4.3^a
t值		0.46	2.57	3.73	3.61	7.58	8.07	8.68	8.77	8.17	8.11	8.13
P值		>0.05	<0.05	<0.05	<0.05	<0.05	<0.05	<0.05	<0.05	<0.05	<0.05	<0.05
组别	例数	DBP(mmHg)
组别	例数	T₀	T₁	T₂	T₃	T₄	T₅	T₆	T₇	T₈	T₉	T₁₀
Ⅳ组	30	42.9±5.7	45.3±4.6^a	48.4±4.5^a	50.4±4.5^a	50.9±4.1^a	51.6±3.7^a	53.1±3.4^a	53.4±3.3^a	55.5±3.1^a	56.8±3.0^a	59.0±2.8^a
IO组	30	42.8±4.9	48.3±5.5^a	53.4±5.5^a	57.4±5.3^a	58.5±4.8^a	60.3±4.6^a	61.3±4.2^a	62.4±3.5^a	63.0±3.0^a	64.4±3.0^a	64.7±2.8^a
t值		0.07	2.34	3.83	5.50	6.57	8.05	8.25	10.26	9.55	9.93	7.96
P值		>0.05	<0.05	<0.05	<0.05	<0.05	<0.05	<0.05	<0.05	<0.05	<0.05^a	<0.05
组别	例数	MAP(mmHg)
组别	例数	T₀	T₁	T₂	T₃	T₄	T₅	T₆	T₇	T₈	T₉	T₁₀
Ⅳ组	30	57.4±5.6	59.8±4.9^a	61.3±4.9^a	62.4±4.8a	63.6±4.8^a	64.6±4.8^a	65.8±4.8^a	66.9±4.9^a	68.0±4.9^a	69.0±4.9^a	70.2±4.9^a
IO组	30	56.7±4.9	64.1±5.8^a	68.3±5.7^a	71.4±5.6^a	75.2±5.9^a	78.1±5.5^a	80.3±4.9^a	82.2±4.5^a	83.9±3.7^a	85.8±2.6^a	87.4±2.0^a
t值		0.51	3.08	5.10	6.68	8.36	10.11	11.62	12.64	14.21	16.43	17.94
P值		>0.05	<0.05	<0.05	<0.05	<0.05	<0.05	<0.05	<0.05	<0.05	<0.05	<0.05

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