Pharmacokinetics of intraosseous and central venous drug delivery during cardiopulmonary resuscitation

Stephen L. Hoskins, Paulo do Nascimento, Rodrigo M. Lima, Jonathan M. Espana-Tenorio, George C. Kramer

Research output: Contribution to journalArticlepeer-review

72 Scopus citations

Abstract

We compared the pharmacokinetics of intraosseous (IO) drug delivery via tibia or sternum, with central venous (CV) drug delivery during cardiopulmonary resuscitation (CPR). Methods: CPR of anesthetized KCl arrest swine was initiated 8. min post arrest. Evans blue and indocyanine green, each were simultaneously injected as a bolus with adrenaline through IO sternal and tibial needles, respectively, n=7. In second group (n=6) simultaneous IO sternal and IV central venous (CV) injections were made. Results: Peak arterial blood concentrations were achieved faster for sternal IO vs. tibial IO administration (53 ± 11. s vs. 107 ± 27. s, p=0.03). Tibial IO dose delivered was 65% of sternal administration (p=0.003). Time to peak blood concentration was similar for sternal IO and CV administration (97 ± 17 s vs. 70 ± 12. s, respectively; p=0.17) with total dose delivered of sternal being 86% of the dose delivered via CV (p=0.22). Conclusions: IO drug administrations via either the sternum or tibia were effective during CPR in anesthetized swine. However, IO drug administration via the sternum was significantly faster and delivered a larger dose.

Original languageEnglish (US)
Pages (from-to)107-112
Number of pages6
JournalResuscitation
Volume83
Issue number1
DOIs
StatePublished - Jan 2012

Keywords

  • CPR
  • Cardiopulmonary resuscitation
  • Drug delivery
  • Intraosseous
  • Pharmacokinetics
  • Tracers

ASJC Scopus subject areas

  • Emergency Medicine
  • Emergency
  • Cardiology and Cardiovascular Medicine

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