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 journalArticle

63 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 1 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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