Universität zu Köln

Eifinger, Frank ORCID: 0000-0003-1758-6039, Scaal, Martin, Wehrle, Lukas, Maushake, Stien, Fuchs, Zeynep and Koerber, Friederike (2021). Finding alternative sites for intraosseous infusions in newborns. Resuscitation, 163. S. 57 - 64. CLARE: ELSEVIER IRELAND LTD. ISSN 1873-1570

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Abstract

Aim: Intraosseous (IO)-access plays an alternative route during resuscitation. Our study in preterm and term stillborns was performed to find alternative IO puncture sites beside the recommended proximal tibia. Methods: The cadavers used were legal donations. 20 stillborns (mean: 29.2weeks, IQR 27.1 +/- 39.6) were investigated. Spectral-CT were analysed to calculate the diameter and circumferences of: i) proximal humerus ii) distal femur iii) proximal tibia iv) diaphyseal tibial. Contrast medium was applied under video documentation to investigate the drainage into the vascular system. Results: In term newborns, diameter of the cortex of the proximal humeral head is 12.1 +/- 1.8 mm, distal end of the femur 11.9 +/- 3.4 mm and the proximal tibial bone 12.0 +/- 2.4 mm with cross-sectional diameter of 113.5 +/- 19.7 mm(2), 120.6 +/- 28.2 mm(2) and 111.6 +/- 29.5 mm(2), respectively. Regarding the preterm groups, there is a strong age-related growth in diameter and cross-sectional size. The diaphyseal area is the smallest in all measured bones with an age-dependent increase and is about half of that of metaphyseal diameters (proximal and distal) and about one third of that of metaphyseal cross sectional areas. The proximal femoral head region has the largest diameter of all measured bones with an egg-shaped formation with an extensive joint capsula. All investigated metaphyseal areas lack a clearly enclosed bone marrow cavity. Infusion of contrast medium into the distal femoral end and the proximal humerus head demonstrate the drainage of contrast medium into the central venous system within seconds. Conclusion: Proximal humeral head and distal femoral end might be alternative IO areas which may lead to further IO puncture sites in neonates.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Eifinger, Frank UNSPECIFIED orcid.org/0000-0003-1758-6039 UNSPECIFIED Scaal, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Wehrle, Lukas UNSPECIFIED UNSPECIFIED UNSPECIFIED Maushake, Stien UNSPECIFIED UNSPECIFIED UNSPECIFIED Fuchs, Zeynep UNSPECIFIED UNSPECIFIED UNSPECIFIED Koerber, Friederike UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-562248
DOI:	10.1016/j.resuscitation.2021.04.004
Journal or Publication Title:	Resuscitation
Volume:	163
Page Range:	S. 57 - 64
Date:	2021
Publisher:	ELSEVIER IRELAND LTD
Place of Publication:	CLARE
ISSN:	1873-1570
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language VASCULAR ACCESS; SMALL CHILDREN; DISTAL FEMUR; DEVICES; RESUSCITATION; NEEDLES; TIBIA; RATES Multiple languages Critical Care Medicine; Emergency Medicine Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/56224