BONE-MARROW INFUSION IN ADULTS

Objective: To asses the feasibility and success rate of vascular acces s through intraosseous infusions in adults, in elective and emergency situations using a novel, automatic device, the bone injection gun. De sign: A prospective, nonrandomized trial. Materials and Methods: Two g roups of patients were prospectively selected over an 11-month period. Group 1: Adult patients with recent closed long bone fractures, who u nderwent orthopedic surgery to upper and lower limbs and needed region al anesthesia, Group 2: Adult patients who required emergency or semie mergency vascular access, in whom intravenous central or peripheral ca nnulation could not be established within a reasonable period of time. Main Results: Fifty adult patients, aged 27 through 78 years, underwe nt the procedure, which was universally successful, In group 1, n = 31 patients; in group 2 (n = 19), 12 patients had multiple injuries, and seven underwent emergency resuscitation, In 76% of the cases, the nee dle was inserted into the area of the tibial tuberosity; in the remind er of the cases, the needle iras inserted at the distal end of the rad ial bone and into tile lateral or the medial malleolus. The success ra te for an adequate insertion was 100% in this group of patients. No co mplications from the procedure were observed in this series. Conclusio ns: This study emphasizes the importance and feasibility of the intrao sseous route for infusion of fluids and medications in emergency situa tions in adults. The use of an impact, high speed automatic needle ins ertion device provides a higher success rate of vascular access via th e intraosseal route in adult patients.