Pharmacokinetics and pharmacodynamics of hydroxyethyl starch in hypovolemic pigs; a comparison of peripheral and intraosseous infusion

Intraosseous (IO) infusion is considered a useful technique for the adminis tration of medications and fluids in emergency situations when peripheral i ntravascular access is not possible. This study investigated the effectiven ess of IO versus intravenous (IV) infusion of hydroxyethyl starch (HES 200/ 0.5) in hypovolemic pigs. Twenty-three pigs (8- to 9-week-old) were anaesth esized, instrumented and blood was withdrawn (25-30 ml/kg) to < 50 mmHg mea n arterial pressure (MAP). The animals were left untreated in haemorrhage f or 30 min. Relevant haemodynamic parameters were monitored and blood sample s were collected for blood gas and HES concentration analysis. Infusion of HES via IV or IO line (20 ml/kg per h) carried out over a period of 30 min for volume resuscitation and measurements were taken every 5 min. Infusion was discontinued after 30 min and the animals were monitored for 1 h. Analy sis of HES-pharmacokinetics and pharmacodynamics revealed no significant di fferences between IO and the IV administration. The results demonstrate IO infusion of HES to be a rapid and effective method for fluid resuscitation in hypovolemic shock. (C) 1999 Elsevier Science Ireland Ltd. All rights res erved.