Intramuscular versus Intraosseous Delivery of Nerve Agent Antidote Pralidoxime Chloride in Swine.

Objective: Exposure to nerve agents requires prompt treatment. We hypothesized that intraosseous (IO) injections of drug antidotes into the vascularized bone marrow will provide a more rapid and effective means to treat exposure to nerve agents than standard intramuscular (IM) injections. We compared the pharmacokinetics of IM and IO administration of pralidoxime chloride (2-PAM Cl) during normovolemia and hypovolemia, as well as their combined administration during normovolemia in swine.

Comparison of frozen versus desiccated reference human red blood cells for hemagglutination assays.

Background: Red blood cells (RBCs) are commonly used fresh or stored in frozen format for identification of patients' antibodies and serologic specificity of such antibodies at reference laboratories. However, maintaining a large pool of fresh RBCs is impossible in a blood-banking environment and blood in frozen format poses a logistic disadvantage in terms of accessibility, maintenance cost, safety, and sample recovery. This study explores an alternative, desiccation storage method for RBCs to provide a reagent that supports greater utilization and flexibility for reference laboratories.

Issues of concern regarding the use of hypertonic/hyperoncotic fluid resuscitation of hemorrhagic hypotension.

Small volume resuscitation fluids continue to be of interest to the military and limited volume resuscitation is becoming more common in the treatment of hemorrhage in the civilian community. With renewed interest to undertake a large US-Canada multi-center clinical trial of hypertonic saline alone or combined with dextran (HSD) possibly in 2006, concerns related to the safe use of this product continue to surface. This review addresses the use of these products in uncontrolled hemorrhage models, in dehydration and addresses perceived risks associated with hypernatremia, dextran-associated anaphylactoid reactions and effects on coagulation and renal function.

Benefit of slow infusion of hypertonic saline/dextran in swine with uncontrolled aortotomy hemorrhage.

In laboratory models of uncontrolled hemorrhage, immediate resuscitation from hemorrhage is associated with high mortality. However, in clinical practice, resuscitation is often delayed and the rate of fluid administration is limited. We hypothesized that a slow rate of infusion after delayed resuscitation, reflecting the clinical environment, might improve survival in the presence of uncontrolled hemorrhage.