Pharmacokinetics of intraosseous and central venous drug delivery during cardiopulmonary resuscitation.

Unlabelled: 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.