Background: It is challenging to establish peripheral intravenous access in adult critically patients. This study aims to compare the success rate of the first attempt, procedure time, operator satisfaction with the used devices, pain score, and complications between intraosseous (IO) access and central venous catheterization (CVC) in critically ill Chinese patients.
Methods: In this prospective clustered randomized controlled trial, eight hospitals were randomly divided into either the IO group or the CVC group. Patients who needed emergency vascular access were included. From April 1, 2017 to December 31, 2018, each center included 12 patients. We recorded the data mentioned above.
Results: A total of 96 patients were enrolled in the study. There were no statistically significant differences between the two groups regarding sex, age, body mass index, or operator satisfaction with the used devices. The success rates of the first attempt and the procedure time were statistically significant between the IO group and the CVC group (91.7% vs. 50.0%, <0.001; 52.0 seconds vs. 900.0 seconds, <0.001). During the study, 32 patients were conscious. There was no statistically significant difference between the two groups regarding the pain score associated with insertion. There were statistically significant differences between the two groups regarding the pain score associated with IO or CVC infusion (1.5 vs. 0.0, =0.044). Complications were not observed in the two groups.
Conclusions: IO access is a safe, rapid, and effective technique for gaining vascular access in critically ill adults with inaccessible peripheral veins in the emergency departments.
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http://dx.doi.org/10.5847/wjem.j.1920-8642.2021.02.004 | DOI Listing |
Cureus
December 2024
Laboratory and Blood Bank, Anatomic Pathology Section, King Faisal Hospital, Makkah, SAU.
Desmoplastic fibroblastoma (collagenous fibroma) is a rare, benign fibroblastic/myofibroblastic tumor that usually arises in the subcutaneous and intramuscular tissues. This tumor type has rarely been described to arise primarily in bones. This is a case of intraosseous desmoplastic fibroblastoma occurring in the mandible of a 35-year-old woman that was detected incidentally during a routine dental examination.
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March 2025
Comprehensive Bone Marrow Failure Center, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
Fanconi anemia (FA) is a congenital multisystem disorder characterized by early-onset bone marrow failure (BMF) and cancer susceptibility. While gene addition and repair therapies are being considered as treatment options, depleted hematopoietic stem cell (HSC) pools, poor HSC mobilization, compromised survival during transduction, and increased sensitivity to conventional conditioning strategies limit eligibility for FA patients to receive gene therapies. As an alternative approach, we explored protein replacement by mRNA delivery via lipid nanoparticles (LNPs).
View Article and Find Full Text PDFResuscitation
December 2024
Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; Department of Anesthesiology and Intensive Care, Aarhus University Hospital, Aarhus, Denmark.
Objective: To summarise evidence on the clinical effectiveness of initial vascular attempts via the intraosseous route compared to the intravenous route in adult cardiac arrest.
Methods: We searched MEDLINE and Embase (OVID platform), the Cochrane library, and the International Clinical Trials Registry Platform from inception to September 4th 2024 for randomised clinical trials comparing the intraosseous route with the intravenous route in adult cardiac arrest. Our primary outcome was 30-day survival.
Cureus
November 2024
Department of Orthopaedic Surgery, Iwaki City Medical Center, Iwaki, JPN.
Suprascapular nerve entrapment caused by intraosseous cystic lesions is a rare condition. We present the case of a 49-year-old man with right shoulder numbness, slight infraspinatus (ISP) weakness, and shoulder pain. He underwent open surgery and arthroscopic evaluation.
View Article and Find Full Text PDFAfr J Emerg Med
March 2025
Department of Emergency Medicine, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA.
Background: Timely vascular access forms a necessary part of patient management in the Emergency Department (ED). Factors such as hypotension, intravenous drug use, obesity, dark skin, patients at extremes of age, and patients with multiple injuries may make peripheral intravenous cannulation difficult. The intraosseous route remains a suitable alternative for emergency circulatory access.
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