Abstract
Background/objective: Prompt treatment of acute intracranial hypertension is vital to preserving neurological function and frequently includes administration of 23.4% NaCl. However, 23.4% NaCl administration requires central venous catheterization that can delay treatment. Intraosseous catheterization is an alternative route of venous access that may result in more rapid administration of 23.4% NaCl. Methods: Single-center retrospective analysis of 76 consecutive patients, between January 2015 and January 2018, with clinical signs of intracranial hypertension received 23.4% NaCl through either central venous catheter or intraosseous access. Results: Intraosseous cannulation was successful on the first attempt in 97% of patients. No immediate untoward effects were seen with intraosseous cannulation. Time to treatment with 23.4% NaCl was significantly shorter in patients with intraosseous access compared to central venous catheter (p < 0.0001). Conclusions: Intraosseous cannulation resulted in more rapid administration of 23.4% NaCl with no immediate serious complications. Further investigations to identify the clinical benefits and safety of hypertonic medication administration via intraosseous cannulation are warranted.
Original language | English (US) |
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Pages (from-to) | 364-371 |
Number of pages | 8 |
Journal | Neurocritical care |
Volume | 30 |
Issue number | 2 |
DOIs | |
State | Published - Apr 15 2019 |
Keywords
- Brain herniation
- Central venous catheter
- Hypertonic saline
- Intracranial hypertension
- Intraosseous cannulation
ASJC Scopus subject areas
- Critical Care and Intensive Care Medicine
- Clinical Neurology