Hematologic safety of intraosseous blood transfusion in a @entity1707 model of pediatric XXXX .

@entity4485 @entity1707 @entity32 @entity548 @entity1792 @entity7825 @entity648 @entity1711 @entity133 @entity7123 @entity5642 @entity887 @entity1391 @entity1710 @entity880 @entity2142 @entity413
OBJECTIVE: To assess the risk of @entity2142 , @entity5642 ( @entity5642 ), or fat @entity887 (FES) with pressurized intraosseous (IO) blood transfusion following @entity548 . METHODS: A controlled, repeated-measures, randomized animal study with blinded pathologic evaluations was conducted. Sixteen @entity4485 -anesthetized, instrumented immature @entity1707 underwent a 20-mL/kg @entity548 into @entity1792 - @entity1391 - @entity413 bags, then received autologous blood transfusion via a 16-ga i.v. catheter (eight), or via a 15-ga IO needle in the proximal tibia (eight) under maximal manual pressure using a 30-mL syringe. At baseline and at one hour and 48 hours posttransfusion, blood samples were assayed for @entity7825 (Hb), schistocytes, free Hb in plasma, @entity648 , @entity880 dehydrogenase, platelets, fibrinogen, and @entity133 gradient. Lung sections were examined for @entity32 after @entity1710 / @entity1711 stain, and for @entity7123 after oil red-O-stain. Kidney sections were examined for @entity32 using @entity1710 / @entity1711 stain. RESULTS: Though the IO transfusion rate of 21 +/- 6 mL/min was slower than the i.v. rate of 35 +/- 5 mL/min (p = 0.0012), all the animals returned to baseline blood pressure within 15 minutes and survived. The presence of schistocytes and mildly elevated free Hb in plasma was noted in both groups at baseline and each time period, and was presumed to be due to sampling from the arterial catheter. All other laboratory values remained within normal limits and without intergroup differences at any time period. No fat @entity887 was noted, and all lung and kidney specimens were free of @entity32 . CONCLUSIONS: In this model, pressurized IO blood transfusion appears to be hematologically safe, i.e., without risk of appreciable @entity2142 , @entity5642 , or FES.
