Brooke Army Medical Center, Fort Sam Houston, San Antonio, TX, USA.
Lab Anim (NY). 2012 Jul 20;41(8):224-9. doi: 10.1038/laban0812-224.
Intraosseous cannulation is an accepted means to achieve vascular access when peripheral venous access is not available. It is common practice to flush the intraosseous cannula with saline prior to establishing infusions. The objective of this study was to evaluate changes in intraosseous pressure during the flush procedure and to assess the variability of pressure changes induced by different practitioners. Two intraosseous cannulas were placed in an isolated cadaveric femur collected from a swine. Intraosseous pressure and the rate of change in pressure were recorded continuously during a series of saline flushes into a distal femoral intraosseous cannula by 21 members of the veterinary research staff at the authors' institution. Median peak intraosseous pressures exceeded 600 mmHg, and an inverse relationship was noted between peak intraosseous pressure and the duration of flush. Bone marrow fat emboli were grossly evident in flush effluents and their presence was confirmed by microscopic examination. Until the practitioners were informed of the pressure changes induced by the intraosseous cannula flush, few had appreciated the magnitude of the pressures that they had generated, suggesting that an instrumented intraosseous flush preparation like the one used in this study may prove useful as a training tool for flush procedures.
当外周静脉通路无法建立时，骨髓腔内穿刺是一种被认可的获得血管通路的方法。在进行输液之前，用生理盐水冲洗骨髓腔内导管是常见的做法。本研究的目的是评估冲洗过程中骨髓内压力的变化，并评估不同操作人员引起的压力变化的可变性。从一头猪身上采集的一个孤立的尸体股骨中插入了两个骨髓内导管。在由作者所在机构的 21 名兽医研究人员对远端股骨骨髓腔内导管进行一系列生理盐水冲洗过程中，连续记录骨髓内压力和压力变化率。中位峰值骨髓内压力超过 600mmHg，并且峰值骨髓内压力与冲洗持续时间呈反比关系。冲洗流出物中明显存在骨髓脂肪栓塞，通过显微镜检查证实了其存在。在操作人员被告知骨髓腔内导管冲洗引起的压力变化之前，很少有人意识到他们所产生的压力的大小，这表明像本研究中使用的那样带有仪器的骨髓腔内冲洗准备可能被证明是冲洗程序的有用培训工具。
