Ginsberg-Peltz Julien
From the Baystate Medical Center, Tufts University School of Medicine, Springfield, MA.
Pediatr Emerg Care. 2016 Nov;32(11):799-800. doi: 10.1097/PEC.0000000000000652.
Time to bone healing after intraosseous (IO) insertion in children has not been clearly established. This report documents the case of a 23-month-old male infant with previous IO placement of the tibia, presenting 3 weeks later to our emergency department with radiographic evidence of previous IO insertion. This report reviews relevant literature on complications of IO insertion, contraindications to IO insertion, and evidentiary support for such recommendations. Time to bone healing after IO insertion and recommendations regarding time to safe cannulation of previously cannulated areas are based on animal models. This case demonstrates 1 instance in which radiographic evidence of bone healing at 3 weeks after IO insertion is not complete, in contradiction to previously reported data. Although the clinical significance of this finding is unknown, further work is needed to define safe timing for IO reinsertion in children.
儿童骨内（IO）穿刺后至骨愈合的时间尚未明确确定。本报告记录了一名23个月大男婴的病例，其胫骨先前已进行过IO穿刺，3周后因有先前IO穿刺的影像学证据前来我院急诊科就诊。本报告回顾了关于IO穿刺并发症、IO穿刺禁忌症以及此类建议的证据支持的相关文献。IO穿刺后至骨愈合的时间以及关于先前穿刺部位安全插管时间的建议均基于动物模型。该病例表明，有1例IO穿刺后3周骨愈合的影像学证据并不完整，这与先前报道的数据相矛盾。尽管这一发现的临床意义尚不清楚，但仍需要进一步研究来确定儿童再次进行IO穿刺的安全时机。
