Mori Takaaki, Takei Hirokazu, Sasaoka Yuta, Nomura Osamu, Ihara Takateru
Division of Pediatric Emergency Medicine, Department of Pediatric Emergency and Critical Care Medicine, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.
Department of Emergency and Disaster Medicine, Hirosaki University, Aomori, Japan.
J Paediatr Child Health. 2020 Sep;56(9):1376-1381. doi: 10.1111/jpc.14940. Epub 2020 Jun 1.
Intraosseous access is an alternative to conventional intravenous access. A number of studies have demonstrated the utility and safety of EZ-IO, a recently introduced semi-automatic intraosseous device. However, few studies have investigated the use of EZ-IO in the paediatric emergency setting. The aim of this study was to describe the epidemiological characteristics EZ-IO use including complications among paediatric patients in a paediatric emergency department.
We conducted a retrospective descriptive study enrolling children younger than 16 years who visited our emergency department between January 2013 and August 2018. Data on age, gender, diagnosis, insertion success rate and complications were collected and analysed.
Seventy-two patients were enrolled; of these 38 (52.8%) were male. The median age was 9 months (interquartile range: 3-34.5 months). Of the total, 22 (30.6%) received more than one IO insertion. Ninety-seven consecutive IO insertions were identified. The rate of successful insertions was achieved at 92.7% (90 insertions). There were 21 complications (21.6%), including 17 extravasations (17.5%) of fluid and four dermal abrasions (4.1%). We found no cases of complications that may have compromised patient safety.
The success rate of the EZ-IO insertion was high in paediatric patients. However, we found a higher incidence of dermal abrasions, which might be a complication specific to children.
骨内通路是传统静脉通路的一种替代方法。多项研究已证明EZ-IO（一种最近推出的半自动骨内装置）的实用性和安全性。然而，很少有研究调查EZ-IO在儿科急诊环境中的使用情况。本研究的目的是描述在儿科急诊科使用EZ-IO的流行病学特征，包括儿科患者的并发症情况。
我们进行了一项回顾性描述性研究，纳入了2013年1月至2018年8月期间到我们急诊科就诊的16岁以下儿童。收集并分析了有关年龄、性别、诊断、穿刺成功率和并发症的数据。
共纳入72例患者；其中38例（52.8%）为男性。中位年龄为9个月（四分位间距：3 - 34.5个月）。总共有22例（30.6%）接受了不止一次骨内穿刺。共识别出97次连续的骨内穿刺。穿刺成功率为92.7%（90次成功）。有21例并发症（21.6%），包括17例液体外渗（17.5%）和4例皮肤擦伤（4.1%）。我们未发现可能危及患者安全的并发症病例。
EZ-IO在儿科患者中的穿刺成功率较高。然而，我们发现皮肤擦伤的发生率较高，这可能是儿童特有的一种并发症。
