Sengasai Chutima, Pacharn Preeyacha, Paes Bosco, Kitsommart Ratchada
Division of Neonatology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Division of Diagnostic Radiology, Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
J Perinatol. 2025 Feb;45(2):229-234. doi: 10.1038/s41372-024-02018-x. Epub 2024 Jun 6.
To determine the appropriate intraosseous (IO) needle insertion site, optimal depth and success using a drill-assisted device (DAD) versus a manually inserted needle (MIN).
Computed tomography scans of neonatal cadavers were analyzed. Success was based on tibial needle tip placement within the marrow cavity and contrast media distribution.
Nineteen cadavers (38 tibiae) were included. The overall success rate was comparable between DAD and MIN needles, but reduced in very-low birthweight (VLBW) infants. The insertion site was consistent across birth weight groups. Contrast leakage occurred overall in 15.8% and 41.7% in VLBW infants and was insignificantly greater in DAD versus MIN needles. Minimum and maximum puncture depth was adjusted for higher BW groups.
IO needles should be placed 2 cm below and 1-2 cm medial to the tibial tuberosity. MIN needles are preferred to minimize leakage. IO depth should be modified by birth weight.
使用钻孔辅助装置（DAD）与手动插入针（MIN）来确定合适的骨内（IO）针插入部位、最佳深度及成功率。
对新生儿尸体的计算机断层扫描进行分析。成功与否基于胫骨针尖端在骨髓腔内的位置及造影剂分布情况。
纳入19具尸体（38根胫骨）。DAD针和MIN针的总体成功率相当，但极低出生体重（VLBW）婴儿的成功率降低。各出生体重组的插入部位一致。VLBW婴儿中造影剂渗漏总体发生率分别为15.8%和41.7%，DAD针的造影剂渗漏比MIN针略高，但差异无统计学意义。针对体重较高的组调整了最小和最大穿刺深度。
IO针应置于胫骨结节下方2 cm且内侧1 - 2 cm处。为尽量减少渗漏，首选MIN针。应根据出生体重调整IO针深度。
Zotero 插件