Resuscitation of pigs with haemorrhagic shock by an intraosseous hyperosmotic solution and transfusion of autologous whole blood.

OBJECTIVE

To evaluate resuscitation after episodes of haemorrhagic shock by the combination of intraosseous infusion of a small volume of hyperosmotic fluid, followed by whole blood, in a standard experiment in pigs.

DESIGN

Randomised open study.

MATERIAL

18 piglets.

INTERVENTIONS

After a 60 minute period of stabilization all animals were bled to an arterial systolic pressure of 60 mm Hg. After 30 minutes 100 ml hyperosmotic fluid was given over a seven minute period into the tibial bone marrow (n = 6) or into an ear vein (n = 6). Ninety minutes later the animals were again bled to a systolic pressure of 60 mm Hg and 30 minutes after this they were treated by autologous blood transfusion either by intraosseous or intravenous infusion. Six animals acted as untreated controls.

MAIN OUTCOME MEASURES

Changes in haemodynamic, haematological and biochemical variables.

RESULTS

Two pigs in the control group died. There was no difference between the intraosseous and intravenous routes for the infusion of small volumes of hyperosmotic fluid or whole blood. There was a significant improvement in haemodynamic variables after resuscitation with intraosseous infusion of small volumes of hyperosmotic fluid (p < 0.05).

CONCLUSION

Intraosseous infusions were easy to establish, and may be a useful method of resuscitation from haemorrhagic shock, particularly in children.