TY - JOUR
T1 - Intraosseous and central venous blood acid-base relationship during cardiopulmonary resuscitation
AU - Kissoon, Niranjan
AU - Idris, Ahmed
AU - Wenzel, Volker
AU - Murphy, Suzanne
AU - Rush, William
PY - 1997/8
Y1 - 1997/8
N2 - Objective: The objectives of this study were: 1) to determine whether obtaining intraosseous (IO) blood samples was practical during cardiopulmonary resuscitation (CPR), and 2) to compare the acid-base status (pH and partial pressure of CO2 (PCO2) of venous and 10 blood during CPR. Design: A prospective repeated measure study. Setting: An animal laboratory at a university medical center. Interventions: Nine mixed breed piglets (mean weight 43 kg) were anesthetized, tracheotomized, and placed on a ventilator (Siemens 900C Elema, Sweden). Placement of a pulmonary artery catheter was done via a surgical incision in the neck. An IO cannula was then placed in the tibial marrow cavity. The animals were positioned under a mechanical thumper (Thumper, (TM) Michigan Instruments, Grand Rapids, MI) for chest compressions. Blood gases were analyzed during steady state (baseline) after five minutes of ventricular fibrillation and during CPR at seven, nine, 11, 13, 15, and 18 minutes. Main results: Blood samples for acid-base analysis were easily obtained from the IO sites during all sampling times. Mixed venous blood was slightly more acidic than IO blood, especially at 13, 15, and 18 minutes. However, there were no significant differences in pH and PCO2 values between IO and central venous (CV) gases at all time intervals except the PCO2. At nine minutes, a significant difference (P < 0.006) was found in PCO2 (59 ± 4 vs 47 ± 5 torr) for the CV versus IO sample, respectively. As the duration of CPR progressed, the differences in PCO2 between IO and CV sites were clinically relevant (though not statistically significant). Conclusion: Obtaining blood from the IO site is practical during CPR. The divergence in values as CPR progresses suggests that, during longer periods of CPR, IO blood may reflect local acidosis and yield lower PCO2 and higher pH values that CV blood. This finding may limit the usefulness of IO blood to judge acid base status as CPR progresses.
AB - Objective: The objectives of this study were: 1) to determine whether obtaining intraosseous (IO) blood samples was practical during cardiopulmonary resuscitation (CPR), and 2) to compare the acid-base status (pH and partial pressure of CO2 (PCO2) of venous and 10 blood during CPR. Design: A prospective repeated measure study. Setting: An animal laboratory at a university medical center. Interventions: Nine mixed breed piglets (mean weight 43 kg) were anesthetized, tracheotomized, and placed on a ventilator (Siemens 900C Elema, Sweden). Placement of a pulmonary artery catheter was done via a surgical incision in the neck. An IO cannula was then placed in the tibial marrow cavity. The animals were positioned under a mechanical thumper (Thumper, (TM) Michigan Instruments, Grand Rapids, MI) for chest compressions. Blood gases were analyzed during steady state (baseline) after five minutes of ventricular fibrillation and during CPR at seven, nine, 11, 13, 15, and 18 minutes. Main results: Blood samples for acid-base analysis were easily obtained from the IO sites during all sampling times. Mixed venous blood was slightly more acidic than IO blood, especially at 13, 15, and 18 minutes. However, there were no significant differences in pH and PCO2 values between IO and central venous (CV) gases at all time intervals except the PCO2. At nine minutes, a significant difference (P < 0.006) was found in PCO2 (59 ± 4 vs 47 ± 5 torr) for the CV versus IO sample, respectively. As the duration of CPR progressed, the differences in PCO2 between IO and CV sites were clinically relevant (though not statistically significant). Conclusion: Obtaining blood from the IO site is practical during CPR. The divergence in values as CPR progresses suggests that, during longer periods of CPR, IO blood may reflect local acidosis and yield lower PCO2 and higher pH values that CV blood. This finding may limit the usefulness of IO blood to judge acid base status as CPR progresses.
KW - Acid-base relationship
KW - Blood
KW - Cardiopulmonary resuscitation
KW - Central venous blood
KW - Intraosseous blood
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UR - http://www.scopus.com/inward/citedby.url?scp=0030868683&partnerID=8YFLogxK
U2 - 10.1097/00006565-199708000-00002
DO - 10.1097/00006565-199708000-00002
M3 - Article
C2 - 9291510
AN - SCOPUS:0030868683
SN - 0749-5161
VL - 13
SP - 250
EP - 253
JO - Pediatric Emergency Care
JF - Pediatric Emergency Care
IS - 4
ER -