Effects of humerus intraosseous versus intravenous amiodarone administration in a hypovolemic porcine model.
Effects of humerus intraosseous versus intravenous amiodarone administration in a hypovolemic porcine model.
复制标题
DOI：
10.5055/ajdm.2016.0248
复制
发表时间：
2016-01-01
影响因子：
--
通讯作者：
Johnson, Don
中科院分区：
文献类型：
--
作者：
Holloway, Cpt Monica M;Jurina, Cpt Shannan L;Johnson, Don
目的：在低血容量性心脏骤停模型中，比较肱骨骨内（HIO）和静脉（IV）途径胺碘酮给药对恢复自主循环（ROSC）、达到最大浓度的时间（Tmax）、最大血浆药物浓度（Cmax）、达到ROSC的时间和平均浓度随时间的变化的影响。干预：将猪麻醉并置于心脏骤停状态。2分钟后，开始心肺复苏。另外2分钟后，通过HIO或IV途径给予胺碘酮300 mg。在5分钟内采集血样。使用高效液相色谱串联质谱法分析样品。主要结果测量：ROSC，Tmax，Cmax，ROSC的时间，和平均浓度随时间的推移。结果：有没有在ROSC之间的HIO和IV组的差异;每个有五个达到ROSC和两个没有（p = 1）。HIO组和IV组之间的Tmax（p = 0.501）或Cmax（p = 0.232）无差异。平均值±标准差（秒）为94.3 ± 78.3，而IV组与HIO组分别为115.7 ± 87.3。HIO组的平均值±标准差（纳克/毫升）为49，041 ± 21，107，IV组为74，258 ± 33，176。相对于至ROSC的时间，HIO组和IV组之间无显著差异（p = 0.220）。重复方差分析表明，组间相对于浓度随时间的变化无显著差异（p > 0.05）。结论：肱骨骨内提供了快速和可靠的途径，在心脏骤停期间管理救生药物。
OBJECTIVE: To compare the effects of amiodarone administration by humerus intraosseous (HIO) and intravenous (IV) routes on return of spontaneous circulation (ROSC), time to maximum concentration (Tmax), maximum plasma drug concentration (Cmax), time to ROSC, and mean concentrations over time in a hypovolemic cardiac arrest model.DESIGN: Prospective, between subjects, randomized experimental design.SETTING: TriService Research Facility.SUBJECTS: Yorkshire-cross swine (n = 28).INTERVENTION: Swine were anesthetized and placed into cardiac arrest. After 2 minutes, cardiopulmonary resuscitation was initiated. After an additional 2 minutes, amiodarone 300 mg was administered via the HIO or the IV route. Blood samples were collected over 5 minutes. The samples were analyzed using high-performance liquid chromatography tandem mass spectrometry.MAIN OUTCOME MEASUREMENTS: ROSC, Tmax, Cmax, time to ROSC, and mean concentrations over time.RESULTS: There was no difference in ROSC between the HIO and IV groups; each had five achieve ROSC and two that did not (p = 1). There was no difference in Tmax (p = 0.501) or in Cmax between HIO and IV groups (p = 0.232). Means ± standard deviations in seconds were 94.3 ± 78.3 compared to 115.7 ± 87.3 in the IV versus HIO groups, respectively. The mean ± standard deviation in nanograms per milliliter for the HIO was 49,041 ± 21,107 and 74,258 ± 33,176 for the IV group. There were no significant differences between the HIO and IV groups relative to time to ROSC (p = 0.220). A repeated analysis of variance indicated that there were no significant differences between the groups relative to concentrations over time (p > 0.05).CONCLUSION: The humerus intraosseous provides rapid and reliable access to administer life-saving medications during cardiac arrest.