Abstract 79: Efficacy of Epinephrine Delivery via the Intraosseous Humeral Head Route during CPR
OBJECTIVES: Obtaining vascular access can delay drug delivery during medical emergencies such as cardiac arrest and circulatory shock. The present study was performed to determine the efficacy of intraosseous (IO) humeral head drug delivery during cardiopulmonary resuscitation (CPR) in swine.
METHODS: 10 alpha chloralose anesthetized swine were subjected to cardiac arrest by KCl injection. Eight min post cardiac arrest CPR was initiated via Thumper (Michigan Instruments Inc.) w/o ventilation. Delivery of epinephrine was evaluated by 3 routes after 2 min of CPR. Group IO: An EZ-IO (Vidacare) was placed in the humeral head (HH) n=4, Group CV Central venous infusion n=4, and Group ET: Endotracheal administration n=3. Mean arterial blood pressure (MAP), and venous pressure (VP) were continuously recorded.
RESULTS: MAP’s for each study group displayed over the 8 min time course are shown. MAP’s time averaged ± SD over the 8 min post injection were CV 68.1 ± 12.2, IO 84.2 ± 12.9, and ET 47.6 ± 4.7 respectively. Mean VP’s over the 8 min period post injection were CV 16.6 ± 1.6, IO 18.5 ± 1.4, and ET 15.2 ± 0.8.
CONCLUSIONS: HH delivery generated higher sustained MAP pressures over the 8 min study period than CV or ET delivery. Higher blood pressures generated by IO versus CV delivery are an unexpected finding that requires further research. These results suggest that IO humeral head delivery of epinephrine during cardiac arrest is as effective as central intravenous infusion.