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Intraosseous access in neonates is feasible and safe – An analysis of a prospective nationwide surveillance study in Germany

BACKGROUND: This was a prospective surveillance study to investigate reports on the safety and frequency of use of intraosseous (IO) access in neonates. METHODS: Over a two-year period, paediatric hospitals in Germany were asked to report all cases of IO access to the nationwide Surveillance Unit fo...

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Autores principales: Schwindt, Eva, Pfeiffer, Daniel, Gomes, Delphina, Brenner, Sebastian, Schwindt, Jens-Christian, Hoffmann, Florian, Olivieri, Martin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9361041/
https://www.ncbi.nlm.nih.gov/pubmed/35958173
http://dx.doi.org/10.3389/fped.2022.952632
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author Schwindt, Eva
Pfeiffer, Daniel
Gomes, Delphina
Brenner, Sebastian
Schwindt, Jens-Christian
Hoffmann, Florian
Olivieri, Martin
author_facet Schwindt, Eva
Pfeiffer, Daniel
Gomes, Delphina
Brenner, Sebastian
Schwindt, Jens-Christian
Hoffmann, Florian
Olivieri, Martin
author_sort Schwindt, Eva
collection PubMed
description BACKGROUND: This was a prospective surveillance study to investigate reports on the safety and frequency of use of intraosseous (IO) access in neonates. METHODS: Over a two-year period, paediatric hospitals in Germany were asked to report all cases of IO access to the nationwide Surveillance Unit for Rare Paediatric Diseases (ESPED). Hospitals reporting a case submitted responses via an anonymised electronic questionnaire, providing details on indication, success rate, system used, location, duration to first successful IO access, complications, alternative access attempts and short-term outcome. We present a subset of data for IO use in infants of less than 28 days. RESULTS: A total of 161 neonates (145 term and 16 preterm born infants) with 206 IO access attempts were reported. In 146 neonates (91%), IO access was successfully established, and success was achieved with the first attempt in 109 neonates (75%). There was no significant impact of gestational age or provider’s educational level on success rates. In 71 infants with successful IO access (79%), the estimated duration of placement was less than 3 min. The proximal tibia was the predominant site used. A semiautomatic battery-driven device was used in 162 attempts (88%). The most often applied medications via IO access were crystalloid fluid and adrenaline. Potentially severe complications occurred in 9 patients (6%). CONCLUSION: Within this surveillance study, IO access in neonates was feasible and safe. IO access is an important alternative for vascular access in neonates.
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spelling pubmed-93610412022-08-10 Intraosseous access in neonates is feasible and safe – An analysis of a prospective nationwide surveillance study in Germany Schwindt, Eva Pfeiffer, Daniel Gomes, Delphina Brenner, Sebastian Schwindt, Jens-Christian Hoffmann, Florian Olivieri, Martin Front Pediatr Pediatrics BACKGROUND: This was a prospective surveillance study to investigate reports on the safety and frequency of use of intraosseous (IO) access in neonates. METHODS: Over a two-year period, paediatric hospitals in Germany were asked to report all cases of IO access to the nationwide Surveillance Unit for Rare Paediatric Diseases (ESPED). Hospitals reporting a case submitted responses via an anonymised electronic questionnaire, providing details on indication, success rate, system used, location, duration to first successful IO access, complications, alternative access attempts and short-term outcome. We present a subset of data for IO use in infants of less than 28 days. RESULTS: A total of 161 neonates (145 term and 16 preterm born infants) with 206 IO access attempts were reported. In 146 neonates (91%), IO access was successfully established, and success was achieved with the first attempt in 109 neonates (75%). There was no significant impact of gestational age or provider’s educational level on success rates. In 71 infants with successful IO access (79%), the estimated duration of placement was less than 3 min. The proximal tibia was the predominant site used. A semiautomatic battery-driven device was used in 162 attempts (88%). The most often applied medications via IO access were crystalloid fluid and adrenaline. Potentially severe complications occurred in 9 patients (6%). CONCLUSION: Within this surveillance study, IO access in neonates was feasible and safe. IO access is an important alternative for vascular access in neonates. Frontiers Media S.A. 2022-07-26 /pmc/articles/PMC9361041/ /pubmed/35958173 http://dx.doi.org/10.3389/fped.2022.952632 Text en Copyright © 2022 Schwindt, Pfeiffer, Gomes, Brenner, Schwindt, Hoffmann and Olivieri. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pediatrics
Schwindt, Eva
Pfeiffer, Daniel
Gomes, Delphina
Brenner, Sebastian
Schwindt, Jens-Christian
Hoffmann, Florian
Olivieri, Martin
Intraosseous access in neonates is feasible and safe – An analysis of a prospective nationwide surveillance study in Germany
title Intraosseous access in neonates is feasible and safe – An analysis of a prospective nationwide surveillance study in Germany
title_full Intraosseous access in neonates is feasible and safe – An analysis of a prospective nationwide surveillance study in Germany
title_fullStr Intraosseous access in neonates is feasible and safe – An analysis of a prospective nationwide surveillance study in Germany
title_full_unstemmed Intraosseous access in neonates is feasible and safe – An analysis of a prospective nationwide surveillance study in Germany
title_short Intraosseous access in neonates is feasible and safe – An analysis of a prospective nationwide surveillance study in Germany
title_sort intraosseous access in neonates is feasible and safe – an analysis of a prospective nationwide surveillance study in germany
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9361041/
https://www.ncbi.nlm.nih.gov/pubmed/35958173
http://dx.doi.org/10.3389/fped.2022.952632
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