Intraosseous Administration of 23.4% NaCl for Treatment of Intracranial Hypertension.
Brain herniation
Central venous catheter
Hypertonic saline
Intracranial hypertension
Intraosseous cannulation
Journal
Neurocritical care
ISSN: 1556-0961
Titre abrégé: Neurocrit Care
Pays: United States
ID NLM: 101156086
Informations de publication
Date de publication:
04 2019
04 2019
Historique:
pubmed:
7
11
2018
medline:
11
1
2020
entrez:
7
11
2018
Statut:
ppublish
Résumé
Prompt treatment of acute intracranial hypertension is vital to preserving neurological function and frequently includes administration of 23.4% NaCl. However, 23.4% NaCl administration requires central venous catheterization that can delay treatment. Intraosseous catheterization is an alternative route of venous access that may result in more rapid administration of 23.4% NaCl. Single-center retrospective analysis of 76 consecutive patients, between January 2015 and January 2018, with clinical signs of intracranial hypertension received 23.4% NaCl through either central venous catheter or intraosseous access. Intraosseous cannulation was successful on the first attempt in 97% of patients. No immediate untoward effects were seen with intraosseous cannulation. Time to treatment with 23.4% NaCl was significantly shorter in patients with intraosseous access compared to central venous catheter (p < 0.0001). Intraosseous cannulation resulted in more rapid administration of 23.4% NaCl with no immediate serious complications. Further investigations to identify the clinical benefits and safety of hypertonic medication administration via intraosseous cannulation are warranted.
Sections du résumé
BACKGROUND/OBJECTIVE
Prompt treatment of acute intracranial hypertension is vital to preserving neurological function and frequently includes administration of 23.4% NaCl. However, 23.4% NaCl administration requires central venous catheterization that can delay treatment. Intraosseous catheterization is an alternative route of venous access that may result in more rapid administration of 23.4% NaCl.
METHODS
Single-center retrospective analysis of 76 consecutive patients, between January 2015 and January 2018, with clinical signs of intracranial hypertension received 23.4% NaCl through either central venous catheter or intraosseous access.
RESULTS
Intraosseous cannulation was successful on the first attempt in 97% of patients. No immediate untoward effects were seen with intraosseous cannulation. Time to treatment with 23.4% NaCl was significantly shorter in patients with intraosseous access compared to central venous catheter (p < 0.0001).
CONCLUSIONS
Intraosseous cannulation resulted in more rapid administration of 23.4% NaCl with no immediate serious complications. Further investigations to identify the clinical benefits and safety of hypertonic medication administration via intraosseous cannulation are warranted.
Identifiants
pubmed: 30397844
doi: 10.1007/s12028-018-0637-2
pii: 10.1007/s12028-018-0637-2
doi:
Substances chimiques
Saline Solution, Hypertonic
0
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
364-371Références
Andrews BT, Pitts LH. Functional recovery after traumatic transtentorial herniation. Neurosurgery. 1991;29(2):227–31.
doi: 10.1227/00006123-199108000-00010
Skoglund TS, Nellgård B. Long-time outcome after transient transtentorial herniation in patients with traumatic brain injury. Acta Anaesthesiol Scand. 2005;49(3):337–40.
doi: 10.1111/j.1399-6576.2005.00624.x
Qureshi AI, Geocadin RG, Suarez JI, Ulatowski JA. Long-term outcome after medical reversal of transtentorial herniation in patients with supratentorial mass lesions. Crit Care Med. 2000;28(5):1556–64.
doi: 10.1097/00003246-200005000-00049
Koenig MA, Bryan M, Lewin JL 3rd, Mirski MA, Geocadin RG, Stevens RD. Reversal of transtentorial herniation with hypertonic saline. Neurology. 2008;70(13):1023–9.
doi: 10.1212/01.wnl.0000304042.05557.60
Seelig JM, Greenberg RP, Becker DP, Miller JD, Choi SC. Reversible brain-stem dysfunction following acute traumatic subdural hematoma: a clinical and electrophysiological study. J Neurosurg. 1981;55(4):516–23.
doi: 10.3171/jns.1981.55.4.0516
Stevens RD, Shoykhet M, Cadena R. Emergency neurological life support: intracranial hypertension and herniation. Neurocrit Care. 2015;23(Suppl 2):S76–82.
doi: 10.1007/s12028-015-0168-z
Farahvar A, Gerber LM, Chiu Y-L, et al. Response to intracranial hypertension treatment as a predictor of death in patients with severe traumatic brain injury. J Neurosurg. 2011;114(5):1471–8.
doi: 10.3171/2010.11.JNS101116
Carney N, Totten AM, O’Reilly C, et al. Guidelines for the management of severe traumatic brain injury, fourth edition. Neurosurgery. 2017;80(1):6–15.
pubmed: 27654000
Tyagi R, Donaldson K, Loftus CM, Jallo J. Hypertonic saline: a clinical review. Neurosurg Rev. 2007;30(4):277–89 discussion 289–90.
doi: 10.1007/s10143-007-0091-7
Hays AN, Lazaridis C, Neyens R, Nicholas J, Gay S, Chalela JA. Osmotherapy: use among neurointensivists. Neurocrit Care. 2011;14(2):222–8.
doi: 10.1007/s12028-010-9477-4
Schwarz S, Georgiadis D, Aschoff A, Schwab S. Effects of hypertonic (10%) saline in patients with raised intracranial pressure after stroke. Stroke. 2002;33(1):136–40.
doi: 10.1161/hs0102.100877
Schwarz S, Schwab S, Bertram M, Aschoff A, Hacke W. Effects of hypertonic saline hydroxyethyl starch solution and mannitol in patients with increased intracranial pressure after stroke. Stroke. 1998;29(8):1550–5.
doi: 10.1161/01.STR.29.8.1550
Lazaridis C, Neyens R, Bodle J, DeSantis SM. High-osmolarity saline in neurocritical care: systematic review and meta-analysis. Crit Care Med. 2013;41(5):1353–60.
doi: 10.1097/CCM.0b013e31827ca4b3
Al-Benna S, O’Boyle C, Holley J. Extravasation injuries in adults. ISRN Dermatol. 2013;2013:856541.
pubmed: 23738141
pmcid: 3664495
Zimmet SE. The prevention of cutaneous necrosis following extravasation of hypertonic saline and sodium tetradecyl sulfate. J Dermatol Surg Oncol. 1993;19(7):641–6.
doi: 10.1111/j.1524-4725.1993.tb00404.x
Worthington-Kirsch RL. Injection sclerotherapy. Semin Intervent Radiol. 2005;22(3):209–17.
doi: 10.1055/s-2005-921954
McGee DC, Gould MK. Preventing complications of central venous catheterization. N Engl J Med. 2003;348(12):1123–33.
doi: 10.1056/NEJMra011883
Petitpas F, Guenezan J, Vendeuvre T, Scepi M, Oriot D, Mimoz O. Use of intra-osseous access in adults: a systematic review. Crit Care. 2016;20:102.
doi: 10.1186/s13054-016-1277-6
Lee PMJ, Lee C, Rattner P, Wu X, Gershengorn H, Acquah S. Intraosseous versus central venous catheter utilization and performance during inpatient medical emergencies. Crit Care Med. 2015;43(6):1233–8.
doi: 10.1097/CCM.0000000000000942
Leidel BA, Kirchhoff C, Bogner V, et al. Is the intraosseous access route fast and efficacious compared to conventional central venous catheterization in adult patients under resuscitation in the emergency department? a prospective observational pilot study. Patient Saf Surg. 2009;3(1):24.
doi: 10.1186/1754-9493-3-24
Leidel BA, Kirchhoff C, Bogner V, Braunstein V, Biberthaler P, Kanz K-G. Comparison of intraosseous versus central venous vascular access in adults under resuscitation in the emergency department with inaccessible peripheral veins. Resuscitation. 2012;83(1):40–5.
doi: 10.1016/j.resuscitation.2011.08.017
Ziai WC, Chandolu S, Geocadin RG. Cerebral herniation associated with central venous catheter insertion: risk assessment. J Crit Care. 2013;28(2):189–95.
doi: 10.1016/j.jcrc.2012.09.013
Greenstein YY, Koenig SJ, Mayo PH, Narasimhan M. A serious adult intraosseous catheter complication and review of the literature. Crit Care Med. 2016;44(9):e904–9.
doi: 10.1097/CCM.0000000000001714
Paramedic KR, Lockwood C, Grantham H. First attempt success using intraosseous (IO) as an alternative to intravenous (IV) vascular access in out of hospital cardiac arrest (OHCA): a systematic review. JBI Libr Syst Rev. 2012;10(56 Suppl):1–12.
pubmed: 27820278
Chesnut RM, Temkin N, Carney N, et al. A trial of intracranial-pressure monitoring in traumatic brain injury. N Engl J Med. 2012;367(26):2471–81.
doi: 10.1056/NEJMoa1207363
Morris GF, Juul N, Marshall SB, Benedict B, Marshall LF. Neurological deterioration as a potential alternative endpoint in human clinical trials of experimental pharmacological agents for treatment of severe traumatic brain injuries. Executive committee of the international selfotel trial. Neurosurgery. 1998;43(6):1369–72 discussion 1372–4.
pubmed: 9848851
Clark A, Clarke TNS, Gregson B, Hooker PNA, Chambers IR. Variability in pupil size estimation. Emerg Med J. 2006;23(6):440–1.
doi: 10.1136/emj.2005.030247
Kerr RG, Bacon AM, Baker LL, et al. Underestimation of pupil size by critical care and neurosurgical nurses. Am J Crit Care. 2016;25(3):213–9.
doi: 10.4037/ajcc2016554
Qureshi AI, Suarez JI. More evidence supporting a “brain code” protocol for reversal of transtentorial herniation. Neurology. 2008;70(13):990–1.
doi: 10.1212/01.wnl.0000311290.86780.78
Bourdeaux C, Brown J. Sodium bicarbonate lowers intracranial pressure after traumatic brain injury. Neurocrit Care. 2010;13(1):24–8.
doi: 10.1007/s12028-010-9368-8
Bourdeaux CP, Brown JM. Randomized controlled trial comparing the effect of 8.4% sodium bicarbonate and 5% sodium chloride on raised intracranial pressure after traumatic brain injury. Neurocrit Care. 2011;15(1):42–5.
doi: 10.1007/s12028-011-9512-0
Zeiler FA, Sader N, West M, Gillman LM. Sodium bicarbonate for control of ICP: a systematic review. J Neurosurg Anesthesiol. 2018. https://doi.org/10.1097/ANA.0000000000000373 .
doi: 10.1097/ANA.0000000000000373
pubmed: 27673506
Rajajee V, Vanaman M, Fletcher JJ, Jacobs TL. Optic nerve ultrasound for the detection of raised intracranial pressure. Neurocrit Care. 2011;15(3):506–15.
doi: 10.1007/s12028-011-9606-8
Kimberly HH, Shah S, Marill K, Noble V. Correlation of optic nerve sheath diameter with direct measurement of intracranial pressure. Acad Emerg Med. 2008;15(2):201–4.
doi: 10.1111/j.1553-2712.2007.00031.x
Suarez JI, Qureshi AI, Bhardwaj A, et al. Treatment of refractory intracranial hypertension with 23.4% saline. Crit Care Med. 1998;26(6):1118–22.
doi: 10.1097/00003246-199806000-00038
Surani S, Lockwood G, Macias MY, Guntupalli B, Varon J. Hypertonic saline in elevated intracranial pressure: past, present, and future. J Intensive Care Med. 2015;30(1):8–12.
doi: 10.1177/0885066613487151
Dolister M, Miller S, Borron S, et al. Intraosseous vascular access is safe, effective and costs less than central venous catheters for patients in the hospital setting. J Vasc Access. 2013;14(3):216–24.
doi: 10.5301/jva.5000130
Cadena R, Shoykhet M, Ratcliff JJ. Emergency neurological life support: intracranial hypertension and herniation. Neurocrit Care. 2017;27(Suppl 1):82–8.
doi: 10.1007/s12028-017-0454-z
Goldman MP, Kaplan RP, Oki LN, Bennett RG, Strick RA. Extravascular effects of sclerosants in rabbit skin: a clinical and histologic examination. J Dermatol Surg Oncol. 1986;12(10):1085–8.
doi: 10.1111/j.1524-4725.1986.tb02087.x
Xie F, Hou K-D, Song Q, Jiang C-G. The change in bone marrow after intraosseous hypertonic saline-hydroxyethyl starch infusion for resuscitation of hemorrhagic shock in dog. Zhongguo Wei Zhong Bing Ji Jiu Yi Xue. 2010;22(5):309–12.
pubmed: 20519085
Alam HB, Punzalan CM, Koustova E, Bowyer MW, Rhee P. Hypertonic saline: intraosseous infusion causes myonecrosis in a dehydrated swine model of uncontrolled hemorrhagic shock. J Trauma. 2002;52(1):18–25.
pubmed: 11791047
Duffy DM. Sclerosants: a comparative review. Dermatol Surg. 2010;36(Suppl 2):1010–25.
doi: 10.1111/j.1524-4725.2009.01469.x
Reades R, Studnek JR, Garrett JS, Vandeventer S, Blackwell T. Comparison of first-attempt success between tibial and humeral intraosseous insertions during out-of-hospital cardiac arrest. Prehosp Emerg Care. 2011;15(2):278–81.
doi: 10.3109/10903127.2010.545479
Kien ND, Kramer GC, White DA. Acute hypotension caused by rapid hypertonic saline infusion in anesthetized dogs. Anesth Analg. 1991;73(5):597–602.
pubmed: 1952141