Abstract
Objective: To compare intraosseous catheter placement difficulty, success rates, and flow rates at four different locations in canine cadavers.Design: Prospective study.Setting: Private referral center.Animals: Eleven fresh canine cadavers.Interventions: With owner consent, animals presenting for euthanasia were recruited. Animals received heparin (1,000 IU/kg IV) at least 5 min prior to euthanasia. After euthanasia, EZIO intraosseous catheters were placed into the ilial wing, proximal medial tibia, proximal lateral humerus, and distal lateral femur on one side of the animal. Time to catheter placement and catheter difficulty were scored for each placement site. Sterile saline was infused into each location simultaneously over 5 min, first via gravity then using 300 mmHg pressure. Animals were repositioned onto the contra-lateral side and the experiment repeated.Measurements and Main Results: Placement was successful in 16/22 ilial, 18/22 tibial, and 22/22 femoral and humoral attempts. A post-hoc analysis revealed the ileum had a significantly greater difficulty score when compared to the femur and humerus (p ≤ 0.0001). The femur had a statistically significant faster placement time when compared to the ileum (p ≤ 0.05). Gravity infusion rates were statistically lower in the tibia when compared to humerus (p ≤ 0.01) and between the tibia when compared to the femur (p ≤0.001). Additionally, pressurized infusion rates were statistically lower in the tibia compared to the humerus (p ≤ 0.0001), the femur (p ≤ 0.0001), and the ileum (p ≤ 0.01).Conclusions: The femur and humerus had high success rate for IO catheter placement and low placement time and difficulty scores. Pressurized intraosseous flow rates were highest in the humerus and femur. Contrary to human literature, success rates for catheter placement in the humerus and femur were higher than at other sites, suggesting the humerus and femur may be preferred sites for intraosseous catheter placement in the dog. Further investigation through a larger sample size is required to confirm these findings.
Highlights
Intraosseous (IO) catheterization was first described as two independent discoveries by Drinker et al and Doan in 1922, as a means of gaining vascular access in human patients [1, 2]
Ten client owned adult dogs that presented to a private veterinary referral center for euthanasia and one dog animal that presented to Municipal Animal Shelter were recruited into this study
Dog 7 failed both tibia and one side of the ileum. Both of these animals were excluded from statistical analysis of flow rates
Summary
Intraosseous (IO) catheterization was first described as two independent discoveries by Drinker et al and Doan in 1922, as a means of gaining vascular access in human patients [1, 2]. While the use of IO catheters diminished with the invention of plastic intravenous catheters [3], there was a resurgence in IO catheter utilization in the 1980’s, as it was recognized as an effective means of gaining vascular access in hypovolemic pediatric human patients [4]. There has been growing recognition that IO catheters provide a rapid and consistent means of vascular access in patients of all ages. Factors such as trauma, peripheral edema, small patient size, and obesity can increase the difficulty of intravenous (IV) access [5]. There was a higher successful first attempt placement in the IO group when compared to the IV group
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