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Vol. 12. Issue 1.
Pages 31-40 (January 2001)
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Vol. 12. Issue 1.
Pages 31-40 (January 2001)
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La vía intraósea. Cuando las venas han desaparecido
The intraosseal route. When the veins have disappeared
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17501
P.E. Orgiler Uranga1,
Corresponding author
porgiler@cecova.org

Correspondencia: Av. Pintor Baeza n.º 7, Bloque 6-2, 3.º A 03010 Alicante Tel.: 965 251281
, J.M. Navarro Arnedo1, S. De Haro Marín2
1 Diplomados en Enfermería Unidad de Cuidados Intensivos Pediátricos. Hospital General Universitario de Alicante. Avda. Maestro Alonso 109 - 03010 Alicante
2 Diplomado en Enfermería Unidad de Cuidados Intensivos. Unidad de Cuidados Intensivos Pediátricos. Unidad de Cuidados Intensivos. Hospital General Universitario de Alicante. Avda. Maestro Alonso 109 - 03010 Alicante
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Resumen

El objetivo de este estudio es mostrar la utilidad de la vía intraósea como acceso vascular de emergencia, especialmente en niños, cuando el acceso vascular a través de vías periféricas o centrales se hace difícil o imposible.

De la bibliografía revisada se deduce que la vía intraósea constituye una vía de acceso rápida, fácil y eficaz al sistema vascular, sobre todo en los niños menores de 6 años. Su utilidad está indicada cuando, en situaciones de extrema urgencia, se tarda mucho en canalizar una vía periférica o central y la vida del niño está en peligro.

La zona más adecuada para su inserción es la porción proximal y porción distal de la tibia y la porción distal del fémur.

Permite la administración de líquidos, electrólitos y fármacos comparable a la vía venosa. Las complicaciones son escasas, siendo la más grave el síndrome compartimental.

Además de ser una vía alternativa para la perfusión de sustancias y fármacos en el torrente circulatorio, sirve como lugar de acceso al sistema vascular para la toma de muestras con fines de estudios de laboratorio. Se concluye que la vía intraósea constituye una vía de acceso al sistema vascular fácil, rápida y segura. Las complicaciones suelen ser raras y las contraindicaciones escasas.

Palabras Clave:
Perfusión intraósea
Acceso vascular
Abstract

The aim of this study was to demonstrate the usefulness of the intraosseal route in providing emergency vascular access, especially in children, when vascular access through peripheral or central routes is difficult or impossible. A literature review revealed that the intraosseal route provides rapid, easy and effective access to the vascular system, especially in children under the age of 6 years. This route is indicated when, in emergencies, peripheral or central cannulation is too slow and the child’s life is at risk. The most appropriate sites of insertion are the proximal or distal segments of the tibia and the distal segment of the femur. The administration of fluids, electrolytes and drugs through the intraosseal route is similar to that through the venous route. Complications are rare, the most serious being compartmental syndrome. In addition to providing an alternative route for the infusion of drugs and other substances into the bloodstream, the intraosseal route also provides access to the vascular system when samples for laboratory investigations are required. In conclusion, the intraosseal route provides rapid, safe and easy access to the vascular system. Complications are infrequent and there are few contraindications.

Key Words:
Intraosseous infusion
Vascular access
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Bibliografía
[1.]
C.K. Drinker, K.R. Drinker, C.C. Lund.
The circulation in the mammalian bone marrow.
Am J Physiol, 62 (1922), pp. 1-92
[2.]
A. Josefson.
A new method of treatment: intraossal injections.
Acta Medica Scand, 81 (1934), pp. 550-564
[3.]
L.M. Tocantis.
Rapid absorption of substances injected into the bone marrow.
Proc Soc Exp Biol Med, 45 (1940), pp. 292-296
[4.]
L.M. Tocantis, J.F. O’Neill.
Infusions of blood and other fluids into the general circulation via the bone marrow: technique and results.
Surg Gynecol Obstet, 73 (1941), pp. 281-287
[5.]
L.M. Tocantis, J.E. O’Neill, H.W. Jones.
Infusions of blood and other fluids via the bone marrow.
JAMA, 117 (1941), pp. 1229-1234
[6.]
L.M. Tocantis, J.F. O’Neill, A.H. Price.
Infusion of blood and other fluids via the bone marrow in traumatic shock and other forms of peripheral circulatory failure.
Ann Surg, 114 (1941), pp. 1085-1092
[7.]
L.M. Tocantis, A.H. Price, J. O’Neill.
Infusions via the bone marrow in children.
Penn Med J, 46 (1943), pp. 1267-1273
[8.]
E.M. Papper.
The bone marrow route for injecting fluids and drug into the general circulation.
Anesthesiology, 3 (1942), pp. 307-313
[9.]
H.I. Arbeiter, J. Greengard.
Tibial bone marrow infusions in infancy.
J Pediatr, 25 (1944), pp. 1-12
[10.]
F. Meola.
Bone marrow infusions as a routine procedure in children.
J Pediatr, 25 (1944), pp. 13-16
[11.]
F.W. Gunz, R.F.A. Dean.
Tibial bone-marrow transfusions in infants.
Br Med J, 1 (1945), pp. 220-221
[12.]
J.J. Quilligan, H. Turkel.
Bone marrow infusions and its complications.
Am J Dis Child, 71 (1946), pp. 457-465
[13.]
S. Heinild, T. Sondergaard, F. Tudvad.
Bone marrow infusion in childhood.
J Pediatr, 30 (1947), pp. 400-412
[14.]
J.T. Elston, R.V. Jaynes, D.H. Kaump, et al.
Intraosseous infusions in infants.
Am J Clin Pathol, 17 (1947), pp. 143-150
[15.]
J.D. Gimson.
Bone marrow transfusion in infants and children.
Br Med J, 1 (1944), pp. 748-749
[16.]
M.M. Valdes.
Intraosseous fluid administration in emergencies.
Lancet, 11 (1977), pp. 1235-1236
[17.]
H. Turkel.
Intraosseous infusions.
Am J Dis Child, 137 (1983), pp. 706
[18.]
J.P. Orlowski.
My kingdom for an intravenous line.
[editorial] Am J Dis Child, 138 (1984), pp. 803
[19.]
R.A. Berg.
Emergency infusion of catecholamines into bone marrow.
Am J Dis Child, 138 (1984), pp. 810-811
[20.]
V. Rosetti, B.M. Thompson, C. Aprahamian, J.C. Darin, J.R. Mateer.
Difficulty and delay in intravascular access in pediatric arrests.
Ann Emerg Med, 13 (1984), pp. 406
[21.]
R.M. McNamara, W.H. Spivey, H.D. Unger, D.R. Malone.
Emergency applications of intraosseous infusion.
J Emerg Med, 5 (1987), pp. 97-101
[22.]
V. Rosetti, B.M. Thompson, J. Miller, J.R. Mateer, C. Aprahamian.
Intraosseous infusion: an alternative route of pediatric intravascular access.
Ann Emerg Med, 14 (1985), pp. 885-888
[23.]
D.H. Fiser.
Intraosseous infusion.
N Engl J Med, 322 (1990), pp. 1579-1581
[24.]
P.W. Glaeser, T.R. Hellmich, D. Szewczuga, J.D. Losek, D.S. Smith.
Five-year experience in prehospital intraosseous infusion in children and adults.
Ann Emerg Med, 22 (1993), pp. 1119-1124
[25.]
S.R. Neish, M.G. Macon, J.W. Moore, G.M. Graeber.
Intraosseous infusion of hypertonic glucose and dopamine.
Am J Dis Child, 142 (1988), pp. 878-880
[26.]
C.M. Walsh-Kelly, R.J. Berens, P.W. Glaeser, J.D. Losek.
Intraosseous infusion of phenytoin.
Am J Emerg Med, 4 (1986), pp. 523-524
[27.]
B.S. Katan, J.S. Olshaker, S.E. Dickerson.
Intraosseous infusion of muscle relaxants.
Am J Emerg Med, 6 (1988), pp. 353-354
[28.]
J. Cano España.
Vías para la administración de líquidos y drogas.
Emergencias pediátricas, pp. 233-240
[29.]
R. Carbajal, A. Paupe, R. Lenclen, P. Blanc, M. Olivier-Martin, N. Simon.
Perfusion intraosseuse chez l’enfant.
Arch Pédiatr, 2 (1995), pp. 339-342
[30.]
C. Dumillard, N. Suze, J.M. Duquesne, S. Petri, N. Lode, B. Maupetit, et al.
Dispositif intraosseux de perfusion.
Cahiers d’Anesthésiologie, 44 (1996), pp. 71-76
[31.]
H. Ellemunter, B. Simma, R. Trawöger, H. Maurer.
Intraosseous lines in preterm and full term neonates.
Arch Dis Child Fetan Neonatal Ed, 80 (1999), pp. F74-F75
[32.]
R.J. Evans, F. Jewkes, G. Owen, M. McCabe, D. Palmer.
Intraosseous infusion –a technique available for intravascular administration of drugs and fluids in the child whit burns.
Burns, 21 (1995), pp. 552-553
[33.]
J.S. Hurren, K.W. Dunn.
Intraosseous infusion for burns resuscitation.
Burns, 21 (1995), pp. 285-287
[34.]
R. Martino Alba, M.J. Ruiz Lopez, J. Casado Flores.
Use of the intraosseous route in resuscitation in a neonate.
Intensive Care Med, 20 (1994), pp. 529-533
[35.]
M. Monleón Luque.
Alternativas a la vía intravenosa.
Niño críticamente enfermo, pp. 221-225
[36.]
A. Nasimi, P. Gorin, M. Berthier, T. Boussemart, C. Follet-Bouhamed, D. Oriot.
Utilisation de la voie intraosseuse chez un prémature.
Arch Pédiatr, 5 (1998), pp. 414-417
[37.]
J.P. Orlowski.
Opciones de urgencia respecto del acceso intravenoso: farmacoterapia intraósea, intratraqueal, sublingual y en otros sitios.
Clínicas Pediátricas de Norteamérica, 6 (1994), pp. 1179-1193
[38.]
D. Oriot, J. Cardona, M. Berthier, A. Nasimi, T. Boussemart.
La voie intraosseuse, une voie d’abord vasculaire méconnue en France.
Arch Pédiatr, 1 (1994), pp. 684-688
[39.]
A. Rodríguez Núñez, I. Martínez Soto, J.M. Martinón.
Elective use of intra-osseous infussions in paediatrics.
Eur J Pediat, 154 (1995), pp. 755
[40.]
M. Stovroff, W.G. Teague.
Intravenous access in infants and children.
Pediatric Clinics of North America, 45 (1998), pp. 1373-1393
[41.]
M. Waisman, D. Waisman.
Bone marrow infusion in adults.
J Trauma, 42 (1997), pp. 288-293
[42.]
J.I. Zabala Argüelles, R. Marañón Pardillo, P. González Serrano, C. Seriña Ramírez.
Acceso vascular prioritario en situaciones de extrema urgencia: la infusión intraósea.
An Esp Pediatr, 37 (1992), pp. 489-492
[43.]
C. Tormo Calandín, C. Calvo Macías, M.A. Delgado Domínguez, J. López-Herce Cid, A. Rodríguez Núñez, M. Loscertales Abril, et al.
Soporte vital en pediatría.
Manual de Soporte Vital Avanzado. Comité Español de RCP, pp. 111-134
[44.]
J. Guy, C. Haley, S.J. Zuspan.
Use of intraosseous infusion in the pediatric trauma patient.
J Pediatr Surg, 28 (1993), pp. 158-161
[45.]
B. Goldstein, D. Doody, S. Briggs.
Emergency intraosseous infusion in severely burned children.
Pediatric Emergency Care, 6 (1990), pp. 195-197
[46.]
M. McDonald, R.A. Wiebe.
Intraosseous infusions.
Essentials of Pediatric Intensive Care, pp. 1249-1253
[47.]
F.J. Parra Vázquez, J. Domínguez Morales, F. Ayuso Baptista, S. Castro García, F.A. Vázquez Martínez.
Infusión intraósea: una alternativa.
Medicina Intensiva, 23 (1999), pp. 167-173
[48.]
P. Clarke.
Intraosseous infusion.
Nursing Times, 87 (1991), pp. 40-41
[49.]
D. Maguer, B. Delaporte, F. Godde, P. Amusini.
Voie intraosseuse: autre abord vasculaire dans l’urgence.
Arch Pédiatr, 2 (1995), pp. 704-705
[50.]
I. Claudet, F. Fries, M.C. Bloom, M.C. Lelong-Tissier.
Etude retrospective de 32 cas de perfusion intraosseuse.
Arch Pediatr, 6 (1999), pp. 516-519
[51.]
M. Helm, W. Breschinski, L. Lampl, W. Frey, K.H. Bock.
Intraosseous puncture in preclinical emergency medicine. Experiences of an air rescue service.
Anaesthesist, 45 (1996), pp. 1196-1202
[52.]
E. Geller, K.L. Crisci.
Intraosseous infusion of iodinated contrast in an abused child.
Pediatric Emergency Care, 15 (1999), pp. 328-329
[53.]
E.J. Cambray, J.S. Donaldson, R.M. Shore.
Intraosseous contrast infusion: efficacy and associated findings.
Pediatr Radiol, 27 (1997), pp. 892-893
[54.]
M.I. Herman, P.A. Chyka, A.Y. Butler, S.E. Rieger.
Methylene blue by intraosseous infusion for methemoglobinemia.
Ann Emerg Med, 33 (1999), pp. 111-113
[55.]
F.D. Friedman.
Intraosseous adenosine for the termination of supraventricular tachycardia in an infant.
Ann Emerg Med, 28 (1996), pp. 356-358
[56.]
R. Martino, M.J. Ruiz López, J.L. García Jiménez, A. Martínez Azagra, J. Casado Flores.
La vía intraósea en las situaciones de urgencia vital en niños.
Medicina Intensiva, 19 (1995), pp. 15-19
[57.]
G. McCarthy, P. Buss.
The calcaneum as a site for intraosseous infusion.
J Accid Emerg Med, 15 (1998), pp. 421
[58.]
R. Wright, S.L. Reynolds, B. Nachtsheim.
Compartment syndrome secondary to prolonged intraosseous infusion.
Pediatric Emergency Care, 10 (1994), pp. 157-159
[59.]
J. Ribeiro, C. Price, R. Knapp.
Compartment syndrome of the lower extremity after intraosseous infusion of fluid (a report of two cases.
J Bone Joint Surg, 75-A (1993), pp. 430-433
[60.]
T. Burke, D.K. Kehl.
Intraosseous infusions in infants.
J Bone Joint Surg, 75-A (1993), pp. 428-429
[61.]
D.W. Chirstensen, D.D. Vernon, W. Banner, J.M. Dean.
Skin necrosis complicating intraosseous infusion.
Pediatric Emergency Care, 7 (1991), pp. 289-290
[62.]
I. Claudet, C. Alberge, M.C. Bloom, F. Fries, M.C. Lelong-Tissier.
Intraosseous infusion in children.
Ann Fr Anesth Reanim, 18 (1999), pp. 313-318
[63.]
R.T. Fiser, W.M. Walker, J.J. Seibert, R. McCarthy, D. Fiser.
Tibial lenght following intraosseous infusion: a prospective, radiographic analysis.
Pediatric Emergency Care, 13 (1997), pp. 186-187
Copyright © 2001. Elsevier España, S.L. y Sociedad Española de Enfermería Intensiva
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