The intraosseous route is a suitable alternative to intravenous route for fluid resuscitation in severely dehydrated children

Abstract

It is sometimes difficult to gain a rapid intravenous access in hypovolemic states. The suitability of intraosseous (IO) route for fluid infusion as an effective, safe and reliable alternative to intravenous (IV) route was explored. Sixty children (age range 3 months to 2 years) with severe dehydration were assigned alternately to receive resuscitating fluid through either IO or IV routes. The IO route was successfully secured in all cases within the first 5 minutes of attempt. On the other hand, the IV line could not be secured in 33% (10 out of 30) patients within 5 minutes. The time taken for IV cannulation when it was successful (129 +/- 13 seconds, 95% confidence interval 103-156 seconds) was significantly longer than the time taken for IO cannulation (67 +/- 7 seconds, 95% confidence interval 55-80 seconds). Fluid infusion through either routes was equally effective in stabilizing vital signs and normalizing laboratory abnormalities. No significant complication of IO route was noted on short term follow-up. We conclude that IO route is a safe, effective alternative for emergency fluid administration in severe dehydration when intravenous line cannot be secured rapidly.