title: Effects of sternal intraosseous and intravenous administration of Hextend on time of administration and hemodynamics in a swine model of hemorrhagic shock.
abstract: OBJECTIVE
  Disasters may cause traumatic injuries leading to hemorrhage. Hemorrhage is the leading cause of death for military and civilian trauma casualties. The US Army's Tactical Combat Casualty Care guidelines recommend administering a 500 mL Hextend bolus via the intravenous (IV) or intraosseous (IO) routes for patients in hypovolemic shock. The purposes of this study were to compare administration time of Hextend and the effects on hemodynamics when Hextend is administered by the sternal IO (SIO) and IV routes in a swine model of hemorrhagic shock.
  
  
  METHODS
  This was a prospective, experimental study with random assignment.
  
  
  METHODS
  The study was implemented at an animal vivarium.
  
  
  METHODS
  Yorkshire-cross (N=21) swine were used.
  
  
  METHODS
  Each swine was hemorrhaged 30 percent of their total blood volume to simulate a class II hemorrhage; 500 mL of Hextend was administered by the SIO and IV routes after hemorrhage. The control group did not receive any resuscitative fluids.
  
  
  METHODS
  The predetermined variables of the study were time of administration and hemodynamics over 8 minutes. Hemodynamic data were collected every 2 minutes until administration was complete.
  
  
  RESULTS
  There were no significant differences in the time to administer Hextend between the SIO (616±166 seconds) and the IV groups (534±151 seconds) (p=0.37). There were no significant differences between the SIO and IV groups relative to hemodynamics (p>0.05), but both were significantly different than the control group (p<0.05).
  
  
  CONCLUSIONS
  The SIO route is an effective method of administering Hextend.
authors.affiliation: Director of Research and Professor, US Army Graduate Program in Anesthesia, Fort Sam Houston, Texas.
authors.forename: Don
authors.initials: D
authors.lastname: Johnson
authors.affiliation: Student at the US Army Graduate Program in Anesthesia Nursing, Fort Sam Houston, Texas.
authors.forename: Christian
authors.initials: C
authors.lastname: Penaranda
authors.affiliation: Student at the US Army Graduate Program in Anesthesia Nursing, Fort Sam Houston, Texas.
authors.forename: Kent
authors.initials: K
authors.lastname: Phillips
authors.affiliation: Student at the US Army Graduate Program in Anesthesia Nursing, Fort Sam Houston, Texas.
authors.forename: Daniel
authors.initials: D
authors.lastname: Rice
authors.affiliation: Student at the US Army Graduate Program in Anesthesia Nursing, Fort Sam Houston, Texas.
authors.forename: Lauren
authors.initials: L
authors.lastname: Vanderhoek
authors.affiliation: Veteran Anesthesia Services, San Antonio, Texas; Coinvestigator, Geneva Foundation, Tacoma, Washington.
authors.forename: Brian
authors.initials: B
authors.lastname: Gegel
authors.affiliation: Assistant Professor, US Army Graduate Program in Anesthesia Nursing, Fort Sam Houston, Texas; Coinvestigator, Geneva Foundation, Tacoma, Washington.
authors.forename: James
authors.initials: J
authors.lastname: Burgert
authors.affiliation: Coinvestigator, Geneva Foundation, Tacoma, Washington.
authors.forename: Jose
authors.initials: J
authors.lastname: Blanco
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D004573:Electrolytes / Q000008:administration & dosage; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000008:administration & dosage*; D017148:Infusions, Intraosseous; D007262:Infusions, Intravenous; D010952:Plasma Substitutes / Q000008:administration & dosage*; D011446:Prospective Studies; D012769:Shock / Q000503:physiopathology / Q000628:therapy*; D012996:Solutions; D013249:Sternum; D034421:Sus scrofa
chemical_list: D004573:Electrolytes; D006895:Hydroxyethyl Starch Derivatives; D010952:Plasma Substitutes; D012996:Solutions