Evaluation of intraosseous sampling for measurements of alanine aminotransferase, alkaline phosphatase, aspartate aminotransferase, creatinine kinase, gamma-glutamyl transferase and lactate dehydrogenase.
BACKGROUND
Intraosseous (IO) access can be established faster than a venous or arterial access when there is an urgent need for rapid initiation of treatment. The access can also be used to draw marrow samples. The aim of the present study was to evaluate the potential use of IO samples for enzyme determinations using a porcine model.


METHODS
Bilateral tibial intraosseous cannulae and an arterial catheter were used for blood sampling from five healthy anesthetized pigs. Samples were collected at baseline and thereafter hourly for 6 h and analyzed for alanine aminotransferase, alkaline phosphatase, aspartate aminotransferase, creatinine kinase, gamma-glutamyl transferase and lactate dehydrogenase.


RESULTS
Creatinine kinase, lactate dehydrogenase and alkaline phosphatase levels decreased over time. The differences between IO and arterial sampling were limited for all studied markers.


CONCLUSIONS
The correlation between marrow and blood analysis for liver function tests and CK is sufficiently accurate in an emergency situation.
a Section of Anesthesiology & Intensive Care, Department of Surgical Sciences , Uppsala University , Uppsala , Sweden.
Mats
M
Eriksson
a Section of Anesthesiology & Intensive Care, Department of Surgical Sciences , Uppsala University , Uppsala , Sweden.
Gunnar
G
Strandberg
a Section of Anesthesiology & Intensive Care, Department of Surgical Sciences , Uppsala University , Uppsala , Sweden.
Miklós
M
Lipcsey
b Section of Clinical Chemistry, Department of Medical Sciences , Uppsala University , Uppsala , Sweden.
Anders
A
Larsson
D000410:Alanine Transaminase / Q000378:metabolism; D000469:Alkaline Phosphatase / Q000378:metabolism; D000704:Analysis of Variance; D000818:Animals; D001219:Aspartate Aminotransferases / Q000378:metabolism; D001853:Bone Marrow / Q000201:enzymology*; D002404:Catheterization; D003402:Creatine Kinase / Q000378:metabolism; D005260:Female; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000378:metabolism; D013048:Specimen Handling / Q000379:methods*; D013552:Swine; D013977:Tibia / Q000201:enzymology*; D016909:Tibial Arteries / Q000201:enzymology*; D005723:gamma-Glutamyltransferase / Q000378:metabolism
D007770:L-Lactate Dehydrogenase; D005723:gamma-Glutamyltransferase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D003402:Creatine Kinase; D000469:Alkaline Phosphatase
Alanine aminotransferase; alkaline phosphatase; aspartate aminotransferase; creatinine kinase; gamma-glutamyl transferase; intraosseous sampling; lactate dehydrogenase; marrow; phlebotomy