Comparison of tranexamic acid plasma concentrations when administered via intraosseous and intravenous routes.
BACKGROUND
There is a lack of information regarding intraosseous (IO) administration of tranexamic acid (TXA). Our hypothesis was that a single bolus IO injection of TXA will have a similar pharmacokinetic profile to TXA administered at the same dose IV.


METHODS
Sixteen male Landrace cross swine (mean body weight 27.6±2.6kg) were divided into an IV group (n=8) and an IO group (n=8). Each animal received 30mg/kg TXA via an IV or IO catheter, respectively. Jugular blood samples were collected for pharmacokinetic analysis over a 3h period. The maximum TXA plasma concentration (Cmax) and corresponding time as well as distribution half-life, elimination half-life, area under the curve, plasma clearance and volume of distribution were calculated. One- and two-way analysis of variance for repeated measures (time, group) with Tukey's and Bonferonni post hoc tests were used to compare TXA plasma concentrations within and between groups, respectively.


RESULTS
Plasma concentrations of TXA were significantly higher (p<0.0001) in the IV group during the TXA infusion. Cmaxoccurred at 4min after initiation of the bolus in the IV group (9.36±3.20ng/μl) and at 5min after initiation of the bolus in the IO group (4.46±0.49ng/μl). Plasma concentrations were very similar from the completion of injection onwards. There were no significant differences between the two administration routes for any other pharmacokinetic variables measured.


CONCLUSIONS
The results of this study support pharmacokinetic bioequivalence of IO and IV administration of TXA.
Department of Veterinary Clinical and Diagnostic Sciences, University of Calgary, 3280 Hospital Drive NW, Calgary, Alberta T2N 4Z6, Canada. Electronic address: srboysen@ucalgary.ca.
Søren R
SR
Boysen
Department of Veterinary Clinical and Diagnostic Sciences, University of Calgary, 3280 Hospital Drive NW, Calgary, Alberta T2N 4Z6, Canada.
Jessica M
JM
Pang
Defence Research and Development Canada - Suffield Research Centre, Box 4000, Station Main, Medicine Hat, Alberta T1A 8K6, Canada.
John R
JR
Mikler
Department of Veterinary Clinical and Diagnostic Sciences, University of Calgary, 3280 Hospital Drive NW, Calgary, Alberta T2N 4Z6, Canada.
Cameron G
CG
Knight
Defence Research and Development Canada - Suffield Research Centre, Box 4000, Station Main, Medicine Hat, Alberta T1A 8K6, Canada.
Hugh A
HA
Semple
Department of Veterinary Clinical and Diagnostic Sciences, University of Calgary, 3280 Hospital Drive NW, Calgary, Alberta T2N 4Z6, Canada.
Nigel A
NA
Caulkett
D000818:Animals; D000933:Antifibrinolytic Agents / Q000008:administration & dosage / Q000097:blood / Q000493:pharmacokinetics; D001784:Blood Gas Analysis / Q000295:instrumentation / Q000379:methods*; D004195:Disease Models, Animal; D017148:Infusions, Intraosseous; D007262:Infusions, Intravenous; D008297:Male; D013552:Swine; D014148:Tranexamic Acid / Q000008:administration & dosage* / Q000097:blood* / Q000493:pharmacokinetics
D000933:Antifibrinolytic Agents; D014148:Tranexamic Acid
EZ-Io; Intraosseous; Intraosseous catheter; Intravenous; Io; Pharmacokinetic