title: Effects of intravenous, sternal, and humerus intraosseous administration of Hextend on time of administration and hemodynamics in a hypovolemic swine model.
abstract: To determine if there were significant differences among humerus intraosseous (HIO), sternal intraosseous (SIO), and intravenous (IV) administration of 500 mL Hextend in hemodynamics or administration time in a hypovolemic swine model.
  
  
  
  Vivarium.
  
  
  
  Yorkshire swine; sample size was based on a large effect size of 0.5, an α of 0.05, and a power of 80 percent Swine were randomly assigned to one of four groups: HIO (n = 9), SIO (n = 9), IV (n = 9), and control (n = 9).
  
  
  
  Swine were exsanguinated 30 percent of their blood volume. Hextend (500 mL) was administered by either the HIO, SIO, or IV route; the control group received none.
  
  
  
  Time of administration of Hextend; systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR), cardiac output (CO), and stroke volume (SV) data were collected every 2 minutes and compared by group over 8 minutes.
  
  
  
  A repeated analysis of variance found that there were no significant differences in SBP, DBP, MAP, HR, CO, and SV among HIO, SIO, and IV groups over 8 minutes (p > 0.05). An analyses of variance determined that there was no significant difference between groups relative to time of administration (p = 0.521).
  
  
  
  When IV access is difficult, both HIO and SIO are effective techniques for rapid vascular access and the administration of Hextend for patients in hypovolemic shock.
authors.affiliation: Research Coordinator, Geneva Foundation, Tacoma, Washington.
authors.forename: Dawn
authors.initials: D
authors.lastname: Blouin
authors.affiliation: CEO/Owner, Gegel Anesthesia Services, San Antonio, Texas.
authors.forename: Brian T
authors.initials: BT
authors.lastname: Gegel
authors.affiliation: Faculty Member, US Army Graduate Program in Anesthesia Nursing, Fort Sam Houston, San Antonio, Texas.
authors.forename: Don
authors.initials: D
authors.lastname: Johnson
authors.affiliation: Texas Tech University Health Science Center at El Paso, El Paso, Texas.
authors.forename: Jose C
authors.initials: JC
authors.lastname: Garcia-Blanco
mesh_terms: D000818:Animals; D001794:Blood Pressure / Q000187:drug effects; D002302:Cardiac Output / Q000187:drug effects; D003971:Diastole; D004195:Disease Models, Animal; D005440:Fluid Therapy / Q000379:methods*; D006339:Heart Rate / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects*; D006811:Humerus; D006895:Hydroxyethyl Starch Derivatives / Q000008:administration & dosage* / Q000494:pharmacology; D020896:Hypovolemia / Q000503:physiopathology / Q000628:therapy; D017148:Infusions, Intraosseous / Q000379:methods; D007262:Infusions, Intravenous; D008297:Male; D010952:Plasma Substitutes / Q000008:administration & dosage* / Q000494:pharmacology; D011446:Prospective Studies; D011897:Random Allocation; D012769:Shock / Q000503:physiopathology / Q000628:therapy*; D013249:Sternum; D013318:Stroke Volume / Q000187:drug effects; D034421:Sus scrofa; D013552:Swine; D013599:Systole; D016896:Treatment Outcome
chemical_list: D006895:Hydroxyethyl Starch Derivatives; D010952:Plasma Substitutes