title: The effects of sternal and intravenous vasopressin administration on pharmacokinetics.
abstract: Purposes of this study were to compare intravenous (IV) and sternal intraosseous (SIO) administration of vasopressin relative to concentration maximum (Cmax), time to maximum concentration (Tmax), and mean concentration in a cardiac arrest model.
  
  
  
  Prospective, between subjects, randomized experimental design.
  
  
  
  Vivarium.
  
  
  
  Yorkshire-cross swine (N = 16) INTERVENTION: Swine were anesthetized, placed into cardiac arrest, and after 2 minutes, cardiopulmonary resuscitation was initiated. After additional 2 minutes, 40 units of vasopressin was administered either by SIO or IV route. Blood samples were collected over 4 minutes. Cmax and means were analyzed using high-performance liquid chromatography tandem mass spectrometry.
  
  
  
  Cmax, Tmax, and mean plasma concentrations.
  
  
  
  There were no significant differences in the SIO and IV groups in Cmax (p = 0.96) or Tmax (p = 0.27). The IV and SIO group had a mean Cmax of 68,151 ± SD 21,534 and 69,034 ± SD 40,169 pg/mL, respectively. The IV and SIO vasopressin groups had a mean Tmax of 105 ± SD 39 and 80 ± SD 41 seconds, respectively.
  
  
  
  A multivariate analyses of variance indicated that there were no statistically significant differences in pretest data, Cmax, and Tmax; a repeated analyses of variance indicated that there were no significant differences between the groups relative to mean concentrations of serum vasopressin over time (p > 0.05).
  
  
  
  When a patient is in cardiac arrest, it is essential to establish rapid and reliable access to blood vessels so that life-saving drugs can be administered and the SIO provides such a route.
authors.affiliation: Student, US Army Graduate Program in Anesthesia Nursing, Joint Base San Antonio-Fort Sam Houston, San Antonio, Texas.
authors.forename: Donald J
authors.initials: DJ
authors.lastname: Vallier
authors.affiliation: Student, US Army Graduate Program in Anesthesia Nursing, Joint Base San Antonio-Fort Sam Houston, San Antonio, Texas.
authors.forename: Ashley D
authors.initials: AD
authors.lastname: Torrence
authors.affiliation: Student in the US Army Graduate Program in Anesthesia Nursing, Joint Base San Antonio-Fort Sam Houston, San Antonio, Texas.
authors.forename: Robinson
authors.initials: R
authors.lastname: Stevens
authors.affiliation: US Army Graduate Program in Anesthesia Nursing, Joint Base San Antonio- Fort Sam Houston, San Antonio, Texas.
authors.forename: Peta Noreen
authors.initials: PN
authors.lastname: Arcinue
authors.affiliation: Professor and Director of Research, US Army Graduate Program in Anesthesia Nursing, Joint Base San Antonio-Fort Sam Houston, San Antonio, Texas.
authors.forename: Don
authors.initials: D
authors.lastname: Johnson
mesh_terms: D000818:Animals; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D002851:Chromatography, High Pressure Liquid; D004195:Disease Models, Animal; D006323:Heart Arrest / Q000628:therapy*; D017148:Infusions, Intraosseous / Q000379:methods*; D007262:Infusions, Intravenous / Q000379:methods*; D008297:Male; D015999:Multivariate Analysis; D011446:Prospective Studies; D011897:Random Allocation; D013249:Sternum; D034421:Sus scrofa; D013552:Swine; D053719:Tandem Mass Spectrometry; D014662:Vasoconstrictor Agents / Q000008:administration & dosage* / Q000493:pharmacokinetics; D014667:Vasopressins / Q000008:administration & dosage* / Q000493:pharmacokinetics
chemical_list: D014662:Vasoconstrictor Agents; D014667:Vasopressins