title: Effects of tibial intraosseous and intravenous administration of Hextend on time of administration and hemodynamics in a hypovolemic swine model.
abstract: To determine if there were significant differences between the tibial intraosseous (TIO) and intravenous (IV) administration of Hextend relative to time and in hemodynamics in a hypovolemic model.
  
  
  
  Vivarium.
  
  
  
  Yorkshire swine; sample size was based on a power of 80 percent, α of 0.05, and a large effect size of 0.6. Swine were randomly assigned to one of three groups: TIO (n = 7), IV (n = 7), and control (n = 7).
  
  
  
  Swine were exsanguinated 30 percent of their blood volume. Hextend (500 mL) was administered either by the TIO 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.
  
  
  
  An independent t test determined that there was no significant difference between groups relative to time of administration (p = 0.001). A repeated analysis of variance found that there were no significant differences in SBP, DBP, MAP, HR, CO, and SV between the TIO and IV groups over 8 minutes (p > 0.05) but significant differences between both TIO and IV compared to the control group (p < 0.05).
  
  
  
  TIO is an effective and easily used method to administer Hextend for patients in hypovolemic shock. Based upon the findings of this study, the TIO route might be considered the first choice for rapid vascular access and the administration of Hextend.
authors.affiliation: Student, US Army Graduate Program in Anesthesia Nursing, Fort Sam Houston, San Antonio, Texas.
authors.forename: James
authors.initials: J
authors.lastname: Wilson
authors.affiliation: Student, US Army Graduate Program in Anesthesia Nursing, Fort Sam Houston, San Antonio, Texas.
authors.forename: Alex
authors.initials: A
authors.lastname: Passmore
authors.affiliation: Student, US Army Graduate Program in Anesthesia Nursing, Fort Sam Houston, San Antonio, Texas.
authors.forename: Sephra
authors.initials: S
authors.lastname: Leger
authors.affiliation: Student, US Army Graduate Program in Anesthesia Nursing, Fort Sam Houston, San Antonio, Texas.
authors.forename: Johnathon
authors.initials: J
authors.lastname: Lannan
authors.affiliation: Faculty Member, US Army Graduate Program in Anesthesia Nursing, Fort Sam Houston, San Antonio, Texas.
authors.forename: Michael
authors.initials: M
authors.lastname: Bentley
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
mesh_terms: D000818:Animals; D062186:Arterial Pressure / Q000187:drug effects; D002302:Cardiac Output / Q000187:drug effects; D003971:Diastole; D005440:Fluid Therapy / Q000379:methods*; D006339:Heart Rate / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects*; D006895:Hydroxyethyl Starch Derivatives / Q000008:administration & dosage* / Q000494:pharmacology; D020896:Hypovolemia / Q000503:physiopathology / Q000628:therapy; D017148:Infusions, Intraosseous; 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*; D013318:Stroke Volume / Q000187:drug effects; D034421:Sus scrofa; D013552:Swine; D013599:Systole; D013977:Tibia; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D006895:Hydroxyethyl Starch Derivatives; D010952:Plasma Substitutes