title: The effects of sternal intraosseous and intravenous administration of amiodarone in a hypovolemic swine cardiac arrest model.
abstract: This study compared the effects of amiodarone via sternal intraosseous (SIO) and intravenous (IV) routes on return of spontaneous circulation (ROSC), time to ROSC, concentration maximum (Cmax), time to maximum concentration (Tmax), and mean concentrations over time in a hypovolemic cardiac arrest model.
  
  
  
  Prospective, between subjects, randomized experimental design.
  
  
  
  TriService Research Facility.
  
  
  
  Yorkshire-cross swine (n = 28).
  
  
  
  Swine were anesthetized and placed into cardiac arrest. After 2 minutes, cardiopulmonary resuscitation was initiated. After an additional 2 minutes, amiodarone 300 mg was administered via the tibial intraosseous TIO or the IV route. Blood samples were collected over 5 minutes. The plasma concentrations were analyzed using high-performance liquid chromatography tandem mass spectrometry.
  
  
  
  ROSC, time to ROSC, Cmax, Tmax, and mean concentrations over time.
  
  
  
  A multivariate analyses of variance indicated that there were no significant differences in the SIO and IV groups in ROSC (p = 0.191), time to ROSC (p > 0.05), Tmaxmean 88.1 ± 24.8 seconds versus 49.5 ± 21.8 seconds (p = 0.317), or Cmaxmean 92,700 ± 161,112 ng/mL versus 64,159.8 ± 14,174.8 ng/mL (p = 0.260). A repeated analyses of variance indicated that there were no significant differences between the groups relative to concentrations over time (p > 0.05).
  
  
  
  The SIO provides rapid and reliable access to administer life-saving medications during cardiac arrest.
authors.affiliation: US Army Graduate Program in Anesthesia Nursing, Fort Sam Houston, San Antonio, Texas.
authors.forename: Samuel
authors.initials: S
authors.lastname: Smith
authors.affiliation: Student, US Army Graduate Program in Anesthesia Nursing, Fort Sam Houston, San Antonio, Texas.
authors.forename: Bradley
authors.initials: B
authors.lastname: Borgkvist
authors.affiliation: Student, US Army Graduate Program in Anesthesia Nursing, Fort Sam Houston, San Antonio, Texas.
authors.forename: Teara
authors.initials: T
authors.lastname: Kist
authors.affiliation: Student, US Army Graduate Program in Anesthesia Nursing, Fort Sam Houston, San Antonio, Texas.
authors.forename: Jason
authors.initials: J
authors.lastname: Annelin
authors.affiliation: Faculty Member and Co-Director of Research, US Army Graduate Program in Anesthesia Nursing, Fort Sam Houston, San Antonio, Texas.
authors.forename: Don
authors.initials: D
authors.lastname: Johnson
authors.affiliation: Faculty Member and Co-Director of Research, US Army Graduate Program in Anesthesia Nursing, Fort Sam Houston, San Antonio, Texas.
authors.forename: Robert
authors.initials: R
authors.lastname: Long
mesh_terms: D000638:Amiodarone / Q000008:administration & dosage* / Q000493:pharmacokinetics*; D000818:Animals; D016887:Cardiopulmonary Resuscitation; D002851:Chromatography, High Pressure Liquid; D004195:Disease Models, Animal; D006323:Heart Arrest / Q000188:drug therapy*; D020896:Hypovolemia / Q000188:drug therapy*; D017148:Infusions, Intraosseous; D007262:Infusions, Intravenous; D011446:Prospective Studies; D011897:Random Allocation; D013249:Sternum; D013552:Swine; D053719:Tandem Mass Spectrometry
chemical_list: D000638:Amiodarone