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Neurocritical Care
Published in: Neurocritical Care 2/2019

01-04-2019 | Original Article

Intraosseous Administration of 23.4% NaCl for Treatment of Intracranial Hypertension

Authors: Jing Wang, Yun Fang, Subhashini Ramesh, Asma Zakaria, Maryann T. Putman, Dan Dinescu, James Paik, Romergryko G. Geocadin, Pouya Tahsili-Fahadan, Laith R. Altaweel

Published in: Neurocritical Care | Issue 2/2019

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Abstract

Background/objective

Prompt treatment of acute intracranial hypertension is vital to preserving neurological function and frequently includes administration of 23.4% NaCl. However, 23.4% NaCl administration requires central venous catheterization that can delay treatment. Intraosseous catheterization is an alternative route of venous access that may result in more rapid administration of 23.4% NaCl.

Methods

Single-center retrospective analysis of 76 consecutive patients, between January 2015 and January 2018, with clinical signs of intracranial hypertension received 23.4% NaCl through either central venous catheter or intraosseous access.

Results

Intraosseous cannulation was successful on the first attempt in 97% of patients. No immediate untoward effects were seen with intraosseous cannulation. Time to treatment with 23.4% NaCl was significantly shorter in patients with intraosseous access compared to central venous catheter (p < 0.0001).

Conclusions

Intraosseous cannulation resulted in more rapid administration of 23.4% NaCl with no immediate serious complications. Further investigations to identify the clinical benefits and safety of hypertonic medication administration via intraosseous cannulation are warranted.
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Metadata
Title
Intraosseous Administration of 23.4% NaCl for Treatment of Intracranial Hypertension
Authors
Jing Wang
Yun Fang
Subhashini Ramesh
Asma Zakaria
Maryann T. Putman
Dan Dinescu
James Paik
Romergryko G. Geocadin
Pouya Tahsili-Fahadan
Laith R. Altaweel
Publication date
01-04-2019
Publisher
Springer US
Published in
Neurocritical Care / Issue 2/2019
Print ISSN: 1541-6933
Electronic ISSN: 1556-0961
DOI
https://doi.org/10.1007/s12028-018-0637-2

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