Experience of using intraosseous access in infants with severe dehydration

Introduction. Ensuring vascular access in children when developing critical condition is an urgent problem. Circulatory insufficiency, hypovolemia, dehydration, and peripheral venous reserve deficiency significantly complicate access to the vascular bed, even with modern technical support. Intraosseous access is an alternative method that provides the possibility of rapid administration of medications and infusion media, including when resuscitation is necessary. Literature data indicate extremely limited experience of using intraosseous access in children in Russia with the development of critical conditions, especially those associated with the development of acute hypovolemia and dehydration. The objective was to present the experience of providing and using intraosseous access in infants in critical condition with severe dehydration. Materials and methods . The study describes a group of 10 infants who were admitted to the anesthesiology and intensive care unit of a children’s infectious diseases hospital with acute infectious diseases of the gastrointestinal tract and severe dehydration (dehydration on the CDS is more than 2 points). Results. The average time for setting up an intraosseous access took no more than 30 seconds, which was significantly less than the time for providing access to the main or peripheral venous vessels. The procedure of intraosseous access in none of the patients was associated with technical difficulties. Assessment of the degree of dehydration on the СDS 2 and 4 hours after the start of intensive therapy showed a decrease in the degree of dehydration. Conclusions. Intraosseous access is an effective and safe way to provide emergency vascular access in children with severe degrees of dehydration.