Comparison of tibial intraosseous, sternal intraosseous, and intravenous routes of administration on pharmacokinetics of epinephrine during cardiac arrest: A pilot study

James Burgert, Brian Gegel, Michael Loughren, Thomas Ceremuga, Manish Desai, Michael Schlicher, Joseph O'Sullivan, Paul Lewis, Don Johnson

Research output: Contribution to journalArticle

16 Scopus citations

Abstract

The purpose of this study was to determine and compare the maximum concentration (Cmax) and time to maximum concentration (Tmax) of epinephrine administered via tibial intraosseous (IO), sternal IO, and intravenous (IV) routes in a porcine model of cardiac arrest during cardiopulmonary resuscitation. Five pigs each were randomly assigned to 3 groups: tibial IO, sternal IO, and IV. Cardiac arrest was induced with IV potassium chloride. After 2 minutes, cardiopulmonary resuscitation was initiated. Epinephrine was administered to each animal, and serial blood samples were collected over the next 3 minutes. Enzyme-linked immunosorbent assay was used to determine the epinephrine concentration. Multivariate analysis of variance helped determine if there were statistically significant differences between groups. There were significant differences in Cmax between the sternal IO and IV (P = .009) and tibial IO and IV (P =.03) groups but no significant difference between tibial and sternal IO groups (P =.75). Significant differences existed in Tmax between the tibial IO and IV (P =.04) and between tibial IO and sternal IO (P =.02) groups but no difference between the sternal IO and IV groups (P=.56). Intravenous administration of 1 mg of epinephrine resulted in a serum concentration 5.87 and 2.86 times greater than for the tibial and sternal routes, respectively.

Original languageEnglish (US)
Pages (from-to)S6-S10
JournalAANA Journal
Volume80
Issue numberSUPPL.4
StatePublished - Aug 1 2012
Externally publishedYes

Keywords

  • Advanced cardiac life support
  • Cardiac arrest
  • Epinephrine
  • Intraosseous

ASJC Scopus subject areas

  • Medical–Surgical
  • Advanced and Specialized Nursing
  • Anesthesiology and Pain Medicine

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    Burgert, J., Gegel, B., Loughren, M., Ceremuga, T., Desai, M., Schlicher, M., O'Sullivan, J., Lewis, P., & Johnson, D. (2012). Comparison of tibial intraosseous, sternal intraosseous, and intravenous routes of administration on pharmacokinetics of epinephrine during cardiac arrest: A pilot study. AANA Journal, 80(SUPPL.4), S6-S10.