• Jens Heyder-Musolf, Judith Giest, and Jochen Straub.
• Anasthesiol Intensivmed Notfallmed Schmerzther. 2011 Oct 1;46(10):654-7.

AbstractThis article reports about the perioperative disposition of an intraosseous (IO) needle on a 15 days old critically ill premature infant (weight 1300g) in line with an urgent surgery and sole possible vascular access on circulation insufficiency.Due to vital danger there was perioperatively no time to place a large-bore vascular access in addition to the 2 lying 28G-submerging venous catheters with a minimal flow rate. Because it was not possible to set a secure vascular access in several attempts - with generalised oedema and anasarca -, after having interrupted the surgery, the sole possibility was to dispose an IO needle in the range of the tibia.It was obvious, that a puncture of very small and weak bones is difficult and that a secure bone marrow puncture on infants beyond the weight category of 3 kg declared by the producer can be hard. Anyhow in case of emergency, an attempt is reasonable and useful, the effect after the application on the whole circulation situation was considerably verifiable.© Georg Thieme Verlag Stuttgart · New York.

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