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Intraosseous fluid resuscitation in meningococcal disease and lower limb injury

Suparna Dasgupta1, Stephen D Playfor

  • 1Royal Manchester Children's Hospital, Oxford Road, Manchester, UK;

Pediatric Reports
|May 19, 2011
PubMed

Insights

Aggressive fluid resuscitation in children with meningococcal sepsis using intraosseous (IO) needles may lead to extravasation and compartment syndrome. Early recognition and management are crucial for preventing serious complications in pediatric intensive care.

Area of Science:

  • Pediatric Intensive Care
  • Infectious Diseases
  • Emergency Medicine

Background:

  • Severe sepsis and septic shock in children require aggressive early fluid resuscitation.
  • Intraosseous (IO) needles are a critical route for rapid fluid administration in pediatric emergencies.
  • Meningococcal disease is a significant cause of sepsis in children.

Observation:

  • A review of 18 children with meningococcal sepsis admitted to a Pediatric Intensive Care Unit (PICU) over 12 months was conducted.
  • Four children received resuscitation via IO needles.
  • Two of these children developed serious complications, including extravasation and compartment syndrome.

Findings:

  • Aggressive intraosseous fluid resuscitation in pediatric septic shock presents a risk of extravasation and lower limb injury.
  • The incidence of these complications, while seemingly low, warrants attention in clinical practice.
  • Powered IO access systems may offer improved accuracy and speed.

Implications:

  • Clinical practice guidelines should consider the potential for extravasation and compartment syndrome with aggressive IO fluid resuscitation in pediatric sepsis.
  • Enhanced vigilance and monitoring for lower limb complications are necessary.
  • Further research into optimal IO resuscitation techniques and monitoring in pediatric septic shock is recommended.

Keywords:
complications.intraosseousmeningococcal disease

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