Biological Sex Is Associated with Pre-Tibial Subcutaneous Tissue Depth for Intraosseous Catheter Insertion

Area of Science:

• Emergency Medicine
• Anatomy & Physiology
• Medical Imaging

Background:

• Intraosseous (IO) vascular access is crucial for rapid fluid and medication delivery in critically ill patients.
• The proximal tibia (PT) is a preferred IO insertion site due to high success rates.
• Inadequate catheter length remains a challenge in IO line placement.

Purpose of the Study:

• To identify patient characteristics associated with increased pre-tibial soft tissue depth at the PT IO insertion site.
• To determine if specific patient subgroups are at higher risk for difficult IO access due to soft tissue depth.

Main Methods:

• Retrospective analysis of adult patients undergoing lower extremity CT scans.
• Calculation of pre-tibial soft tissue depth using CT imaging.
• Collection and analysis of patient data including age, sex, BMI, height, weight, and comorbidities.

Main Results:

• Increased BMI, height, and weight significantly correlated with greater pre-tibial soft tissue depth.
• Female sex was associated with significantly increased soft tissue depth.
• No significant association was found between comorbidities and soft tissue depth.

Conclusions:

• Female sex, shorter stature, and higher BMI are associated with increased soft tissue thickness at the PT IO site.
• Consideration of longer IO catheter sizes may be necessary for obese and female patients.
• These findings can help optimize IO access in diverse patient populations.