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Updated: Feb 8, 2026

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Pressure Measurements Obtained from Intraosseous Access: Potential Clinical Applications Explored Using a Porcine

Joerg Reifart1,2, Nida Asif3, Paul Iaizzo4

  • 1Visible Heart® Laboratories, Department of Surgery, Institute for Engineering in Medicine, University of Minnesota, B172 Mayo, MMC195 | 420 Delaware Street S.E., Minneapolis, MN, 55455, USA. reifartpublications@gmail.com.

Journal of Cardiovascular Translational Research
|February 6, 2026
PubMed
Summary
This summary is machine-generated.

Intraosseous pressure closely mirrors arterial pressure in emergencies, even during CPR. This bone marrow access can help identify asystole, potentially improving resuscitation efforts.

Keywords:
Arterial pressureCPRCardiac arrestIntraosseous accessIntraosseous pressureMedullary pressurePEAPressure prediction

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Area of Science:

  • Emergency Medicine
  • Physiology
  • Critical Care

Background:

  • Intraosseous (IO) access is the fastest emergency route for fluid and medication delivery.
  • The relationship between IO pressure and arterial pressure is not well understood.
  • Understanding this correlation is crucial for optimizing emergency interventions.

Purpose of the Study:

  • To investigate the correlation between intraosseous and arterial pressures.
  • To analyze this correlation across various hemodynamic conditions, including different heart rates, arrhythmias, asystolic arrest, and cardiopulmonary resuscitation (CPR).

Main Methods:

  • 11 male Yorkshire pigs underwent anesthesia, with femoral artery and tibial IO lines placed.
  • Pressures were recorded during induced hemodynamic changes, cardiac arrest, and CPR.
  • Statistical analyses included Pearson's r, Wilcoxon rank-sum test, and Bayesian Vector Autoregression (BVAR).

Main Results:

  • IO pressure exhibited pulsatility correlating with mean arterial pressure (9-71%).
  • Strong correlations were observed under baseline conditions (r=0.75-0.96) and during CPR (r=0.65-0.99).
  • Correlation weakened during asystole (r=0.26±0.46) and was disrupted by epinephrine (r=0.04). Asystole was detectable via IO tracings.

Conclusions:

  • Intraosseous pressure effectively reflects circulatory status.
  • IO tracings can aid in identifying asystole during emergencies.
  • This finding has potential clinical implications for improving CPR and resuscitation outcomes.