Meta-analysis of the application effect of intraosseous infusion access and peripheral intravenous infusion access in the emergency resuscitation of adults

Sheng Wanting; Li Xiangyun; Yang Xiaohui; Wang Jie; Zhao Linfang

doi:10.3969/j.issn.1002-1949.2024.10.014

Abstract：Objective To analyze the effectiveness of intraosseous(IO)infusion access versus peripheral intravenous(PIV)infusion access in the emergency resuscitation of adults.Methods Computer searches of PubMed,Web of Science,the Cochrane Library,Embase,CINAHL,CNKI,Wanfang Data,VIP and CBM for the studies on the effectiveness of IO infusion access versus PIV infusion access in the emergency resuscitation of adults were conducted.The time limit was from the establishment of the database until June 2023.Meta-analysis was performed by using RevMan 5.3 software after two investigators independently screened the literatures,extracted the data and evaluated the quality of the included literatures.Results A total of 26 literatures with 38 988 patients were included.Meta-analysis showed that the establishment of IO infusion access can shorten the time required for successful establishment of infusion access and blood pressure to return to the normal level,improve the successful rate of first catheterization,the incidence of complications was low,but the speed of infusion at normobaric pressure was slow,the successful rate of the recovery of spontaneous circulation(ROSC)was low(P＜0.05),compared with the establishment of PIV infusion access during emergency resuscitation of adult patients.The difference in infusion speed under pressurization was not statistically significant(P＞0.05).Conclusions Based on the available evidences,it is recommended that during emergency resuscitation of adult patients,IO infusion access should be preferred and continuous fluid infusion should be provided by using an external pressure device or infusion pump,and then was removed after the completion of resuscitation or successful establishment of PIV.It is important to note that the effectiveness of IO infusion access during emergency resuscitation in adult patients needs to be further discussed in more high-quality,large-sample studies.