open access

Vol 79, No 3 (2021)
Original article
Published online: 2021-01-07
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Intraosseous versus intravenous access while wearing personal protective equipment: a meta-analysis in the era of COVID-19

Anna Drozd, Jacek Smereka, Krzysztof J. Filipiak, Miłosz Jaguszewski, Jerzy R. Ładny, Karol Bielski, Klaudiusz Nadolny, Kurt Ruetzler, Łukasz Szarpak
DOI: 10.33963/KP.15741
·
Pubmed: 33415967
·
Kardiol Pol 2021;79(3):277-286.

open access

Vol 79, No 3 (2021)
Original article
Published online: 2021-01-07

Abstract

Background: Obtaining vascular access is one of the key procedures performed in patients in emergency settings.

Aims: The study was conducted as a meta‑analysis and a systematic review and aimed to address the following question: which intravascular access method should be used in patients with COVID‑19 when wearing full personal protective equipment (PPE)?

Methods: We performed a systematic search of PubMed, EMBASE, and CENTRAL databases for randomized controlled trials that compared intravascular access methods used by operators wearing full level C PPE. We evaluated procedure duration and the success rate of intraosseous and peripheral intravenous accesses.

Results: Eight randomized controlled trials were included in quantitative synthesis. The use of PPE during intravascular access procedures had an impact on procedure duration in the case of intraosseous access (mean difference [MD], 11.69; 95% CI, 6.47–16.92; P < 0.001), as well as reduced the success rate of intraosseous access by 0.8% and intravenous access by 10.1%. Under PPE conditions, intraosseous access, compared with peripheral intravenous access, offered a shorter procedure time (MD, –41.43; 95% CI, –62.36 to –24.47; P < 0.001).

Conclusion: This comprehensive meta‑analysis suggested that the use of PPE significantly extends the duration of intravascular procedures. However, under PPE conditions, operators were able to obtain intraosseous access in a shorter time and with a higher success rate than in the case of intravenous access.

Abstract

Background: Obtaining vascular access is one of the key procedures performed in patients in emergency settings.

Aims: The study was conducted as a meta‑analysis and a systematic review and aimed to address the following question: which intravascular access method should be used in patients with COVID‑19 when wearing full personal protective equipment (PPE)?

Methods: We performed a systematic search of PubMed, EMBASE, and CENTRAL databases for randomized controlled trials that compared intravascular access methods used by operators wearing full level C PPE. We evaluated procedure duration and the success rate of intraosseous and peripheral intravenous accesses.

Results: Eight randomized controlled trials were included in quantitative synthesis. The use of PPE during intravascular access procedures had an impact on procedure duration in the case of intraosseous access (mean difference [MD], 11.69; 95% CI, 6.47–16.92; P < 0.001), as well as reduced the success rate of intraosseous access by 0.8% and intravenous access by 10.1%. Under PPE conditions, intraosseous access, compared with peripheral intravenous access, offered a shorter procedure time (MD, –41.43; 95% CI, –62.36 to –24.47; P < 0.001).

Conclusion: This comprehensive meta‑analysis suggested that the use of PPE significantly extends the duration of intravascular procedures. However, under PPE conditions, operators were able to obtain intraosseous access in a shorter time and with a higher success rate than in the case of intravenous access.

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About this article
Title

Intraosseous versus intravenous access while wearing personal protective equipment: a meta-analysis in the era of COVID-19

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 79, No 3 (2021)

Article type

Original article

Pages

277-286

Published online

2021-01-07

DOI

10.33963/KP.15741

Pubmed

33415967

Bibliographic record

Kardiol Pol 2021;79(3):277-286.

Authors

Anna Drozd
Jacek Smereka
Krzysztof J. Filipiak
Miłosz Jaguszewski
Jerzy R. Ładny
Karol Bielski
Klaudiusz Nadolny
Kurt Ruetzler
Łukasz Szarpak

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