From the Research
The most common complication of an intraosseous (IO) line is compartment syndrome, as reported in the most recent study 1. This complication occurs when fluid leaks into the surrounding tissue instead of entering the vascular system, leading to increased pressure within the muscle compartment. Compartment syndrome can lead to tissue necrosis, infection, and potentially long-term disability if not promptly identified and addressed. Other potential complications of IO lines include:
- Infection at the insertion site
- Bone fracture, especially in elderly patients with osteoporosis
- Growth plate injury in pediatric patients
- Osteomyelitis, as reported in a case study 2
- Traumatic bullae, a previously unreported cutaneous complication 1 To minimize these risks, proper insertion technique is crucial, including:
- Selecting an appropriate insertion site, typically the proximal tibia, distal tibia, or humeral head
- Confirming placement with aspiration of bone marrow
- Securing the device properly IO lines should be considered temporary vascular access and should be replaced with conventional intravenous access as soon as feasible, ideally within 24 hours, to reduce complication rates 3. It is essential for healthcare providers to be aware of the potential complications associated with IO line use and to take steps to prevent and promptly treat them, as highlighted in a case report of calf compartment syndrome associated with IO line use in an adult patient 4. Additionally, a study on IO line use in children found no complications, but the overall incidence of IO line use was low 5. Overall, while IO lines can be a lifesaving intervention, it is crucial to carefully consider the potential risks and take steps to minimize them.