Can blood taken from intraosseous cannulations be used for blood analysis?

Intraosseous infusion is increasingly finding application for venous access to infuse drugs and fluids in paediatric resuscitation including burns. The aim of this study was to determine the feasibility of using blood samples taken from the bone marrow cavity for routine blood analysis. In paediatric resuscitation where alternative venous access is not available this could prove valuable. Peripheral venous blood samples were compared with blood obtained from the bone marrow cavity in patients undergoing bone marrow aspiration for the investigation of possible medical pathology. Haemoglobin, haematocrit, sodium, urea, creatinine, and calcium levels values were sufficiently similar to be clinically useful. The potassium level was elevated in most bone marrow samples and the difference from peripheral venous samples variable. Great caution should be exercised in their interpretation. Glucose levels should also be interpreted with care. In conclusion, blood samples obtained intraosseously may give a useful guide to peripheral blood levels of some haematological and biochemical variables. This is potentially useful where a peripheral venous sample cannot be obtained. The values must be interpreted with care. Whether these findings can be extended to paediatric patients who are not haemodynamically stable has not been assessed.