Abstract
Transfusion into the Bone Marrow WORKERS who are studying the intravenous administration of blood and other fluids will be interested in the method of delivering such parenteral fluids into the manubrium of the sternum which is described by Mr. Hamilton Bailey, of the Royal Northern Hospital, London (Brit. Med. J., Feb. 5, 1944). Referring to the work of L. M. Tocantins and J. F. O'Neill (Surg. Gynœc. Obstetr., 73, 281; 1941), Mr. Bailey says that he considers the manubrium as good a receptor as a vein for infusions of all kinds and for pentothal anæsthesia. After local anæsthesia with novocain, a special trochar is introduced between the two plates of the manubrium, the depth to which it penetrates being controlled by two wings on the instrument. To make sure that the bone marrow has been reached and to avoid such possible accidents as the injection of the fluids into the superior mediastinum, sodium citrate is first injected with a syringe fixed to the cannula. If this syringe then withdraws bone marrow, which looks like blood, easily and liberally, it is known that the cannula is in the bone marrow. It is then quickly linked to the transfusion apparatus. A possible danger is the production of osteomyelitis, but this has not occurred in Mr. Bailey's sixty cases. Whole blood cannot be introduced as rapidly as it can be given into a vein by gravity, but this difficulty is being overcome. Advantages of the method are that it is relatively painless, that thrombosis or phlebitis cannot occur, and that the apparatus is on the sternum and so is out of the way of the surgeon during operations and can be controlled by the anæsthetist, The method is also free from the difficulty, which is often considerable, of getting a cannula into the veins of severely shocked patients, whose veins may be also so severely collapsed that satisfactory reception of the parenteral fluid is difficult; in dehydrated infants the method is certain and safe. It can, moreover, be carried out in a poor light, so that fluids can be given more easily and quickly under black-out conditions.
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Research Items. Nature 153, 258–259 (1944). https://doi.org/10.1038/153258a0
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DOI: https://doi.org/10.1038/153258a0