Objective: Purposes of this study were to compare intravenous (IV) and sternal intraosseous (SIO) administration of vasopressin relative to concentration maximum (Cmax), time to maximum concentration (Tmax), and mean concentration in a cardiac arrest model. Design: Prospective, between subjects, randomized experimental design. Setting: Vivarium. Subjects: Yorkshire-cross swine (N=16) Intervention: Swine were anesthetized, placed into cardiac arrest, and after 2 minutes, cardiopul-monary resuscitation was initiated. After additional 2 minutes, 40 units of vasopressin was administered either by SIO or IV route. Blood samples were collected over 4 minutes. Cmax and means were analyzed using high-performance liquid chromatography tandem mass spectrometry. Main outcome Measurements: Cmax, Tmax, and mean plasma concentrations. Results: There were no significant differences in the SIO and IV groups in Cmax (p = 0.96) or Tmax (p = 0.27). The IV and SIO group had a mean Cmax of 68,151 ±SD 21,534 and 69,034±SD 40,169pg/mL, respectively. The IV and SIO vasopressin groups had a mean Tmax of 105+SD 39 and 80±SD 41 seconds, respectively. Conclusion: A multivariate analyses of variance indicated that there were no statistically significant differences in pretest data, Cmax, and Tmax; a repeated analyses of variance indicated that there were no significant differences between the groups relative to mean concentrations of serum vasopressin over time (p>0.05). Conclusion: When a patient is in cardiac arrest, it is essential to establish rapid and reliable access to blood vessels so that life-saving drugs can be administered and the SIO provides such a route.
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