In children requiring emergency vascular access, are intraosseous lines associated with significant long-term complications?
When definitive IV access is elusive in a pediatric patient, IO placement remains a reliable option given the low incidence of severe long-term complications. You can proceed with IO access without undue hesitation, as the evidence does not support significant risks like growth disturbance or thrombosis. Remember that while minor local complications can occur, the benefit of securing rapid access outweighs the rare, documented risks.
This review synthesized data from 11 observational studies to assess the long-term safety profile of intraosseous (IO) access in children needing urgent vascular access. The authors systematically reviewed the literature to address ongoing concerns about potential late complications associated with this technique. Overall, the findings suggest that severe long-term sequelae following pediatric IO placement are quite uncommon. Specifically, the review found no evidence linking IO use to growth disturbance, venous thrombosis, or fat embolism. While minor, isolated issues like compartment syndrome, fracture, or extravasation were noted at low frequencies, the overall picture points toward a favorable risk-benefit profile for IO use in acute settings.