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May 1985

Emergency Bone Marrow Infusions-Reply

Author Affiliations

Pediatric Clinic Maricopa Medical Center 2601 E Roosevelt PO Box 5099 Phoenix, AZ 85010

Am J Dis Child. 1985;139(5):439. doi:10.1001/archpedi.1985.02140070012004

In Reply.—Dr Turkel has certainly contributed a great deal in the field of intraosseous infusions.1,2 He refers to a study3 of "massive arsenotherapy" delivered by bone marrow infusion in seven rabbits. Four rabbits developed asymptomatic pulmonary fat emboli and one died suddenly from fat embolism. A sharp, 18-gauge needle with fitted stylet was used in all the animals. It is unclear what role the infusion agent (massive arsenotherapy) had in the development of these fat emboli. Two studies in the mid-1940s described 70 intraosseous infusions in children using the Turkel trephine technique without evidence of pulmonary emboli.1,4 Additionally, Heinild et al5 utilized a standard bone marrow needle approach on 982 infusions in children without evidence of pulmonary emboli. Meola,6 in children, and Valdes, 7 in adults, demonstrated the safety of 341 bone marrow infusions with simple hypodermic needles, again without evidence of pulmonary emboli.