Pharmacokinetics of sternal intraossesous atropine administration in normovolemic and hypovolemic swine


  • Mark Cornell, MSN, CRNA
  • Jaime Kelbaugh, MSN, CRNA
  • Brian Todd, MSN, CRNA
  • Krista Christianson, MSN, CRNA
  • Kevin Grayson, DVM, PhD
  • Joseph O’Sullivan, CRNA, PhD
  • Don Johnson, RN, PhD
  • Michael Loughren, CRNA, PhD



intraosseous, sternal, atropine, nerve agent, shock, pharmacokinetics


Objective: Characterize and compare the pharmacokinetics of atropine administered via the sternal intraosseous (IO) route in a normovolemic and hypovolemic swine model.

Design: Prospective, experimental study.

Setting: Vivarium.

Subjects: Yorkshire-cross swine (N = 12).

Intervention: Atropine was administered via the sternal IO route to normovolemic and hypovolemic swine. Blood samples were drawn at regular intervals after atropine administration and analyzed for plasma atropine concentration. Pharmacokinetic parameters were obtained from modeling the plasma concentrations.

Main Outcome Measurements: Pharmacokinetic parameters, maximum concentration (Cmax), and time to maximum concentration (Tmax).

Results: The normovolemic and hypovolemic models reached peak plasma concentration immediately and had a very rapid distribution phase with no apparent absorption phase for the IO groups. The hypovolemic group had slower clearance and longer half-life compared to the normovolemic group.

Conclusion: The sternal IO route is an effective method of administering atropine and is comparable to the previously reported tibial IO and intravenous data even under conditions of significant hemorrhage.

Author Biographies

Mark Cornell, MSN, CRNA

US Army Graduate Program in Anesthesia Nursing, Fort Sam Houston, Texas.

Jaime Kelbaugh, MSN, CRNA

US Army Graduate Program in Anesthesia Nursing, Fort Sam Houston, Texas.

Brian Todd, MSN, CRNA

David Grant USAF Medical Center, Travis AFB, California

Krista Christianson, MSN, CRNA

David Grant USAF Medical Center, Travis AFB, California

Kevin Grayson, DVM, PhD

David Grant USAF Medical Center, Travis AFB, California

Joseph O’Sullivan, CRNA, PhD

US Army Graduate Program in Anesthesia Nursing, Fort Sam Houston, Texas.

Don Johnson, RN, PhD

US Army Graduate Program in Anesthesia Nursing, Fort Sam Houston, Texas.

Michael Loughren, CRNA, PhD

Department of Anesthesia and Operative Services, Madigan Army Medical Center, Joint Base Lewis-McChord, Fort Lewis, Washington


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How to Cite

Cornell, MSN, CRNA, M., J. Kelbaugh, MSN, CRNA, B. Todd, MSN, CRNA, K. Christianson, MSN, CRNA, K. Grayson, DVM, PhD, J. O’Sullivan, CRNA, PhD, D. Johnson, RN, PhD, and M. Loughren, CRNA, PhD. “Pharmacokinetics of Sternal Intraossesous Atropine Administration in Normovolemic and Hypovolemic Swine”. American Journal of Disaster Medicine, vol. 11, no. 4, Oct. 2016, pp. 233-6, doi:10.5055/ajdm.2016.0244.

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