Evidence map›Paper›PMID 41799722›Full record

ArticleJournal of medical biochemistry2026

Randomized controlled trial of intraosseous access vs. intravenous access in traumatic hemorrhagic shock: Effects on inflammation, hematopoiesis, and coagulation.

Gaorong Deng, Lang Jiang, Xin Miao, Yuying Dong, Xiang Gao, Zongfang Li

Abstract read
In one paragraph

Article in Journal of medical biochemistry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Gaorong DengSecond Affiliated Hospital of Xi'an Jiaotong University, Department of Orthopaedics, Xian, Shaanxi, 710004, China.
Lang JiangFourth Affiliated Hospital of Nanchang University, Department of Orthopaedics, Nanchang, Jiangxi, 330002, China.
Xin MiaoFourth Affiliated Hospital of Nanchang University, Department of Orthopaedics, Nanchang, Jiangxi, 330002, China.
Yuying DongFourth Affiliated Hospital of Nanchang University, Department of Obstetrics and Gynecology, Nanchang, Jiangxi, 330002, China.
Xiang GaoFourth Affiliated Hospital of Nanchang University, Department of Orthopaedics, Nanchang, Jiangxi, 330002, China.
Zongfang LiSecond Affiliated Hospital of Xi'an Jiaotong University, National-Local Joint Engineering Research Center of Biodiagnostics and Biotherapy, Xian, Shaanxi, 710004, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: This study aimed to evaluate the impact of intraosseous (IO) access on inflammatory mediators, hematopoietic cell function, and coagulation-metabolic disturbances in patients presenting with emergency traumatic hemorrhagic shock (THS), thereby providing clinical evidence to refine IO resuscitation protocols in emergency settings. Methods: We conducted a randomized controlled trial involving 84 THS patients admitted between February 2024 and February 2025. Participants were allocated equally into two groups: the IO group (n= 42), where vascular access was established via humeral or proximal tibial puncture, and the intravenous (IV) group (n= 42), where conventional peripheral or central venous access was prioritized. Serial measurements were performed at baseline (T0), 24 hours (T1), and 72 hours (T2) post-intervention to assess: (1) inflammatory mediators (IL-1 b, IL-6, IL-10, HMGB1, MDA); (2) hematopoietic parameters (CD34+ cell proportion, CFU-GM /BFU-E colony formation, CXCL12, EPO, and TPO ); (3) coagulation profiles (PT, APTT, and D-dimer); and (4) tissue perfusion indicators (blood lactate and lactate clearance rate). Comparative analyses were conducted both between groups and across different time points. Results: The IO group demonstrated significantly elevated levels of IL-1P, HMGB1, and MDA at T1 and T2 compared to the IV group (P< 0.05), coupled with reduced IL-10 expression (P< 0.05), indicating exacerbated inflammatory imbalance and oxidative stress. Hematopoietic evaluation revealed progressive declines in CD34+ cell populations, CFU-GM /BFU-E colony formation, and CXCL12 concentration in the IO group at T1 and T2 (P< 0.05), despite modest compensatory increases in EPO and TPO that remained inferior to the IV group (P< 0.05). Coagulation studies showed prolonged PT/APTT (P< 0.01) and higher D-dimer levels (P< 0.05) in the IO group, along with worse blood lactate levels and lactate clearance rates compared to the IV group (P< 0.05), suggesting increased tissue hypoxia and coagulopathy risk. Conclusions: While IO access enables rapid vascular access for resuscitation and reduces critical intervention time, despite its procedural efficiency in rapid vascular access for resuscitation, IO may inadvertently aggravate systemic inflammatory dysregulation, impair hematopoietic function, and worsen coagulation-metabolic disturbances through mechanisms such as mechanical stimulation, hypothermic fluid infusion, and oxidative stress.

Indexed as

coagulationhematopoiesisinflammatory mediatorsintraosseous accessmetabolic disturbancestraumatic hemorrhagic shock

Identifiers

PMID41799722
PMCPMC12967180

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.