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Bone Marrow Aspiration and Biopsy

This document discusses bone marrow aspiration and biopsy procedures. It outlines the indications for the procedures such as pancytopenia, myelodysplasia, and leukemia. Contraindications including bleeding disorders and infection are also covered. The necessary equipment, potential complications, and intraosseous infusion procedure are described.

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Benjamin AD
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© © All Rights Reserved
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403 views

Bone Marrow Aspiration and Biopsy

This document discusses bone marrow aspiration and biopsy procedures. It outlines the indications for the procedures such as pancytopenia, myelodysplasia, and leukemia. Contraindications including bleeding disorders and infection are also covered. The necessary equipment, potential complications, and intraosseous infusion procedure are described.

Uploaded by

Benjamin AD
Copyright
© © All Rights Reserved
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
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Bone marrow aspiration and biopsy

• Bone marrow examination is useful in the


diagnosis of hematologic disease and
• To asses over all bone marrow cellularity.
Indication
• Pancytopenia
• Myelodysplasia
• Myeloproliferative disease
• Non-Hodgkin or Hodgkin
lymphoma
• Childhood solid tumors
• Bone marrow failure
• Fever of unknown origin
• Storage disease
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Indication cont…
Aspiration only
• Unexplained anemia, leukopenia, or
thrombocytopenia
• Monitoring during chemotherapy or following
stem cell transplantation
• Acute or chronic leukemia
CONTRAINDICATIONS
Relative
• Congenital factor deficiency or acquired
coagulation defect
• Anticoagulation with warfarin or heparin
• Severe thrombocytopenia
• Infection or prior radiation at sample site

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Contraindication con….
Absolute
• Hemophilia,
• DIC, or other related severe bleeding disorders
• Supected multiple myeloma & other disorders
resulting in bone resorption (Contraindications only
for sternal BM aspiration)
Equipment

• Sodium heparin, injection, 1000 USP units/mL,


preservative free.
• Bone marrow aspiration needles (15 and 18 gauge,
adjustable lengths).
• Bone marrow biopsy needles (11 and 13 gauge, 4 or
2 inches in length).
• Sterile syringes, 10 to 20 mL.
• Container with fixative for trephine biopsy
specimen.
• Vacutainers; one for sodium heparin and one
for ethylenediaminetetraacetic acid (EDTA).
• Gauze sponges.
• Bandages.
Complications
• Bleeding at any site, with or without
development of a hematoma
• Osteomyelitis
• Infection (rare)
• Needle breakage
• Other rare
transient neuropathy,
tumour seeding & others

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Intraosseos infusion
Is the process of injecting directly into the marrow
of a bone to provide a non collapsible entry point
into the systemic venous system.
• Used in emergency situations when
intravenous access is not available or not
feasible

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INDICATIONS
■ Emergent temporary vascular access during
cardiopulmonary
resuscitation or during the treatment of
uncompensated
shock when unable to insert an intravenous line.
■ Volume resuscitation.
■ Administration of blood and blood products.

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Indication cont…
■ Administration of fluids and electrolytes.
■ Administration of medications.
■ Infusion of inotropes and pressors.
■ Sampling of blood and bone marrow.
Contraindications
Absolute
■ Do not insert in a recently fractured bone.
■ Do not insert through an infected site.
■ Osteogenesis imperfecta.
■ Osteopetrosis.
Relative
■ Osteoporosis or osteopenia.
■ Cystic bones.

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Equipment

■ Intraosseous needle (18 or 20 gauge) or bone


marrow
aspiration needle.
■ Povidone, chlorhexidine, and alcohol wipes.
■ Gauze.
■ Tape.
■ Extension tubing.
■ T-connector.
■ Syringe.
■ Gloves
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Risks
■ Infection
Injury to growth plate.
■ Bone fracture.
■ Hematoma.
■ Extravasation.
■ Compartment syndrome.
■ Severe vasoconstriction if vasoactive substances
extravasate.

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