Insulin infusions in the neonatal unit: Delivery variation due to adsorption
Insulin infusions in the neonatal unit: Delivery variation due to adsorption
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DOI：
10.1046/j.1440-1754.2000.00488.x
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发表时间：
2000-06-01
影响因子：
1.7
通讯作者：
Simmer, K
中科院分区：
文献类型：
--
作者：
Hewson, MP;Nawadra, V;Simmer, K
目的：为了评估胰岛素输送随时间变化的程度，在澳大利亚新生儿单位使用的条件下，研究以下变量：稀释剂，预处理，冲洗，顺序预处理和冲洗，胰岛素浓度，流速，导管类型，并添加albumin.Methodology：一系列的模拟胰岛素输注进行了研究。输注持续22 h，在基线和15 min、30 min、1 h、2 h、6 h和22 h后采集输注液等分试样。结果：以1 mL/h的速度输注50 mU/mL胰岛素，22 h内胰岛素释放量可忽略不计。然而，在预处理和冲洗管路后，6小时内达到了一致的胰岛素输注。以1 mL/h输注200 mU胰岛素/mL，直到6 h才提供一致的输注。在此浓度和速率下，通过预处理和冲洗管路或向输注液中添加白蛋白，可在输注开始后30分钟内实现一致的胰岛素输注。除非采取应对措施，否则在新生儿环境中将发生静脉内胰岛素输送的临床显著变化，例如连续的预处理和输送系统的冲洗或向输注液中加入白蛋白。
Objective: To assess the extent of the variability in insulin delivery over time, under conditions used in Australian neonatal units, studying the following variables: diluent, preconditioning, flushing, sequential preconditioning and flushing, insulin concentration, flow rate, catheter type, and addition of albumin.Methodology: A range of simulated insulin infusions was studied. Infusions were run over 22 h, with aliquots of infusate collected at baseline and after 15 min, 30 min, 1 h, 2 h, 6 h and 22 h. Insulin concentration was assayed using a radioimmunoassay.Results: An infusion of 50 mU insulin/mL at 1 mL/h gave negligible insulin delivery until 22 h. However, after preconditioning and flushing the tubing, consistent insulin delivery was attained by 6 h. An infusion of 200 mU insulin/mL at 1 mL/h did not provide consistent delivery until 6 h. At this concentration and rate, consistent insulin delivery was attained within 30 min of the start of the infusion either by preconditioning and flushing the tubing, or by addition of albumin to the infusate.Conclusion: Clinically significant variation in intravenous insulin delivery will occur in the neonatal setting unless counter-measures are taken, such as sequential preconditioning and flushing of the delivery system or the addition of albumin to the infusate.