"Waste not, want not,": Determining the optimal priming volume for intravenous insulin infusions
"Waste not, want not,": Determining the optimal priming volume for intravenous insulin infusions
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DOI：
10.1089/dia.2006.8.598
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发表时间：
2006-10-01
影响因子：
5.4
通讯作者：
Inzucchi, Silvio E.
中科院分区：
文献类型：
--
作者：
Goldberg, Philip A.;Kedves, Alexia;Inzucchi, Silvio E.
背景：胰岛素吸附到用于静脉（IV）管路的塑料上。因此，临床IV胰岛素输注方案建议初始预充体积高达50 mL，这可能是浪费的-特别是因为大多数机构使用100 mL IV溶液袋。在这份简短的报告中，我们试图确定临床IV insulin infuses.Methods所需的最佳预充体积：将100单位的常规人胰岛素溶解于100 mL的0.9%NaCl中。使用标准聚丙烯输注管路，开始预充输注。以10 mL间隔（0 - 50 mL）将流出液直接收集至玻璃小瓶中。使用专利缓冲液稀释（1：10，000）后，然后使用双抗体放射免疫测定法测量胰岛素浓度。结果：未预充的胰岛素水平比50 mL预充后的胰岛素水平低15.8% [95%置信区间（CI），9.1-22.6%]（称为“最大值”）。预充体积为10 mL后，胰岛素吸附损失降至略显著的6.6%（95% CI，0.1-13.1%）。在20 mL预充后，胰岛素浓度与最大值（3.4%损失，95%CI，-0.2%至7.1%）没有区别。结论：对于标准IV胰岛素输注，20 mL的预充体积足以使IV管路的胰岛素吸附损失的影响最小化。预充量超过20 mL是浪费的，会增加成本，并为护士和药剂师带来不必要的工作。
Background: Insulin adsorbs to plastics used for intravenous (IV) tubing. As a result, clinical IV insulin infusion procotols advise an initial priming volume of up to 50 mL, which may be wasteful-especially since most institutions use 100-mL IV solution bags. In this brief report, we sought to determine the optimal priming volume required for clinical IV insulin infusions.Methods: One hundred units of regular human insulin was dissolved into 100 mL of 0.9% NaCl. Employing a standard polypropylene infusion set, a priming infusion was started. At 10-mL intervals, from 0 to 50 mL, effluent was collected directly into glass vials. After dilution (1:10,000) using a proprietary buffer, insulin concentrations were then measured using a double antibody radioimmunoassay. Twenty individually prepared insulin bags were tested in this manner.Results: Insulin levels without prime were 15.8% [95% confidence interval (CI), 9.1-22.6%] lower than insulin levels following 50 mL of prime (designated as "maximal values"). After a priming volume of 10 mL, insulin adsorption losses fell to a marginally significant 6.6% (95% Cl, 0.1-13.1%). Following 20 mL of prime, insulin concentrations were indistinguishable from maximal values (3.4% loss, 95% Cl, -0.2% to 7.1%).Conclusions: For standard IV insulin infusions, a priming volume of 20 mL is sufficient to minimize the effect of insulin adsorption losses to IV lines. Priming volumes exceeding 20 mL are wasteful, increase costs, and generate unnecessary work for nurses and pharmacists.