Insulin Adsorption To Parenteral Infusion Systems: Case Report and Review of the Literature

Seres, David S.

doi:10.1177/0115426590005003111

Cited by 11 publications

(6 citation statements)

References 36 publications

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“…Availability of insulin within the admixture may be variable depending on adsorption on to the plastic in the bag and/or tubing and giving set thereby limiting availability to the patient [109,110]. Earlier reports from 3 to 4 decades ago suggested approximately 50% loss of insulin from PN solutions by nonspecific binding to infusion material [111].…”

Section: Parenteral Nutrition Formulationmentioning

confidence: 99%

ESPEN guidelines on chronic intestinal failure in adults

et al. 2016

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CIF management requires complex technologies, multidisciplinary and multiprofessional activity, and expertise to care for both the underlying gastrointestinal disease and to provide HPN support. The rarity of the condition impairs the development of RCTs. As a consequence, most of the recommendations have a low or very low grade of evidence. However, two-thirds of the recommendations are considered strong. Specialized management and organization underpin these recommendations.

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Section: Parenteral Nutrition Formulationmentioning

confidence: 99%

ESPEN guidelines on chronic intestinal failure in adults

et al. 2016

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“…[19][20][21][22] This wide difference is most likely accounted for by the differing PN compositions, PN container material, assay methods, and type of insulin used in the analyses. 23 Yu et al, 22 for example, found insulin adsorption on the ethylene vinyl acetate-containing bag to be 62.7%, compared with 6.3% on the glass material.…”

Section: Insulin Availability In Pnmentioning

confidence: 99%

Addition of Insulin to Parenteral Nutrition for Control of Hyperglycemia

McCulloch

Bansiya

Woodward

2017

J Parenter Enteral Nutr

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Administration of parenteral nutrition (PN) may result in hyperglycemia in patients with preexisting diabetes or disease-related insulin resistance, and it can be associated with increased rates of complications. Treatment requires insulin therapy. Insulin can be administered subcutaneously, intravenously via a variable rate sliding scale, or by adding it directly to the PN. The last method is a potentially attractive technique for a number of reasons-it could deliver the insulin intravenously at a steady rate alongside carbohydrates, and in malnourished patients with little subcutaneous tissue, it may prevent the need for frequent insulin injections. Despite such potential advantages, the addition of insulin to PN remains controversial, largely with respect to the bioavailability of insulin in PN and resultant concerns of the risk of hypoglycemia. There is a paucity of long-term quality controlled studies to address this question. The available literature suggests that, at least in the short term, insulin addition to PN can achieve reasonable glycemic control with low rates of hypoglycemia, and the technique compares favorably with the use of long-acting insulin preparations. This literature review finds a wide range of values reported for insulin availability via PN, ranging from 44% to 95% depending on the type of PN container material used and the presence of added vitamins and trace elements. Few studies looking at glycemic control among patients receiving home PN were found, and larger prospective trials are needed to assess the efficacy and safety of this technique in this patient group.

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“…The solution within the container can also affect the extent of insulin adsorption. Sodium chloride 0.9% and dextrose have the greatest influence on absorption, and AAs and serum albumin, the least 43 . If insulin is required for the patient receiving HPN, it should be added immediately prior to the start of the infusion.…”

Section: Medicationsmentioning

confidence: 99%

“…Sodium chloride 0.9% and dextrose have the greatest influence on absorption, and AAs and serum albumin, the least. 43 If insulin is required for the patient receiving HPN, it should be added immediately prior to the start of the infusion. Histamine 2 -receptor antagonists, such as famotidine, ranitidine, and cimetidine, are used to decrease gastric acid secretions, particularly in patients with massive small bowel resection, or to prevent stress-induced ulceration.…”

Section: Medicationsmentioning

confidence: 99%

Overview of Home Parenteral Nutrition: An Update

et al. 2017

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The trend in modern medicine is to transition care from the hospital to home or other nonacute settings as soon as possible. Increasingly, nutrition support professionals are being asked to help facilitate discharge and/or manage patients who require prolonged intravenous fluid and/or nutrition after having been stabilized during a hospitalization. This updated tutorial reviews many of the concepts and challenges that must be considered for successful care that helps to focus on the patients and their quality of life.

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Insulin Adsorption To Parenteral Infusion Systems: Case Report and Review of the Literature

Cited by 11 publications

References 36 publications

ESPEN guidelines on chronic intestinal failure in adults

ESPEN guidelines on chronic intestinal failure in adults

Addition of Insulin to Parenteral Nutrition for Control of Hyperglycemia

Overview of Home Parenteral Nutrition: An Update

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