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Availability of insulin from continuous low-dose insulin infusions

1979; Oxford University Press; Volume: 36; Issue: 3 Linguagem: Inglês

10.1093/ajhp/36.3.330

1535-2900

Forrest J. Whalen, William K. LeCain, Clifton J. Latiolais,

Diabetes Management and Research

The effects of different i.v. solutions, containers, administration sets, insulin concentration and rate of infusion on the amount of insulin delivered during low-dose insulin infusion were studied. Intravenous solution containers were admixed with samples consisting of 1 μCi of 125I-labeled insulin arid 50 units of regular insulin. Samples of 0.5 ml were drawn from the end of each administration set at various times (0, 5 and 30 min and 1, 2, 4 and 8 hr) and radioactivity was measured. Variables studied included: (1) type of solution (0.9% sodium chloride, dextrose 5% in 0.45% sodium chloride, dextrose 5% in water, and lactated Ringer's); (2) type of container (glass and polyvinyl chloride); (3) type of administration set (four manufacturers, eight sets); (4) rate of infusion (83 ml, 125 ml and 250 ml/hr); (5) insulin concentration of admixture (25 unite, 50 units and 100 units/liter); and (6) mechanical and pump flow rate controls versus manual controls. Data were analyzed using a one-way analysis of variance. The amount of insulin delivered varied significantly with the type of solution and administration set used (p < 0.001). The Buretrol with Minidrip solution administration set delivered the lowest and dextrose 5% in water the highest cumulative amount of insulin over an eight-hour period. The mean percentage of insulin delivered varied significantly with collection time, the majority of insulin adsorption occurring during the first 30 minutes of the infusion. At the highest insulin concentrations, a higher percentage of total insulin delivery occurred. The total amount of insulin delivered was not significantly affected by flow rate (p > 0.36) but the infusion rate did affect the time it took to reach a plateau phase in insulin delivery. Insulin delivery was not significantly affected by the type of container used (p > 0.05), by a one-hour delay in administration of i.v. admixture solutions, or by flow control mechanism. Insulin availability from continuous low-dose insulin infusions can vary widely with the type of solution and administration set used and the insulin concentration of the admixture. Knowledge of the amount of insulin delivered by infusion systems can be critical to the proper dosing of insulin.