Insulin Instability in Parenteral Nutrition Admixtures

JPEN. Journal of Parenteral and Enteral Nutrition
Maria Luisa ForchielliGermana Bersani

Abstract

Biosynthetic human recombinant short-acting insulin is added to parenteral nutrition (PN) admixtures to nourish glucose-intolerant patients. Insulin, however, is electrostatically attracted and inactivated by ethyl-vinyl-acetate (EVA) bags and filling system tubes. Our aim was to verify and quantify the presence of insulin in PN with and without intravenous lipid emulsion (ILE), just after addition (T0) until the infusion's end (T24). Four undiluted samples of 12 different PN complete admixtures (6 with ILE and 6 without), each containing 250 g of glucose in a 2000 mL volume, were taken and analyzed at T0 and T24 by an automated electrochemiluminescence immunoassay after the addition of biosynthetic human recombinant short-acting insulin at increasing doses (from 6 to 72 IU/bag) by an automated compounding device. Assay sensitivity was set at 2 μIU/mL. Admixtures with and without ILE were compared in terms of insulin-detected amounts at T0 and T24. Regardless of the amount initially provided, insulin was missing in PN without ILE. In admixtures with ILE, the greater the insulin and ILE doses initially included, the higher the insulin availability at T0 and T24, both in absolute terms and as a percentage of the initial amount (f...Continue Reading

References

May 1, 1990·JPEN. Journal of Parenteral and Enteral Nutrition·S P MarcuardJ F Caro
Sep 1, 1989·JPEN. Journal of Parenteral and Enteral Nutrition·G B DogliettoF Crucitti
Jan 8, 2004·Clinical Chemistry·William E Owen, William L Roberts
Jul 2, 2005·Journal of Pediatric Gastroenterology and Nutrition·Jean-Claude LavoieThérèse Rouleau
Jan 3, 2006·JPEN. Journal of Parenteral and Enteral Nutrition·Matthew A ChristiansonNorman Suzuki
Feb 3, 2007·Clinical Chemistry·Santica MarcovinaUNKNOWN Insulin Standardization Workgroup
Oct 16, 2012·Current Diabetes Reports·Aidar R Gosmanov, Guillermo E Umpierrez
Jan 1, 2016·Journal of Food and Drug Analysis·Kuo-Hua YuChung-Yu Chen

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Citations

Nov 10, 2018·JPEN. Journal of Parenteral and Enteral Nutrition·Krishnan Sriram, Renee Blaauw
Sep 27, 2019·Hospital Pharmacy·Roland N DickersonAnne M Tucker
Feb 16, 2021·Clinical Nutrition : Official Journal of the European Society of Parenteral and Enteral Nutrition·Mariah Sigala, Todd Canada
Apr 9, 2021·Nutrición hospitalaria·Francisco Martínez de la TorrePilar Gomis Muñoz

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