Insulin loss in parenteral nutrition systems

• Published in: Anaesthesia and intensive care 1976-11, Vol.4 (4), p.342-346
• Main Authors: Oh, T E, Dyer, H, Wall, B P, Hall, R A, Jellet, L B
• Format: Article
• Language: English
• Subjects: Adsorption; Glass; Glucose; Humans; Insulin; Parenteral Nutrition - instrumentation; Plastics; Serum Albumin; Solutions
• ISSN: 0310-057X; 1448-0271
• DOI: 10.1177/0310057x7600400417

This study investigated insulin adsorptive loss occurring in various infusion systems used in regimens of parenteral nutrition. The results suggested early and considerable insulin loss in dextrose infusion solutions with doses of insulin used clinically. Maximum percentage loss occurred within 30 seconds following administration of insulin to infusion bottles of 5% and 50% dextrose. Mean insulin loss over eight hours amounted to 47·6%± 2·0 s.e.m. in 5% dextrose and 34 · 8% ± 1· 5 s.e.m. in 50% dextrose. The combination of infusion bottle and infusion set further increased the mean insulin loss in 50% dextrose to 43 ·6%± 1·7 s.e.m. Percentage insulin loss in bottles of 5% dextrose decreased with increasing insulin concentration, however, insulin loss in 50% dextrose was unaffected by varying insulin concentration. The addition of human serum albumin (0·05% w/v) to 50% dextrose lessened insulin loss to a small but significant extent and mean insulin loss in solutions of Aminofusin 600 was only 14·0% ± 1·6 s.e.m. over 30 minutes. With a regimen of parenteral nutrition in any one patient, it would seem logical where possible to add insulin to one type of parenteral nutrition solution only, so that the variability of insulin adsorptive loss seen with different solutions may be minimized.