Optimising insulin aspart practices in a neonatal intensive care unit: a clinical and pharmaco-technical study.
Glycation
Hyperglycaemia
Insulin aspart
Neonates
Stability
Journal
European journal of pediatrics
ISSN: 1432-1076
Titre abrégé: Eur J Pediatr
Pays: Germany
ID NLM: 7603873
Informations de publication
Date de publication:
Sep 2021
Sep 2021
Historique:
received:
01
02
2021
accepted:
21
03
2021
revised:
16
03
2021
pubmed:
19
4
2021
medline:
11
8
2021
entrez:
18
4
2021
Statut:
ppublish
Résumé
Neonatal hyperglycaemia is frequent and requires insulin therapy. To resolve the difficulties encountered by paediatricians in stabilising glycaemia, the preparation and administration of insulin aspart were assessed and optimised. After high-performance liquid chromatography (HPLC-UV) assessment of insulin aspart preparations made according to the old protocol, a new protocol was drawn up. Dosage reliability of solutions prepared by paediatric nurses was evaluated by HPLC-UV. This new protocol was also tested in a Y-infusion situation and the need to saturate infusion tubes assessed. Wide deviations in insulin aspart concentrations were found between theoretical concentrations and preparations made according to the old protocol. Glycated insulin aspart was found in the majority of these preparations. The new protocol significantly reduced the variability of data and relative deviations around the target value. It also eliminated the formation of glycated insulin even in the case of co-infusion of parenteral nutrition and confirmed the need to saturate infusion tubes.Conclusion: The revision of the insulin therapy protocol reduced the variability of insulin concentration in preparations and avoided the administration of glycated derivatives potentially toxic for neonates. What is Known: • Insulin preparation in NICUs is a risky task because it is a two-step preparation • Diluted in dextrose, insulin aspart is unstable, with formation of potentially toxic glycated derivatives What is New: • This work proposes a new insulin therapy protocol validated by HPLC-UV for NICU allowing suppression of the formation of glycated insulin, to significantly reduce deviations from theoretical concentrations and to limit adsorption phenomena • This protocol is validated in case of co-infusion of parenteral nutrition.
Identifiants
pubmed: 33866404
doi: 10.1007/s00431-021-04041-y
pii: 10.1007/s00431-021-04041-y
doi:
Substances chimiques
Blood Glucose
0
Hypoglycemic Agents
0
Insulin
0
Insulin Aspart
D933668QVX
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2985-2992Informations de copyright
© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
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