{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T22:03:13Z","timestamp":1791237793785,"version":"4.1.0"},"reference-count":15,"publisher":"American Academy of Pediatrics (AAP)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1998,12,1]]},"abstract":"<jats:sec><jats:title>Background.<\/jats:title><jats:p>A retrospective medical record review of 13 consecutive, hyperglycemic, extremely low birth weight (ELBW) infants treated with continuous insulin infusions revealed a 14- to 24-hour delay (mean, 19 hours) in blood glucose normalization despite stepwise increases in insulin infusion rates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective.<\/jats:title><jats:p>This in vitro study examined the effects of flow rate and insulin priming on insulin recovery from polyvinyl chloride (PVC) tubing and polyethylene (PE)-lined PVC tubing infused with a standard insulin stock solution.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods.<\/jats:title><jats:p>Stock insulin solution (0.2 U\/mL) was infused through microbore PVC or PE-lined tubing at flow rates of 0.05 and 0.2 mL\/h. To determine if saturation of nonspecific binding sites would alter effluent insulin concentration, we compared insulin recovery from tubing previously flushed with the stock solution and tubing primed with 5 U\/mL of insulin for 20 minutes. Effluent samples, which were collected at baseline and at six time points during a 24-hour period, were immediately frozen at \u221220\u00b0C. Insulin concentration was measured by IMx immunoassay. Data were analyzed using general linear modeling with repeated measures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results.<\/jats:title><jats:p>At 0.05 mL\/h flow rate, insulin recovery from unprimed PVC tubing at 1, 2, 4, and 8 hours was 17%, 11%, 27%, and 55%, respectively, with 100% recovery at 24 hours. From insulin-primed tubing, insulin recovery was \u223c70% at 1, 2, and 4 hours, and close to 100% at 8 hours. At a faster flow rate of 0.2 mL\/h, insulin recovery at 1, 2, 4, and 8 hours was 22%, 38%, 67%, and 75% vs 42%, 85%, 91% and 95% from unprimed and insulin-primed PVC tubing, respectively. Similar results were obtained from unprimed and insulin-primed PE-lined tubing at 0.2 mL\/h flow rate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions.<\/jats:title><jats:p>Priming of microbore tubing with 5 U\/mL of insulin solution for 20 minutes to block nonspecific binding sites enhances delivery of a standard insulin stock at infusion rates typically used to treat hyperglycemic ELBW infants. We conclude that priming the tubing with a higher concentration of insulin before initiation of standard insulin infusion therapy should accelerate achievement of steady-state insulin delivery and correction of hyperglycemia in ELBW infants.<\/jats:p><\/jats:sec>","DOI":"10.1542\/peds.102.6.1401","type":"journal-article","created":{"date-parts":[[2004,8,13]],"date-time":"2004-08-13T23:44:32Z","timestamp":1092440672000},"page":"1401-1406","source":"Crossref","is-referenced-by-count":46,"title":["Effect of Flow Rate and Insulin Priming on the Recovery of Insulin From Microbore Infusion Tubing"],"prefix":"10.1542","volume":"102","author":[{"given":"Mamta","family":"Fuloria","sequence":"first","affiliation":[{"name":"From the Department of Pediatrics and Brenner Center for Child and Adolescent Health, and the"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael A.","family":"Friedberg","sequence":"additional","affiliation":[{"name":"Department of Pathology, Wake Forest University School of Medicine, Winston-Salem, North Carolina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert H.","family":"DuRant","sequence":"additional","affiliation":[{"name":"From the Department of Pediatrics and Brenner Center for Child and Adolescent Health, and the"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judy L.","family":"Aschner","sequence":"additional","affiliation":[{"name":"From the Department of Pediatrics and Brenner Center for Child and Adolescent Health, and the"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[1998,12,1]]},"reference":[{"key":"2021121000335725000_B1","first-page":"783","article-title":"Risk factors for neonatal hyperglycemia associated with 10% dextrose infusion.","volume":"139","author":"Louik","year":"1985","journal-title":"Am J Dis Child"},{"key":"2021121000335725000_B2","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1542\/peds.53.2.189","article-title":"Glucose intolerance in infants of very low birth weight. I. Incidence of hyperglycemia in infants of birth weight 1100 grams or less.","volume":"53","author":"Dweck","year":"1974","journal-title":"Pediatrics"},{"key":"2021121000335725000_B3","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1542\/peds.61.4.546","article-title":"Glucose disposal in low-birth weight infants during steady-state hyperglycemia: effects of exogenous insulin administration.","volume":"61","author":"Pollak","year":"1978","journal-title":"Pediatrics"},{"key":"2021121000335725000_B4","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1097\/00005176-198201020-00010","article-title":"Continuous insulin infusion in hyperglycemic, very low birth weight infants.","volume":"1","author":"Vaucher","year":"1982","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"2021121000335725000_B5","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1542\/peds.78.4.625","article-title":"Insulin pump therapy in the very low birth weight infant.","volume":"78","author":"Ostertag","year":"1986","journal-title":"Pediatrics"},{"key":"2021121000335725000_B6","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1016\/S0022-3476(89)80797-8","article-title":"Insulin infusion with parenteral nutrition in extremely low birth weight infants with hyperglycemia.","volume":"114","author":"Binder","year":"1989","journal-title":"J Pediatr"},{"key":"2021121000335725000_B7","doi-asserted-by":"crossref","first-page":"921","DOI":"10.1016\/S0022-3476(05)82212-7","article-title":"A controlled trial of insulin infusion and parenteral nutrition in extremely low birth weight infants with glucose intolerance.","volume":"118","author":"Collins","year":"1991","journal-title":"J Pediatr"},{"key":"2021121000335725000_B8","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1097\/00000542-197404000-00018","article-title":"Insulin adsorption by glass infusion bottles, polyvinylchloride infusion containers, and intravenous tubing.","volume":"40","author":"Petty","year":"1974","journal-title":"Anesthesiology"},{"key":"2021121000335725000_B9","first-page":"583","article-title":"Clinical significance of insulin adsorption by polyvinyl chloride infusion systems.","volume":"34","author":"Hirsch","year":"1977","journal-title":"Am J Hosp Pharm"},{"key":"2021121000335725000_B10","first-page":"995","article-title":"Insulin adsorption to polyolefin infusion bottles and polyvinyl chloride administration sets.","volume":"38","author":"Hirsch","year":"1981","journal-title":"Am J Hosp Pharm"},{"key":"2021121000335725000_B11","first-page":"330","article-title":"Availability of insulin from continuous low-dose insulin infusions.","volume":"36","author":"Whalen","year":"1979","journal-title":"Am J Hosp Pharm"},{"key":"2021121000335725000_B12","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1136\/bmj.3.5981.464","article-title":"Carrier solutions for low-level intravenous insulin infusion.","volume":"3","author":"Kraegen","year":"1975","journal-title":"Br Med J"},{"key":"2021121000335725000_B13","first-page":"353","article-title":"Availability of insulin from parenteral nutrient solutions.","volume":"34","author":"Weber","year":"1977","journal-title":"Am J Hosp Pharm"},{"key":"2021121000335725000_B14","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1016\/S0022-3476(05)81382-4","article-title":"Continuous insulin infusions in neonates: pharmacologic availability of insulin in intravenous solutions.","volume":"124","author":"Simeon","year":"1994","journal-title":"J Pediatr"},{"key":"2021121000335725000_B15"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/102\/6\/1401\/890261\/1401.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/102\/6\/1401\/890261\/1401.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,18]],"date-time":"2024-12-18T07:32:48Z","timestamp":1734507168000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/102\/6\/1401\/62125\/Effect-of-Flow-Rate-and-Insulin-Priming-on-the"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1998,12,1]]},"references-count":15,"journal-issue":{"issue":"6","published-online":{"date-parts":[[1998,12,1]]},"published-print":{"date-parts":[[1998,12,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.102.6.1401","relation":{},"ISSN":["1098-4275","0031-4005"],"issn-type":[{"value":"1098-4275","type":"electronic"},{"value":"0031-4005","type":"print"}],"subject":[],"published":{"date-parts":[[1998,12,1]]}}}