title: The effect of tubing dwell time on insulin adsorption during intravenous insulin infusions.
abstract: BACKGROUND
  Insulin adsorbs to plastic tubing, which decreases the concentration of an insulin solution delivered from an intravenous infusion set. Dwelling insulin within tubing before starting the infusion decreases adsorption but delays treatment initiation and wastes time in infusion preparation. The lack of data on dwell time effects results in wide variability in practice. We aim to determine the effect of dwell time on insulin concentration from intravenous infusion tubing.
  
  
  METHODS
  In this in vitro study, we used insulin solutions with concentrations of 0.1 unit/mL, 1 unit/mL, and 10 units/mL. Each solution dwelled in intravenous infusion sets for 0, 15, 30, or 60 min. After the dwell, we measured insulin concentrations from the solution bags and tubing. We repeated each insulin concentration-dwell time combination five times. Comparisons were performed using analyses of variance.
  
  
  RESULTS
  For each of the three insulin concentrations, the mean insulin concentrations from the tubing were not significantly different between dwell times. Duration of dwell time did not affect insulin adsorption in polypropylene intravenous infusion sets.
  
  
  CONCLUSIONS
  We recommend that following a 20-mL flush, insulin infusions can be started without any dwell time. Removal of dwell times may improve clinical practice by minimizing preparation time and will allow faster initiation of insulin infusion therapy.
authors: Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut 06520-8064, USA. cecilia.thompson@yale.edu
authors: Cecilia D
authors: CD
authors: Thompson
authors: Jessica
authors: J
authors: Vital-Carona
authors: E Vincent S
authors: EV
authors: Faustino
mesh_terms: D000327:Adsorption; D000704:Analysis of Variance; D001786:Blood Glucose / Q000187:drug effects*; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy*; D016503:Drug Delivery Systems / Q000295:instrumentation*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000493:pharmacokinetics; D066298:In Vitro Techniques; D007262:Infusions, Intravenous / Q000295:instrumentation; D007328:Insulin / Q000008:administration & dosage* / Q000493:pharmacokinetics*; D008297:Male; D011095:Polyethylenes / Q000737:chemistry*; D011143:Polyvinyl Chloride / Q000737:chemistry*; D012996:Solutions; D013997:Time Factors
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin; D011095:Polyethylenes; D012996:Solutions; D011143:Polyvinyl Chloride