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Sample records for intravenous insulin infusion

  1. Determination of 24-hour insulin infusion pattern by an artificial endocrine pancreas for intravenous insulin infusion with a miniature pump

    DEFF Research Database (Denmark)

    Kølendorf, K; Christiansen, J S; Bojsen, J;

    1981-01-01

    UNLABELLED: Intravenous insulin infusion with a glucose controlled insulin infusion system (GCIIS) is known to restore glucose homeostasis. A simpler approach to improve blood glucose regulation is preprogrammed intravenous insulin infusion with portable pumps without sensor-mediated feedback. We...... report a study designed to evaluate whether the preprogrammed insulin infusion pattern to be used in the miniature insulin infusion pump (MIIP) could be optimized by concomitant employment of the GCIIS for blood glucose control. Six juvenile-onset insulin-dependent diabetics (mean age 31 yrs) were...... studied. Mean blood glucose (MBG) was 6.2 mmol/l +/- 0.5 (SD) during glucose controlled infusion and 5.3 +/- 0.6 during the combined MIIP + GCIIS-day. The insulin requirements calculated from the s.c. regimen (56 U +/- 10 SD) were identical to the GCIIS-measured (51 U +/- 14) and to the amounts delivered...

  2. The direct cost of intravenous insulin infusions to the NHS in England and Wales.

    Science.gov (United States)

    Rajendran, Rajesh; Scott, Anne; Rayman, Gerry

    2015-08-01

    The cost of intravenous insulin infusion to the NHS is unknown. The aim of this study was to estimate the direct cost of insulin infusions to the NHS in England and Wales in the first 24-hour period of infusion. Data from the National Inpatient Diabetes Audit 2013 in the UK were used to estimate the number of insulin infusions in use across England and Wales. Costs were calculated for six models for setting up and maintenance of insulin infusions, depending on the extent of involvement of different healthcare professionals in the UK. In this study, the direct costs of intravenous insulin infusions to the NHS in England and Wales have been estimated to vary from £6.4-8.5 million in the first 24-hour period on infusion. More appropriate use of these infusions could result in substantial cost savings.

  3. Induction of hyperlipidemia by intravenous infusion of tallow emulsion causes insulin resistance in Holstein cows.

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    Pires, J A A; Souza, A H; Grummer, R R

    2007-06-01

    The objective was to test whether the induction of elevated blood nonesterified fatty acids (NEFA) by i.v. infusion of a tallow emulsion altered glucose tolerance and responsiveness to insulin in Holstein cows. Six non-lactating, nongestating Holstein cows were assigned to a crossover design. One cow was excluded before initiation of the experiment because of complications from mastitis. Treatments consisted of 11-h i.v. infusions of saline (control) or a 20% (wt/vol) triacylglycerol (TG) emulsion derived from tallow (tallow) to elevate plasma NEFA. Each period consisted of two 11-h infusions (INF1 and INF2), separated by 1 d in which cows were not infused. Intravenous glucose tolerance tests (IVGTT) and insulin challenges (IC) were performed 8 h after initiation of INF1 and INF2, respectively. The infusion of treatments continued during the 3 h of sampling for IVGTT and IC. Cows were fed every 4 h at a rate to meet energy requirements for 5 d prior to each period, and every 2 h during the first 8 h of infusions. Infusion of tallow induced hyperlipidemia by increasing plasma NEFA (295 +/- 9 vs. 79 +/- 7 microEq/L), serum TG (41.0 +/- 6 vs. 11.4 +/- 4.4 mg/dL), and glycerol (0.81 +/- 0.09 vs. 0.23 +/- 0.1 mg/dL) concentrations during INF1. During INF2, tallow treatment increased plasma NEFA (347 vs. 139 +/- 18 microEq/L), serum TG (20.8 +/- 4.6 vs. 13.1 +/- 2.3 mg/dL), and glycerol (0.88 +/- 0.04 vs. 0.31 +/- 0.02 mg/dL) concentrations. Induction of hyperlipidemia impaired glucose clearance during IVGTT, despite the greater endogenous insulin response to the glucose infusion, leading to a lower insulin sensitivity index [0.29 vs. 1.88 +/- 0.31 x 10(-4) min(-1)/(microIU/mL)]. Accordingly, hyperlipidemia impaired glucose clearance during IC (1.58 vs. 2.72 %/min), reflecting lower responsiveness to insulin. These data show that induction of hyperlipidemia causes insulin resistance in Holstein cows by impairing both sensitivity and maximum responsiveness to insulin. The

  4. Effect of intravenous glucose infusion on renal function in normal man and in insulin-dependent diabetics

    DEFF Research Database (Denmark)

    Frandsen, M; Parving, H H; Christiansen, JS

    1981-01-01

    The effect of intravenous glucose infusion on glomerular filtration rate and renal plasma flow (constant infusion technique using 125I-iothalamate and 131I-hippuran) and on urinary excretion of albumin and beta-2-microglobulin were studied in ten normal subjects and seven metabolically well...... less than or equal to 0.02). Urinary albumin excretion remained unchanged in both normal subjects and diabetics. beta-2-microglobulin excretion rate increased significantly in the diabetics following glucose infusion, while no significant change was seen in the normal subjects. Our results show......-controlled insulin-dependent diabetics. Following glucose infusion in normal subjects (n = 10) blood glucose increased from 4.7 +/- 0.1 to 10.9 +/- 0.4 mmol/l (SEM) (p less than or equal to 0.01). Glomerular filtration rate increased from 116 +/- 2 to 123 +/- 3 ml/mi x 1.73 m2 (p less than or equal to 0.01), while...

  5. Stimulation of insulin secretion by intravenous bolus injection and continuous infusion of gastric inhibitory polypeptide in patients with type 2 diabetes and healthy control subjects

    DEFF Research Database (Denmark)

    Meier, Juris J; Gallwitz, Baptist; Kask, Bartholomaeus

    2004-01-01

    in both healthy subjects and patients with type 2 diabetes. Eight patients with type 2 diabetes and eight healthy subjects participated in a 240-min hyperglycemic clamp (140 mg/dl) with intravenous infusion of placebo, GIP at a low dose, and GIP at a high dose, each administered continuously over 60 min....... Boluses of placebo, 20 pmol GIP/kg, and 80 pmol GIP/kg were injected intravenously at 0, 60, and 120 min, respectively. Capillary and venous blood was drawn for glucose, insulin, C-peptide, and GIP. Plasma insulin and C-peptide concentrations were lower in patients than in control subjects during all...... infusion periods. GIP bolus administration evoked a significant increase in plasma insulin levels in both patients with type 2 diabetes and healthy subjects. In contrast, the continuous GIP infusion led to a weak increase in insulin secretion in both healthy subjects and type 2 diabetic patients. The dose...

  6. Effect of intravenous glucose infusion on renal function in normal man and in insulin-dependent diabetics

    DEFF Research Database (Denmark)

    Frandsen, M; Parving, H H; Christiansen, JS

    1981-01-01

    -controlled insulin-dependent diabetics. Following glucose infusion in normal subjects (n = 10) blood glucose increased from 4.7 +/- 0.1 to 10.9 +/- 0.4 mmol/l (SEM) (p less than or equal to 0.01). Glomerular filtration rate increased from 116 +/- 2 to 123 +/- 3 ml/mi x 1.73 m2 (p less than or equal to 0.01), while...... no change in renal plasma flow was seen - 552 +/- 11 versus 553 +/- 18 ml/min x 1.73 m2. Volume expansion with intravenous saline infusion in six of the normal subjects induced no changes in blood glucose or kidney function. In seven strictly controlled insulin-dependent diabetics, blood glucose values were...... raised from 4.6 +/- 0.4 to 16.0 +/- 0.6 mmol/l and clamped by means of an 'artificial beta cell'. Glomerular filtration rate increased in all patients, from 133 +/- 5 to 140 +/- 6 ml/min x 1.73 m2 (p less than or equal to 0.02), as did renal plasma flow from 576 +/- 26 to 623 +/- 38 ml/min x 1.73 m2 (p...

  7. Comparison of high-dose and low-dose insulin by continuous intravenous infusion in the treatment of diabetic ketoacidosis in children.

    Science.gov (United States)

    Burghen, G A; Etteldorf, J N; Fisher, J N; Kitabchi, A Q

    1980-01-01

    We studied the efficacy of low-dose (0.1 U/kg/h) and high-dose (1..0 U/kg/h) insulin, given randomly to children with diabetic ketoacidosis (DKA) by continuous intravenous infusion without a loading dose. Plasma glucose reached 250 mg/dl in 3.4 +/- 0.4 h with the high-dose insulin group compared with 5.4 +/- 0.5 h with the low-dose insulin group (P Hypokalemia (K insulin, with a slower rate of glucose decrease, is as effective as a high dose for the treatment of DKA in children with less incidence of hypokalemia and decreased potential for hypoglycemia.

  8. Pancreatic enzyme secretion during intravenous fat infusion.

    Science.gov (United States)

    Burns, G P; Stein, T A

    1987-01-01

    The nutritional support of patients with pancreatic and high gastrointestinal fistulas and severe pancreatitis frequently involves intravenous fat infusion. There are conflicting reports on the effect of intravenous fat on pancreatic exocrine secretion. In 10 dogs with chronic pancreatic fistulas, pancreatic juice was collected during secretin (n = 10) or secretin + cholecystokinin (n = 4) stimulation, with and without intravenous fat infusion (5 g/hr). The hormonal-stimulated secretion of lipase, amylase, trypsin, total protein, bicarbonate, and water was unchanged during fat infusion. This study supports the use of intravenous fat as a nutritional source when it is desirable to avoid stimulation of the pancreas.

  9. Reducing the risk of hypoglycemia associated with intravenous insulin: experience with a computerized insulin infusion program in 4 adult intensive care units.

    Science.gov (United States)

    Sandler, Victoria; Misiasz, Meaghan R; Jones, Jocelyn; Baldwin, David

    2014-09-01

    Computerized insulin infusion protocols have facilitated more effective blood glucose (BG) control in intensive care units (ICUs). This is particularly important in light of the risks associated with hypoglycemia. End stage renal disease (ESRD) increases the risk of insulin-induced hypoglycemia. We evaluated BG control in 210 patients in 2 medical ICUs and in 2 surgical ICUs who were treated with a computerized insulin infusion program (CIIP). Our CIIP was programmed for a BG target of 140-180 mg/dL for medical ICU patients or 120-160 mg/dL for surgical ICU patients. In addition, we focused on BG control in the 11% of our patients with ESRD. Mean BG was 147 ± 20 mg/dL for surgical ICU patients and 171 ± 26 mg/dL for medical ICU patients. Of both surgical and medical ICU patients, 17% had 1 or more BG 60-79 mg/dL, while 3% of surgical ICU and 8% of medical ICU patients had 1 or more BG < 60 mg/dL. Mean BG in ESRD patients was 147 ± 16 mg/dL similar to 152 ± 23 mg/dL in patients without ESRD. Of ESRD patients, 41% had 1 or more BG < 79 mg/dL as compared with 17.8% of non-ESRD patients (P < .01). A higher BG target for medical ICU patients as compared with surgical ICU patients yielded comparably low rates of moderate or severe hypoglycemia. However, hypoglycemia among ESRD patients was more common compared to non-ESRD patients, suggesting a need for a higher BG target specific to ESRD patients.

  10. Intraperitoneal insulin infusion: on the way to the artificial pancreas

    Directory of Open Access Journals (Sweden)

    Vladimir Aleksandrovich Karpel'ev

    2015-06-01

    Full Text Available Creating an "artificial pancreas" (a "closed loop" insulin pump, with self-adjusting insulin abilities, based on real time continuous glucose monitoring data – is one of the most actual medical challenges of modern engineering and cybernetics.Artificial pancreas (AP prototypes based on wearable insulin pump with subcutaneous insulin delivery are still problematic, mainly because of slow insulin pharmacokinetics. Intravenous insulin infusion via AP allows effectively maintain euglycaemia for inpatients, due to insulin pharmacokinetics and pharmacodynamics advantages. Unfortunately, it can’t be used for outpatients. Intraperitoneal insulin infusion is still relatively infrequently used in the world, but it is a promising alternative, compared to both previous methods due to a physiological action profile, fast insulin pharmacokinetics, relatively better safety and availability for outpatient usage.The purpose of this review is to describe the intraperitoneal insulin infusion features for diabetes patients at a point of AP creation perspectives. 

  11. Algorithms for intravenous insulin delivery.

    Science.gov (United States)

    Braithwaite, Susan S; Clement, Stephen

    2008-08-01

    This review aims to classify algorithms for intravenous insulin infusion according to design. Essential input data include the current blood glucose (BG(current)), the previous blood glucose (BG(previous)), the test time of BG(current) (test time(current)), the test time of BG(previous) (test time(previous)), and the previous insulin infusion rate (IR(previous)). Output data consist of the next insulin infusion rate (IR(next)) and next test time. The classification differentiates between "IR" and "MR" algorithm types, both defined as a rule for assigning an insulin infusion rate (IR), having a glycemic target. Both types are capable of assigning the IR for the next iteration of the algorithm (IR(next)) as an increasing function of BG(current), IR(previous), and rate-of-change of BG with respect to time, each treated as an independent variable. Algorithms of the IR type directly seek to define IR(next) as an incremental adjustment to IR(previous). At test time(current), under an IR algorithm the differences in values of IR(next) that might be assigned depending upon the value of BG(current) are not necessarily continuously dependent upon, proportionate to, or commensurate with either the IR(previous) or the rate-of-change of BG. Algorithms of the MR type create a family of IR functions of BG differing according to maintenance rate (MR), each being an iso-MR curve. The change of IR(next) with respect to BG(current) is a strictly increasing function of MR. At test time(current), algorithms of the MR type use IR(previous) and the rate-of-change of BG to define the MR, multiplier, or column assignment, which will be used for patient assignment to the right iso-MR curve and as precedent for IR(next). Bolus insulin therapy is especially effective when used in proportion to carbohydrate load to cover anticipated incremental transitory enteral or parenteral carbohydrate exposure. Specific distinguishing algorithm design features and choice of parameters may be important to

  12. Low-dose insulin infusions in diabetic patients with high insulin requirements.

    Science.gov (United States)

    Dandona, P; Foster, M; Healey, F; Greenbury, E; Beckett, A G

    1978-08-01

    Six patients with high insulin requirements (range 120-3000 units daily) have been infused with much smaller doses (range 50-63 units daily) of insulin intravenously. All six maintained adequate glucose homoestasis on this regimen. It is suggested that subcutaneous tissue at the site of injection may alter insulin or impair its absorption. Insulin resistance in some patients may be due to these mechanisms.

  13. Intravenous infusions in chronic pain management.

    Science.gov (United States)

    Kosharskyy, Boleslav; Almonte, Wilson; Shaparin, Naum; Pappagallo, Marco; Smith, Howard

    2013-01-01

    In the United States, millions of Americans are affected by chronic pain, which adds heavily to national rates of morbidity, mortality, and disability, with an ever-increasing prevalence. According to a 2011 report titled Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research by the Institute of Medicine of the National Academies, pain not only exacts its toll on people's lives but also on the economy with an estimated annual economic cost of at least $560 - 635 billion in health care costs and the cost of lost productivity attributed to chronic pain. Intravenous infusions of certain pharmacologic agents have been known to provide substantial pain relief in patients with various chronic painful conditions. Some of these infusions are better, and although not necessarily the first therapeutic choice, have been widely used and extensively studied. The others show promise, however are in need of further investigations. This article will focus on non-opiate intravenous infusions that have been utilized for chronic painful disorders such as fibromyalgia, neuropathic pain, phantom limb pain, post-herpetic neuralgia, complex regional pain syndromes (CRPS), diabetic neuropathy, and central pain related to stroke or spinal cord injuries. The management of patients with chronic pain conditions is challenging and continues to evolve as new treatment modalities are explored and tested. The following intravenous infusions used to treat the aforementioned chronic pain conditions will be reviewed: lidocaine, ketamine, phentolamine, dexmedetomidine, and bisphosphonates. This overview is intended to familiarize the practitioner with the variety of infusions for patients with chronic pain. It will not, however, be able to provide guidelines for their use due to the lack of sufficient evidence.

  14. Smart syringe pumps for drug infusion during dental intravenous sedation.

    Science.gov (United States)

    Seo, Kwang-Suk; Lee, Kiyoung

    2016-09-01

    Dentists often sedate patients in order to reduce their dental phobia and stress during dental treatment. Sedatives are administered through various routes such as oral, inhalation, and intravenous routes. Intravenous administration has the advantage of rapid onset of action, predictable duration of action, and easy titration. Typically, midazolam, propofol or dexmedetomidine are used as intravenous sedatives. Administration of these sedatives via infusion by using a syringe pump is more effective and successful than infusing them as a bolus. However, during intravenous infusion of sedatives or opioids using a syringe pump, fatal accidents may occur due to the clinician's carelessness. To prevent such risks, smart syringe pumps have been introduced clinically. They allow clinicians to perform effective sedation by using a computer to control the dose of the drug being infused. To ensure patient safety, various alarm features along with a drug library, which provides drug information and prevents excessive infusion by limiting the dose, have been added to smart pumps. In addition, programmed infusion systems and target-controlled infusion systems have also been developed to enable effective administration of sedatives. Patient-controlled infusion, which allows a patient to control his/her level of sedation through self-infusion, has also been developed. Safer and more successful sedation may be achieved by fully utilizing these new features of the smart pump.

  15. Assessment of implantable infusion pumps for continuous infusion of human insulin in rats: potential for group housing

    DEFF Research Database (Denmark)

    Jensen, Vivi Flou Hjorth; Molck, Anne-Marie; Martensson, Martin

    2017-01-01

    compound in these studies, and a comparator model of persistent exposure by HI infusion from external pumps has recently been developed to support toxicological evaluation of long-acting insulin analogues. However, this model requires single housing of the animals. Developing an insulin-infusion model......Group housing is considered to be important for rats, which are highly sociable animals. Single housing may impact behaviour and levels of circulating stress hormones. Rats are typically used in the toxicological evaluation of insulin analogues. Human insulin (HI) is frequently used as a reference...... which allows group housing would therefore greatly improve animal welfare. The aim of the present study was to investigate the suitability of implantable infusion pumps for HI infusion in group-housed rats. Group housing of rats implanted with a battery-driven pump proved to be possible. Intravenous...

  16. Conventional insulin vs insulin infusion therapy in acute coronary syndrome diabetic patients

    Institute of Scientific and Technical Information of China (English)

    Caterina; Arvia; Valeria; Siciliano; Kyriazoula; Chatzianagnostou; Gillian; Laws; Alfredo; Quinones; Galvan; Chiara; Mammini; Sergio; Berti; Sabrina; Molinaro; Giorgio; Iervasi

    2014-01-01

    AIM:To evaluate the impact on glucose variability(GLUCV)of an nurse-implemented insulin infusion protocol when compared with a conventional insulin treatment during the day-to-day clinical activity.METHODS:We enrolled 44 type 2 diabetic patients(n=32 males;n=12 females)with acute coronary syndrome(ACS)and randomy assigned to standard a subcutaneous insulin treatment(n=23)or a nurse-implemented continuous intravenous insulin infusion protocol(n=21).We utilized some parameters of GLUCV representing well-known surrogate markers of prognosis,i.e.,glucose standard deviation(SD),the mean dailyδglucose(mean of daily difference between maximum and minimum glucose),and the coefficient of variation(CV)of glucose,expressed as percent glucose(SD)/glu-cose(mean).RESULTS:At the admission,first fasting blood glucose,pharmacological treatments(insulin and/or anti-diabetic drugs)prior to entering the study and basal glycated hemoglobin(HbA1c)were observed in the two groups treated with subcutaneous or intravenous insulin infusion,respectively.When compared with patients submitted to standard therapy,insulin-infused patients showed both increased first 24-h(median 6.9 mmol/L vs 5.7mmol/L P<0.045)and overall hospitalizationδglucose(median 10.9 mmol/L vs 9.3 mmol/L,P<0.028),with a tendency to a significant increase in first 24-h glycaemic CV(23.1%vs 19.6%,P<0.053).Severe hypoglycaemia was rare(14.3%),and it was observed only in 3 patients receiving insulin infusion therapy.HbA1c values measured during hospitalization and 3 mo after discharge did not differ in the two groups of treatment.CONCLUSION:Our pilot data suggest that no real benefit in terms of GLUCV is observed when routinely managing blood glucose by insulin infusion therapy in type 2 diabetic ACS hospitalized patients in respect to conventional insulin treatment

  17. Insulin delivery route for the artificial pancreas: subcutaneous, intraperitoneal, or intravenous? Pros and cons.

    Science.gov (United States)

    Renard, Eric

    2008-07-01

    Insulin delivery is a crucial component of a closed-loop system aiming at the development of an artificial pancreas. The intravenous route, which has been used in the bedside artificial pancreas model for 30 years, has clear advantages in terms of pharmacokinetics and pharmacodynamics, but cannot be used in any ambulatory system so far. Subcutaneous (SC) insulin infusion benefits from the broad expansion of insulin pump therapy that promoted the availability of constantly improving technology and fast-acting insulin analog use. However, persistent delays of insulin absorption and action, variability and shortterm stability of insulin infusion from SC-inserted catheters generate effectiveness and safety issues in view of an ambulatory, automated, glucose-controlled, artificial beta cell. Intraperitoneal insulin delivery, although still marginally used in diabetes care, may offer an interesting alternative because of its more-physiological plasma insulin profiles and sustained stability and reliability of insulin delivery.

  18. Treatment of Severe Hypertriglyceridemia with Continuous Insulin Infusion

    Directory of Open Access Journals (Sweden)

    Yesica Rodríguez Santana

    2011-01-01

    Full Text Available Severe hypertriglyceridemia (SH represents a therapeutic emergency because of the possibility of developing cardiovascular events and hyperlipemic acute pancreatitis (PA. Most patients with SH suffer primary or genetic abnormality in lipid metabolism in combination with a precipitating factor such as uncontrolled diabetes mellitus, alcoholism, and drug intake. The standard treatment of hypertriglyceridemia (HTG with omega 3 fatty acids and fibrates, along with dietary changes, has no effect on an emergency situation. There are no clinical guidelines to SH, but therapy with insulin, heparin, a combination of both, plasmapheresis, or octreotide have been tested succesfully. We report the case of a 10-year-old girl with clinical acute pancreatitis and diabetic ketoacidosis debut, along with incidental finding of an SH, who had a good outcome after treatment with insulin intravenous infusion.

  19. Enzymuria in neonates receiving continuous intravenous infusion of gentamicin

    DEFF Research Database (Denmark)

    Colding, H; Brygge, K; Brendstrup, L;

    1992-01-01

    with non-treatment periods in the same newborn infant (33 infants). The same tendency applied to AAP. Newborn infants receiving continuous intravenous infusion of gentamicin were not found to be at greater risk of nephrotoxicity than those receiving intermittent gentamicin treatment, using NAG and AAP...

  20. Microcosting Study of Rituximab Subcutaneous Injection Versus Intravenous Infusion.

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    Mihajlović, Jovan; Bax, Pieter; van Breugel, Erwin; Blommestein, Hedwig M; Hoogendoorn, Mels; Hospes, Wobbe; Postma, Maarten J

    2017-06-01

    The goal of this study is to identify and compare all direct costs of intravenous and subcutaneous rituximab given to patients with diffuse large B-cell lymphoma in the Netherlands. Using a prospective, observational, bottom-up microcosting study, we collected primary data on the direct medical costs of the preparation, administration, and acquisition of rituximab. Drug costs and costs of drug wastage, labor costs, material costs, and outpatient costs were identified using standardized forms, structured using prices from official pricelists, and compared for the intravenous and subcutaneous forms of rituximab. Measurements were taken on 53 rituximab administrations (33 intravenous and 20 subcutaneous) and on 13 rituximab preparation (7 intravenous and 6 subcutaneous). The mean total costs were €2176.77 for the intravenous infusion and €1911.09 for the subcutaneous injection. The estimated difference of €265.17 (95% CI, €231.99-`€298.35) per administration was mainly attributable to differences in time spent in the chemotherapy unit, related outpatient costs, drug wastage, and drug costs. Rituximab administered in the form of subcutaneous injection is less costly than its intravenous form. With their equal effectiveness taken into account, subcutaneous rituximab administration can result in significant savings when transferred to the total diffuse large B-cell lymphoma population in the Netherlands. Copyright © 2017 Elsevier HS Journals, Inc. All rights reserved.

  1. Effect of perioperative insulin infusion on surgical morbidity and mortality

    DEFF Research Database (Denmark)

    Gandhi, Gunjan Y; Murad, M Hassan; Flynn, Errol David;

    2008-01-01

    To conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the effect of perioperative insulin infusion on outcomes important to patients.......To conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the effect of perioperative insulin infusion on outcomes important to patients....

  2. Effect of Insulin Infusion on Liver Protein Synthesis during Hemodialysis

    DEFF Research Database (Denmark)

    Reinhard, Mark; Frystyk, Jan; Jespersen, Bente

    2011-01-01

    Background Hemodialysis (HD) is a catabolic procedure that may contribute to the high frequency of protein-energy wasting among patients receiving maintenance HD. The present study investigated the additional effect of glucose and glucose-insulin infusion on liver protein synthesis during HD...... compared with a meal alone. Methods In a randomized cross-over study with three arms, 11 non-diabetic HD patients were assigned to receive a conventional HD session with either: • no treatment (NT) • IV infusion of glucose (G) • IV infusion of glucose-insulin (GI) During infusions blood glucose levels were...... maintained at 8.0-10.0 mmol/L by additional glucose infusion. Glucose and glucose-insulin infusions were commenced 2 h prior to HD and continued throughout the HD session. Fasting blood samples were collected at baseline before infusion and followed by the only meal allowed during the study. Results Blood...

  3. Asthma induced by intravenous infusion of regular insulin and potassium chloride%静脉滴注正规胰岛素及氯化钾诱发哮喘

    Institute of Scientific and Technical Information of China (English)

    张佳丽; 于晓佳

    2011-01-01

    1例62岁男性2型糖尿病患者为控制血糖给予正规胰岛素10 u+15%氯化钾5 ml溶于500 ml葡萄糖氯化钠注射液静脉滴注.输注20 min后患者诉胸闷、气短,伴大汗,两肺可闻及散在喘鸣音.立即停止静脉输液,给予吸氧及硫酸沙丁胺醇雾化吸入.血气分析检查:氧分压73 mm Hg(1 mm Hg=0.133 kPa),二氧化碳分压41 mm Hg.停止输液后约80 min,患者喘憋症状明显好转,可平卧入睡.第2天晨起患者喘憋症状消失.改为重组人胰岛素及精蛋白锌重组人胰岛素皮下注射控制血糖.之后,未再出现上述症状.%A 62-year-old man with type 2 diabetes mellitus was administered an Ⅳ infusion of regular insulin 10 U and 15% potassium chlonde 5 ml dissolved in glucose saline 500 ml to control blood glucose. After 20 minutes of infusion , the patient developed chest distress, short breath, polyhidrosis, and diffuse wheezes in bilateral lungs. The infusion was discontinued immediately and he received oxygen inhalation and aerosol inhalation of salbutamol sulfate. Blood gas analysis revealed a PO2 level of 73 mm Hg and a PCO2 level of 41 mm Hg. About 80 minutes after infusion completion, his asthmatic symptoms improved markedly and he could sleep in the supine position. The next morning, his asthmatic symptoms subsided. His treatment was switched to subcutaneous administration of recombinant human regular insulin and protamine zinc recombinant human insulin to control blood glucose. Subsequently, the abovementioned symptoms did not recur.

  4. Treatment of Diabetic Ketoacidosis With Intravenous U-500 Insulin in a Patient With Rabson-Mendenhall Syndrome: A Case Report.

    Science.gov (United States)

    Moore, Megan M; Bailey, Abby M; Flannery, Alexander H; Baum, Regan A

    2017-08-01

    Rabson-Mendenhall syndrome is a rare genetic disorder resulting from mutations in the insulin receptor and is associated with high degrees of insulin resistance. These patients are prone to complications secondary to their hyperglycemia including diabetic ketoacidosis (DKA). We report the case of a 19-year-old male with Rabson-Mendenhall syndrome presenting with DKA who required doses of up to 500 U/h (10.6 U/kg/h) of insulin. The patient's insulin infusion was originally compounded with U-100 regular insulin, although to minimize volume, the product was compounded with U-500 insulin. The DKA eventually resolved requiring infusion rates ranging from 400 to 500 U/h. Although numerous opportunities for medication errors exist with the use of U-500 insulin, this case outlines the safe use of concentrated intravenous insulin when clinically indicated for patients requiring extremely high doses of insulin to control blood glucose.

  5. Suicide by injecting lispro insulin with an intravenous cannula.

    Science.gov (United States)

    Behera, C; Swain, Rajanikanta; Mridha, Asit Ranjan; Pooniya, Shashank

    2015-09-01

    Suicide by injecting insulin is not uncommon both in diabetic and non-diabetic people. The victim usually uses an insulin syringe or a traditional syringe attached to a needle for the injection of insulin, of either animal or synthetic origin. We report a case of suicide by a non-diabetic physician by injecting lispro insulin through an intravenous cannula. To the best of our knowledge, the use of an intravenous cannula for the injection of insulin for suicide is unusual and is rarely reported in the medico-legal literature.

  6. Effect of glucagon infusion on plasma magnesium, glucose, and insulin in bull calves

    Energy Technology Data Exchange (ETDEWEB)

    Madsen, F.C.; Lentz, D.E.; Miller, J.K.; Hansard, S.L.

    1976-09-01

    Two Holstein bull calves each were infused intravenously with 1 mg glucagon in .9% sodium chloride, and two were given saline alone; 1 wk later treatments were reversed. Glucagon increased concentrations of insulin and glucose but decreased potassium in blood plasma and moderately increased urinary magnesium and calcium losses. When only saline was used, there was no effect. A hypothesis relating elevated glucagon to grass tetany is proposed.

  7. Continuous intravenous perioperative lidocaine infusion for postoperative pain and recovery.

    Science.gov (United States)

    Kranke, Peter; Jokinen, Johanna; Pace, Nathan Leon; Schnabel, Alexander; Hollmann, Markus W; Hahnenkamp, Klaus; Eberhart, Leopold H J; Poepping, Daniel M; Weibel, Stephanie

    2015-07-16

    The management of postoperative pain and recovery is still unsatisfactory in clinical practice. Opioids used for postoperative analgesia are frequently associated with adverse effects including nausea and constipation. These adverse effects prevent smooth postoperative recovery. On the other hand not all patients may be suited to, and take benefit from, epidural analgesia used to enhance postoperative recovery. The non-opioid lidocaine was investigated in several studies for its use in multi-modal management strategies to reduce postoperative pain and enhance recovery. The aim of this review was to assess the effects (benefits and risks) of perioperative intravenous lidocaine infusion compared to placebo/no treatment or compared to epidural analgesia on postoperative pain and recovery in adults undergoing various surgical procedures. We searched the Cochrane Central Register of Controlled Trials (CENTRAL, Issue 5 2014), MEDLINE (January 1966 to May 2014), EMBASE (1980 to May 2014), CINAHL (1982 to May 2014), and reference lists of articles. We searched the trial registry database ClinicalTrials.gov, contacted researchers in the field, and handsearched journals and congress proceedings. We did not apply any language restrictions. We included randomized controlled trials comparing the effect of continuous perioperative intravenous lidocaine infusion either with placebo, or no treatment, or with epidural analgesia in adults undergoing elective or urgent surgery under general anaesthesia. The intravenous lidocaine infusion must have been started intraoperatively prior to incision and continued at least until the end of surgery. Trial quality was independently assessed by two authors according to the methodological procedures specified by the Cochrane Collaboration. Data were extracted by two independent authors. We collected trial data on postoperative pain, recovery of gastrointestinal function, length of hospital stay, postoperative nausea and vomiting (PONV), opioid

  8. Tumour necrosis factor-alpha infusion produced insulin resistance but no change in the incretin effect in healthy volunteers.

    Science.gov (United States)

    Nielsen, Signe Tellerup; Lehrskov-Schmidt, Louise; Krogh-Madsen, Rikke; Solomon, Thomas P J; Lehrskov-Schmidt, Lars; Holst, Jens Juul; Møller, Kirsten

    2013-11-01

    Type 2 diabetes mellitus (T2DM) is associated with peripheral insulin resistance, impaired incretin effect, and increased plasma levels of tumour necrosis factor-alpha (TNF-α). Although TNF-α infusion at a dose that induces systemic inflammation in healthy volunteers has been demonstrated to induce peripheral insulin resistance, the influence of this cytokine on the incretin effect is unknown. We investigated whether systemic inflammation induced by TNF-α infusion in healthy volunteers alters the incretin hormone response to oral and intravenous glucose loads in a crossover study design with ten healthy male volunteers (mean age 24 years, mean body mass index 23.7 kg/m(2) ). The study consisted of four study days: days 1 and 2, 6-h infusion of saline; days 3 and 4, 6-h infusion of TNF-α; days 1 and 3, 4-h oral glucose tolerance test; and days 2 and 4, 4-h corresponding intravenous isoglycaemic glucose tolerance test. Glucose tolerance tests were initiated after 2 h of saline/TNF-α infusion. Plasma concentrations of TNF-α, interleukin 6, glucose, incretin hormones, and cortisol, and serum concentrations of C-peptide and insulin were measured throughout the study days. Insulin sensitivity was estimated by the Matsuda index and homeostasis model assessment of insulin resistance (HOMA-IR). Prehepatic insulin secretion rates were calculated. TNF-α infusion induced symptoms of systemic inflammation; increased plasma levels of cortisol, TNF-α, and interleukin 6; and increased the HOMA-IR. The secretion of incretin hormones as well as the incretin effect remained unchanged. In healthy young male volunteers, acute systemic inflammation induced by infusion of TNF-α is associated with insulin resistance with no change in the incretin effect. Copyright © 2013 John Wiley & Sons, Ltd.

  9. Effect of flow rate and insulin priming on the recovery of insulin from microbore infusion tubing.

    Science.gov (United States)

    Fuloria, M; Friedberg, M A; DuRant, R H; Aschner, J L

    1998-12-01

    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. 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. 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 -20 degreesC. Insulin concentration was measured by IMx immunoassay. Data were analyzed using general linear modeling with repeated measures. 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 approximately 70% 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. 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

  10. Intravenous lidocaine infusion--a new treatment of chronic painful diabetic neuropathy?

    DEFF Research Database (Denmark)

    Kastrup, J; Petersen, P; Dejgård, A

    1987-01-01

    In a randomized double-blind, cross-over study the effect of intravenous lidocaine (5 mg/kg body weight) on the symptoms and signs of painful diabetic neuropathy of more than 6 months duration has been evaluated. Using a clinical symptom scale, there was significant beneficial effect 1 and 8 days...... alternative treatment of chronic painful diabetic neuropathy....... after lidocaine infusion compared to after saline infusion (P less than 0.05 and P less than 0.02, respectively). The duration of the individual effect ranged from 3 to 21 days. Lidocaine infusion had no effect on the objective measurements of neuropathy. Intravenous lidocaine infusion seems to be a new...

  11. Metabolic response of normal man and insulin-infused diabetics to postprandial exercise.

    Science.gov (United States)

    Nelson, J D; Poussier, P; Marliss, E B; Albisser, A M; Zinman, B

    1982-05-01

    Physical exercise is often performed during absorption of meals. We have characterized the metabolic response to 45 min of moderate exercise (approximately 55% of estimated maximal oxygen uptake) beginning 30 min after breakfast in seven healthy controls. Nine insulin-dependent diabetes were studied in an identical manner, with glycemia controlled by a closed-loop "artificial endocrine pancreas" controlled by a closed-loop "artificial endocrine pancreas" (AEP). Responses were compared to those during breakfast without exercise. In the controls, onset of exercise rapidly reversed the rise in both glycemia and insulin (IRI) that occurred with breakfast alone, both returning to fasting levels (glycemia, 80 +/- 3 mg/dl; IRI, 0.38 +/- 0.10 ng/ml). After exercise, small and transient increments occurred (glycemia, 33 +/- 6 mg/dl; IRI, 0.81 +/- 0.15 ng/ml). In the diabetics, prior overnight intravenous insulin normalized fasting glycemia (98 +/- 4 mg/dl), and its postbreakfast excursion was identical to that of controls, as were those of most measured substrates. Similarly, with exercise, glycemia returned rapidly to fasting levels, accompanied by an appropriate decrease in insulin infusion rates. "Free" IRI levels mirrored changes in infusion rates by the AEP, with a decrease in insulin requirement of 30% during exercise as compared to breakfast alone (P less than 0.05). Thus, in both diabetics treated with the AEP and in normals, the responses to postprandial exercise required rapid modulation of insulin delivery. To demonstrate the effect of postprandial exercise on preprogrammed open-loop insulin replacement, four diabetic subjects were studied during breakfast with and without exercise while receiving a fixed open-loop insulin infusion pattern (6.1 +/- 0.7 U over 140 +/- 8 min). The glycemic response to breakfast alone was entirely normalized. However, symptomatic hypoglycemia occurred in all subjects when exercise was initiated 30 min after breakfast. The diabetic

  12. Effect of Insulin Infusion on Liver Protein Synthesis during Hemodialysis

    DEFF Research Database (Denmark)

    Reinhard, Mark; Frystyk, Jan; Jespersen, Bente;

    2011-01-01

    Background Hemodialysis (HD) is a catabolic procedure that may contribute to the high frequency of protein-energy wasting among patients receiving maintenance HD. The present study investigated the additional effect of glucose and glucose-insulin infusion on liver protein synthesis during HD...

  13. Continuous intraperitoneal insulin infusion in patients with 'brittle' diabetes

    DEFF Research Database (Denmark)

    DeVries, J H; Eskes, S A; Snoek, Frank J

    2002-01-01

    AIMS: To evaluate the effects of continuous intraperitoneal insulin infusion (CIPII) using implantable pumps on glycaemic control and duration of hospital stay in poorly controlled 'brittle' Dutch diabetes patients, and to assess their current quality of life. METHODS: Thirty-three patients were...

  14. Intravenous paracetamol infusion versus intramuscular tramadol as an intra-partum labor analgesic

    OpenAIRE

    Rashmi Patil; Vivek Rayadurg

    2016-01-01

    We read with interest the article and ldquo;Intravenous paracetamol infusion versus intramuscular tramadol as an intra-partum labor analgesic and rdquo; by Mohan H et al published in November - December 2015, volume 4 issue 6 of International Journal of Reproduction, Contraception, Obstetrics and Gynecology.1 As we read it, we realized that the article is quite similar to another article and ldquo;Intravenous paracetamol infusion versus intramuscular tramadol as an intra-partum labor analge...

  15. Population pharmacokinetics of buprenorphine following a two-stage intravenous infusion in healthy volunteers

    DEFF Research Database (Denmark)

    Jensen, Mette Lykke; Foster, David J.R.; Upton, Richard N.;

    2007-01-01

    The aim of this investigation was to characterize the pharmacokinetics of buprenorphine following administration of an intravenous (i.v.) infusion. To date, the population kinetics of buprenorphine has been described for bolus administration only.......The aim of this investigation was to characterize the pharmacokinetics of buprenorphine following administration of an intravenous (i.v.) infusion. To date, the population kinetics of buprenorphine has been described for bolus administration only....

  16. Higher Endogenous Glucose Production during OGTT vs Isoglycemic Intravenous Glucose Infusion

    DEFF Research Database (Denmark)

    Lund, Asger; Bagger, Jonatan I; Christensen, Mikkel Bring

    2016-01-01

    CONTEXT: Oral glucose ingestion elicits a larger insulin response and delayed suppression of glucagon compared to isoglycemic intravenous (iv) glucose infusion (IIGI). OBJECTIVE: We studied whether these differences translate into effects on endogenous glucose production (EGP) and glucose disposal......); HbA1c 53.8 ± 11.0 mmol/mol; duration of diabetes 9.2 ± 5.0 years) and 10 matched non-diabetic control subjects (age 56.0±10.7 years; BMI 29.8 ± 2.9 kg/m(2); HbA1c 33.8 ± 5.5 mmol/mol) Interventions: Three experimental days: 75 g-oral glucose tolerance test (OGTT), IIGI and IIGI+glucagon (IIGI...... with a concomitant iv glucagon infusion (0.8 ng/kg/min from 0 to 25 min) designed to mimic portal glucagon concentrations during OGTT in the type 2 diabetic group). MAIN OUTCOME MEASURES: Glucose kinetics assessed by the double-tracer technique. RESULTS: Glucose rate of disappearance was higher during the OGTT vs...

  17. Comparison of Insulin Pump Therapy (Continuous Subcutaneous Insulin Infusion) to Alternative Methods for Perioperative Glycemic Management in Patients with Planned Postoperative Admissions

    Science.gov (United States)

    Corney, Sarah M.; Dukatz, Tamra; Rosenblatt, Solomon; Harrison, Barbara; Murray, Robert; Sakharova, Alla; Balasubramaniam, Mamtha

    2012-01-01

    Background Patients with diabetes who use insulin pumps [continuous subcutaneous insulin infusion (CSII)] undergo surgeries that require postoperative hospital admission. There are no defined guidelines for CSII perioperative use. Methods This retrospective single-institution study identified type 1 and type 2 diabetes subjects by electronically searching 2005–2010 anesthesia preoperative assessments for “pump.” Surgical cases (n = 92) were grouped according to intraoperative insulin delivery method: (a) CSII continuation of basal rate with/without correctional insulin bolus(es) (n = 53); (b) conversion to intravenous insulin infusion (n = 20); and (c) CSII suspension with/without correctional insulin bolus(es) (n = 19). These groups were compared on mean intraoperative blood glucose (BG) and category of most extreme intraoperative BG. Results Differences were found on baseline characteristics of diabetes duration (p = .010), anesthesia time (p = .011), proportions receiving general anesthesia (p = .013), and preoperative BG (p = .033). The conversion group had the longest diabetes duration and anesthesia time; it had a higher proportion of general anesthesia recipients and a higher mean preoperative BG than the continuation group. There was no significant difference in mean BG/surgical case between continuation (163.5 ± 58.5 mg/dl), conversion (152.3 ± 28.9 mg/dl), and suspension groups (188.3 ± 44.9 mg/dl; p = .128). The suspension group experienced a greater percentage of cases (84.2%) with one or more intraoperative BG > 179 mg/dl than continuation (45.3%) and conversion (40%) groups Figure 1 groupings (p = .034). Conclusions In this limited sample, preliminary findings are consistent with similar intraoperative glycemic control between CSII continuation and CSII conversion to intravenous insulin infusions. Continuous subcutaneous insulin infusion suspension had a greater rate of hyperglycemia. Preoperative differences between insulin delivery groups

  18. A Hazard Analysis for a Generic Insulin Infusion Pump

    Science.gov (United States)

    Zhang, Yi; Jones, Paul L.; Jetley, Raoul

    2010-01-01

    Background Researchers at the Food and Drug Administration (FDA)/Center for Device and Radiological Health/Office of Science and Engineering Laboratories have been exploring the concept of model-based engineering as a means for improving the quality of medical device software. Insulin pumps were chosen as a research subject because their design provides the desired degree of research complexity and these types of devices present an ongoing regulatory challenge. Methods Insulin pump hazards and their contributing factors are considered in the context of a highly abstract generic insulin infusion pump (GIIP) model. Hazards were identified by consulting with manufacturers, pump users, and clinicians; by reviewing national and international standards and adverse event reports collected by the FDA; and from workshops sponsored by Diabetes Technology Society. This information has been consolidated in tabular form to facilitate further community analysis and discussion. Results A generic insulin infusion pump model architecture has been established. A fairly comprehensive hazard analysis document, corresponding to the GIIP model, is presented in this article. Conclusions We believe that this work represents the genesis of an insulin pump safety reference standard upon which future insulin pump designs can be based to help ensure a basic level of safety. More interaction with the diabetes community is needed to assure the quality of this safety modeling process. PMID:20307387

  19. A Review of the Security of Insulin Pump Infusion Systems

    Science.gov (United States)

    Paul, Nathanael; Kohno, Tadayoshi; Klonoff, David C

    2011-01-01

    Insulin therapy has enabled patients with diabetes to maintain blood glucose control to lead healthier lives. Today, rather than injecting insulin manually using syringes, a patient can use a device such as an insulin pump to deliver insulin programmatically. This allows for more granular insulin delivery while attaining blood glucose control. Insulin pump system features have increasingly benefited patients, but the complexity of the resulting system has grown in parallel. As a result, security breaches that can negatively affect patient health are now possible. Rather than focus on the security of a single device, we concentrate on protecting the security of the entire system. In this article, we describe the security issues as they pertain to an insulin pump system that includes an embedded system of components, which include the insulin pump, continuous glucose management system, blood glucose monitor, and other associated devices (e.g., a mobile phone or personal computer). We detail not only the growing wireless communication threat in each system component, but also describe additional threats to the system (e.g., availability and integrity). Our goal is to help create a trustworthy infusion pump system that will ultimately strengthen pump safety, and we describe mitigating solutions to address identified security issues. PMID:22226278

  20. A Review of the Security of Insulin Pump Infusion Systems

    Energy Technology Data Exchange (ETDEWEB)

    Klonoff, David C. [Mills-Peninsula Health Services; Paul, Nathanael R [ORNL; Kohno, Tadayoshi [University of Washington, Seattle

    2011-01-01

    Insulin therapy has enabled diabetic patients to maintain blood glucose control to lead healthier lives. Today, rather than manually injecting insulin using syringes, a patient can use a device, such as an insulin pump, to programmatically deliver insulin. This allows for more granular insulin delivery while attaining blood glucose control. The insulin pump system features have increasingly benefited patients, but the complexity of the resulting system has grown in parallel. As a result security breaches that can negatively affect patient health are now possible. Rather than focus on the security of a single device, we concentrate on protecting the security of the entire system. In this paper we describe the security issues as they pertain to an insulin pump system that includes an embedded system of components including the insulin pump, continuous glucose management system, blood glucose monitor, and other associated devices (e.g., a mobile phone or personal computer). We detail not only the growing wireless communication threat in each system component, but we also describe additional threats to the system (e.g., availability and integrity). Our goal is to help create a trustworthy infusion pump system that will ultimately strengthen pump safety, and we describe mitigating solutions to address identified security issues both for now and in the future.

  1. Unprecedented high insulin secretion in a healthy human subject after intravenous glucagon-like peptide-1

    DEFF Research Database (Denmark)

    Knop, Filip K; Lund, Asger; Madsbad, Sten

    2014-01-01

    to as one of the most insulinotropic substances known. CASE PRESENTATION: Plasma insulin and C-peptide concentrations were measured in a healthy Caucasian male (age: 53 years; body mass index: 28.6 kg/m2; fasting plasma glucose: 5.7 mM; 2 h plasma glucose value following 75 g-oral glucose tolerance test: 3...... insulin and C-peptide responses were observed during meal test (peak concentrations: 300 and 3,278 pM) and glucagon test (peak concentrations: 250 and 2,483 pM). During the hyperglycaemic clamp with continuous intravenous infusion of GLP-1 the subject exhibited plasma insulin and C-peptide concentrations...

  2. Intravenous Ketamine Infusions for Neuropathic Pain Management: A Promising Therapy in Need of Optimization.

    Science.gov (United States)

    Maher, Dermot P; Chen, Lucy; Mao, Jianren

    2017-02-01

    Intravenous ketamine infusions have been used extensively to treat often-intractable neuropathic pain conditions. Because there are many widely divergent ketamine infusion protocols described in the literature, the variation in these protocols presents a challenge for direct comparison of one protocol with another and in discerning an optimal protocol. Careful examination of the published literature suggests that ketamine infusions can be useful to treat neuropathic pain and that certain characteristics of ketamine infusions may be associated with better clinical outcomes. Increased duration of relief from neuropathic pain is associated with (1) higher total infused doses of ketamine; (2) prolonged infusion durations, although the rate of infusion does not appear to be a factor; and (3) coadministration of adjunct medications such as midazolam and/or clonidine that mitigate some of the unpleasant psychomimetic side effects. However, there are few studies designed to optimize ketamine infusion protocols by defining what an effective infusion protocol entails with regard to a respective neuropathic pain condition. Therefore, despite common clinical practice, the current state of the literature leaves the use of ketamine infusions without meaningful guidance from high-quality comparative evidence. The objectives of this topical review are to (1) analyze the available clinical evidence related to ketamine infusion protocols and (2) call for clinical studies to identify optimal ketamine infusion protocols tailored for individual neuropathic pain conditions. The Oxford Center for Evidence-Based Medicine classification for levels of evidence was used to stratify the grades of clinical recommendation for each infusion variable studied.

  3. Glycemic increase induced by intravenous glucose infusion fails to affect hunger, appetite, or satiety following breakfast in healthy men.

    Science.gov (United States)

    Schultes, Bernd; Panknin, Ann-Kristin; Hallschmid, Manfred; Jauch-Chara, Kamila; Wilms, Britta; de Courbière, Felix; Lehnert, Hendrik; Schmid, Sebastian M

    2016-10-01

    Meal-dependent fluctuations of blood glucose and corresponding endocrine signals such as insulin are thought to provide important regulatory input for central nervous processing of hunger and satiety. Since food intake also triggers the release of numerous gastrointestinal signals, the specific contribution of changes in blood glucose to appetite regulation in humans has remained unclear. Here we tested the hypothesis that inducing glycemic fluctuations by intravenous glucose infusion is associated with concurrent changes in hunger, appetite, and satiety. In a single blind, counter-balanced crossover study 15 healthy young men participated in two experimental conditions on two separate days. 500 ml of a solution containing 50 g glucose or 0.9% saline, respectively, was intravenously infused over a 1-h period followed by a 1-h observation period. One hour before start of the respective infusion subjects had a light breakfast (284 kcal). Blood glucose and serum insulin concentrations as well as self-rated feelings of hunger, appetite, satiety, and fullness were assessed during the entire experiment. Glucose as compared to saline infusion markedly increased glucose and insulin concentrations (peak glucose level: 9.7 ± 0.8 vs. 5.3 ± 0.3 mmol/l; t(14) = -5.159, p < 0.001; peak insulin level: 370.4 ± 66.5 vs. 109.6 ± 21.5 pmol/l; t(14) = 4.563, p < 0.001) followed by a sharp decline in glycaemia to a nadir of 3.0 ± 0.2 mmol/l (vs. 3.9 ± 0.1 mmol/l at the corresponding time in the control condition; t(14) = -3.972, p = 0.001) after stopping the infusion. Despite this wide glycemic fluctuation in the glucose infusion condition subjective feelings of hunger, appetite satiety, and fullness did not differ from the control condition throughout the experiment. These findings clearly speak against the notion that fluctuations in glycemia and also insulinemia represent major signals in the short-term regulation of hunger and satiety.

  4. Intracranial hemodynamics during intravenous infusion of glyceryl trinitrate

    DEFF Research Database (Denmark)

    Iversen, H.K.; Holm, S.; Friberg, L.;

    2008-01-01

    The mechanisms of glyceryl trinitrate (GTN)-induced headache are not fully elucidated. In this study we administered GTN 0.5 microg/kg/min i.v. for 20 min in six healthy volunteers. Before, during and 60 min after the infusion, we investigated regional cerebral blood flow (rCBF), cerebral blood...... volume (CBV), both estimated with SPECT, and blood flow velocity (BFV) in the middle cerebral artery (MCA), measured with transcranial Doppler. Headache was scored on a numerical verbal rating (0-10) scale. rCBF was unchanged, CBV was slightly increased (13%) during GTN infusion, whereas BFV decreased...... both during (20%) and 60 min (15%) after GTN. Headache was short-lived and maximal during infusion. This discrepancy of time-effect curves for the effect of GTN on headache and dilatation of MCA indicates that MCA is most likely not the primary source of pain in GTN-induced headache. The time...

  5. Radioprotection of the digestive tract by intravenous infusion of vasopressin

    Energy Technology Data Exchange (ETDEWEB)

    Juillard, G.J.F.; Peter, H.H.; Weisenburger, T.H.; Tesler, A.S.; Langdon, E.A.; Barenfus, M.; Lagasse, L.D.; Watring, W.E.; Smith, M.L.

    1975-09-01

    The effect of venous infusions of vasopressin during fractionated abdominal radiation exposures was evaluated in four pairs of dogs. In each pair, the control dog was given venous infusion of saline during irradiation. The results were analyzed from clinical observation, autopsy findings, and pathological examination. It appears that venous infusion of vasopressin has a definite and reproducible effect of radioprotection on the gastrointestinal tract, the dose modifying factor (DMF) being 1.5. Radiation therapy of the gynecologic malignancies would be one major application since the radiosensitivity of the intestinal tract is often a limiting factor in delivering high doses to the tumor, and further investigations are being done to study the effects of vasopressin on the radiosensitivity of malignant tumors.

  6. Microcosting Study of Rituximab Subcutaneous Injection Versus Intravenous Infusion

    NARCIS (Netherlands)

    Mihajloviç, Jovan; Bax, Pieter; van Breugel, Erwin; Blommestein, Hedwig M.; Hoogendoorn, Mels; Hospes, Wobbe; Postma, Maarten J.

    Purpose: The goal of this study is to identify and compare all direct costs of intravenous and subcutaneous rituximab given to patients with diffuse large B-cell lymphoma in the Netherlands.  Methods: Using a prospective, observational, bottom-up microcosting study, we collected primary data on the

  7. Cardiovascular effects of intravenous ghrelin infusion in healthy young men

    DEFF Research Database (Denmark)

    Vestergaard, Esben Thyssen; Andersen, Niels Holmark; Hansen, Troels Krarup

    2007-01-01

    the cardiovascular effects of a constant infusion of human ghrelin at a rate of 5 pmol/kg per minute for 180 min. Fifteen healthy, young (aged 23.2 ± 0.5 yr), normal-weight (23.0 ± 0.4 kg/m2) men volunteered in a randomized double-blind, placebo-controlled crossover study. With the subjects remaining fasting, peak...

  8. Intravenous antibiotics infusion and bacterial resistence: nursing responsability

    OpenAIRE

    2006-01-01

    The success of antibiotics treatment and development of bacterial resistance depend on many factors. The preparation and management of these factors are associated with nursing care. The aim of this paper is review literature about preparation, management and knowledge of intravenous antibiotics errors analyzing possibilities of influence of bacterial resistance prevention by nurses. Methods: a systematic review was done from LiILACS and M...

  9. [Lethal intravenous infusion of a wound antiseptic containing polyhexanide].

    Science.gov (United States)

    Wehner, Frank; Wehner, Heinz-Dieter; Schulz, Martin Manfred

    2009-01-01

    Polyhexamethylene biguanide (PHMB) is considered to be highly histocompatible and is one of the most frequently used wound antiseptics. Only one case of intoxication has been reported so far. The present case of a lethal intoxication is the first fatal incident described where causality is substantiated by a temporal coincidence between application and ascertainable organ damage. The laboratory-chemical and histological investigations verified the toxicity of this substance after intravenous application with the main findings being severe hepatic and pancreatic damage.

  10. Insulin secretion and cellular glucose metabolism after prolonged low-grade intralipid infusion in young men

    DEFF Research Database (Denmark)

    Jensen, Christine B; Storgaard, Heidi; Holst, Jens Juul;

    2003-01-01

    We examined the simultaneous effects of a 24-h low-grade Intralipid infusion on peripheral glucose disposal, intracellular glucose partitioning and insulin secretion rates in twenty young men, by 2-step hyperinsulinemic euglycemic clamp [low insulin clamp (LI), 10 mU/m(2) x min; high insulin clamp...... Intralipid infusion. At LI, glucose oxidation decreased by 10%, whereas glucose disposal, glycolytic flux, glucose storage, and glucose production were not significantly altered. At HI, glucose disposal, and glucose oxidation decreased by 12% and 24%, respectively, during Intralipid infusion. Glycolytic flux......, glucose storage, and glucose production were unchanged. Insulin secretion rates increased in response to Intralipid infusion, but disposition indices (DI = insulin action.insulin secretion) were unchanged. In conclusion, a 24-h low-grade Intralipid infusion caused insulin resistance in the oxidative (but...

  11. Transition From Intravenous to Subcutaneous Insulin in Critically Ill Adults.

    Science.gov (United States)

    Doolin, Meagan K; Walroth, Todd A; Harris, Serena A; Whitten, Jessica A; Fritschle-Hilliard, Andrew C

    2016-07-01

    Glycemic control decreases morbidity and mortality in critically ill patients. However, limited guidance exists regarding the transition from intravenous (IV) to subcutaneous insulin therapy. A validated protocol for transition is necessary since glycemic variability, hyperglycemia, and hypoglycemia adversely impact patient outcomes. The objective was to determine the safest and most effective method to transition critically ill adults from IV to subcutaneous insulin. This single-center, retrospective, observational study included adults admitted to the burn, medical, or surgical/trauma intensive care units from January 1, 2011, to September 30, 2014. A computer-based program provided a reflection of the patient's total daily IV insulin requirements. This information was then utilized to stratify patients into groups according to their initial dose of subcutaneous insulin as a percentage of the prior 24-hour IV requirements (group stratification: 0-49%, 50-59%, 60-69%, 70-79%, ≥80%). The primary endpoint was the percentage of blood glucose (BG) concentrations within target range (70-150 mg/dL) 48 hours following transition. One hundred patients with 1394 BG concentrations were included. The 50-59% group achieved the highest rate of BG concentrations in goal range (68%) (P 50-59% of their 24-hour IV insulin requirements. A dosing protocol will be implemented to transition to 50-70% subcutaneous insulin. Follow-up data will be reviewed to assess the protocol's safety and efficacy. © 2016 Diabetes Technology Society.

  12. Adult respiratory distress syndrome complicating intravenous infusion of low-molecular weight dextran.

    Science.gov (United States)

    Taylor, M A; DiBlasi, S L; Bender, R M; Santoian, E C; Cha, S D; Dennis, C A

    1994-07-01

    Respiratory failure is one of the most uncommon and serious adverse drug reactions. Low-molecular-weight-dextran (Dextran-40) is a useful adjunctive anti-platelet agent in the setting of coronary angioplasty and intracoronary stent placement. We report the occurrence of the adult respiratory distress syndrome following intravenous infusion of Dextran-40.

  13. Administration of gentamicin and ampicillin by continuous intravenous infusion to newborn infants during parenteral nutrition

    DEFF Research Database (Denmark)

    Colding, H; Andersen, G E

    1982-01-01

    Gentamicin and ampicillin were dissolved in an L-amino acid solution especially prepared for newborn infants and infused intravenously over 24 h in 7 babies with serious neonatal surgical problems. Serum concentrations of the antibiotics were maintained rather constant and well above the minimal ...

  14. The course of diabetic retinopathy during treatment with continuous subcutaneous insulin infusion

    NARCIS (Netherlands)

    Hooymans, Johanna Martina Maria

    1986-01-01

    The aim of this prospective study was to investigate the effect of normalization of blood sugar regulation by continuous subcutaneous insulin infusion (CSII) on the course of diabetic retinopathy in insulin-dependent (type I) diabetic patients. Zie: Summary

  15. Intravenous antibiotics infusion and bacterial resistence: nursing responsability

    Directory of Open Access Journals (Sweden)

    Heloisa Helena Karnas Hoefel

    2006-12-01

    Full Text Available The success of antibiotics treatment and development of bacterial resistance depend on many factors. The preparation and management of these factors are associated with nursing care. The aim of this paper is review literature about preparation, management and knowledge of intravenous antibiotics errors analyzing possibilities of influence of bacterial resistance prevention by nurses. Methods: a systematic review was done from LiILACS and Medline searching for the word nursing and bacterial resistance, antibiotics control, hospital infections, administration drugs, errors and adverse events. There were chose 58 papers about nursing and/or were basics for international and Brazilian studies. Results: It was described international classifications errors and consequences analyzing their possible influences on antibiotics effects. Based on these knowledge, interventions are recommended to implement safety practice and care.

  16. Quality of intravenous infusion fluids manufactured in Kenya.

    Science.gov (United States)

    Aluoch-Orwa, J A; Ondari, C O; Kibwage, I O; Hoogmartens, J

    1995-12-01

    The incidence and nature of microbial contamination of intravenous fluids prepared by four manufacturing establishments in Kenya was evaluated using the European Pharmacopoeia membrane filtration method for sterility testing. The percentage failures were 28.6% for source D, 18.8% for source A, 12.5% for source B and 10.5% for source C. The major contaminant was aspergillus which was isolated from samples from three sources. Candida and Staphylococcus accounted for the contamination of samples from two sources. Failure rates due to the chemical composition of the products was 66.7% for Source A, 60.0% for D, 41.7% for C and 13.3% for B. The experience of the manufacturing sites appeared to correlate with the quality of the products, with the older manufacturing establishments showing lower percentage failures.

  17. Safety and feasibility of long-term intravenous sodium nitrite infusion in healthy volunteers.

    Directory of Open Access Journals (Sweden)

    Ryszard M Pluta

    Full Text Available BACKGROUND: Infusion of sodium nitrite could provide sustained therapeutic concentrations of nitric oxide (NO for the treatment of a variety of vascular disorders. The study was developed to determine the safety and feasibility of prolonged sodium nitrite infusion. METHODOLOGY: Healthy volunteers, aged 21 to 60 years old, were candidates for the study performed at the National Institutes of Health (NIH; protocol 05-N-0075 between July 2007 and August 2008. All subjects provided written consent to participate. Twelve subjects (5 males, 7 females; mean age, 38.8±9.2 years (range, 21-56 years were intravenously infused with increasing doses of sodium nitrite for 48 hours (starting dose at 4.2 µg/kg/hr; maximal dose of 533.8 µg/kg/hr. Clinical, physiologic and laboratory data before, during and after infusion were analyzed. FINDINGS: The maximal tolerated dose for intravenous infusion of sodium nitrite was 267 µg/kg/hr. Dose limiting toxicity occurred at 446 µg/kg/hr. Toxicity included a transient asymptomatic decrease of mean arterial blood pressure (more than 15 mmHg and/or an asymptomatic increase of methemoglobin level above 5%. Nitrite, nitrate, S-nitrosothiols concentrations in plasma and whole blood increased in all subjects and returned to preinfusion baseline values within 12 hours after cessation of the infusion. The mean half-life of nitrite estimated at maximal tolerated dose was 45.3 minutes for plasma and 51.4 minutes for whole blood. CONCLUSION: Sodium nitrite can be safely infused intravenously at defined concentrations for prolonged intervals. These results should be valuable for developing studies to investigate new NO treatment paradigms for a variety of clinical disorders, including cerebral vasospasm after subarachnoid hemorrhage, and ischemia of the heart, liver, kidney and brain, as well as organ transplants, blood-brain barrier modulation and pulmonary hypertension. CLINICAL TRIAL REGISTRATION INFORMATION: http

  18. Preliminary evaluation of intravenous infusion and intrapancreatic injection of human umbilical cord blood-derived mesenchymal stem cells for the treatment of diabetic mice

    Directory of Open Access Journals (Sweden)

    Ngoc Kim Phan

    2014-03-01

    Full Text Available Type 1 diabetes mellitus is characterized by the destruction of pancreatic islet beta cells, which leads to insulin insufficiency, hyperglycemia, and reduced metabolic glucose level. Insulin replacement is the current standard therapy for type 1 diabetes mellitus but has several limitations. Pancreatic islet transplantation can result in the production of exogenous insulin, but its use is limited by immune-rejection and donor availability. Recent studies have shown that mesenchymal stem cells (MSCs can transdifferentiate into insulin-producing cells (IPCs, which could be utilized for diabetes mellitus treatment. Previously published reports have demonstrated that MSC or IPC transplantation could produce significant improvement in mouse models of diabetes mellitus. This study was aimed at determining the effects of two different methods of MSC transplantation on the efficacy of diabetes mellitus treatment in mouse models. The MSCs were isolated from umbilical cord blood and were proliferated following a previously published procedure. Diabetes mellitus was induced in mice by streptozotocin (STZ injection. Thirty days after transplantation, the weight of the mice treated by intra-venous infusion and intra-pancreatic injection was found to be 22% and 14% higher than that of the un-treated mice. The blood glucose concentrations in both intra-venous infusion and intra-pancreatic injection groups decreased and remained more stable than those in the control group. Moreover, insulin was detected in the serum of the treated mice, and the pancreas also showed gradual recovery. Based on the results of this preliminary investigation, intra-venous infusion seems more suitable than intra-pancreatic injection for MSC transplantation for diabetes mellitus treatment. [Biomed Res Ther 2014; 1(3.000: 98-105

  19. The metabolic effect of dodecanedioic acid infusion in non-insulin-dependent diabetic patients.

    Science.gov (United States)

    Greco, A V; Mingrone, G; Capristo, E; Benedetti, G; De Gaetano, A; Gasbarrini, G

    1998-04-01

    Dodecanedioic acid (C12) is an even-numbered dicarboxylic acid (DA). Dicarboxylic acids are water-soluble substances with a metabolic pathway intermediate to those of lipids and carbohydrates. Previous studies showed that contrary to other DAs, very low amounts of C12 are lost with urine. The effects of 46.6 mmol of C12 intravenous infusion for 195 min on blood glucose levels were investigated in five patients with non-insulin-dependent diabetes mellitus (NIDDM), with a good metabolic compensation, and in five healthy volunteers matched for gender, age, and body mass index. Blood samples were taken every 15 min for a period of 360 min to measure glucose, insulin, C-peptide, ketone bodies, and free fatty acid (FFA) levels, and 24-h urine samples were collected to measure C12 and urea excretion. Plasma and urinary C12 concentrations were determined by high-pressure liquid chromatography (HPLC). Indirect calorimetry was continuously performed both basally and during the study period. The average 24-h urinary excretion of C12 was 6.5% versus 6.7% of the administered dose, respectively, in NIDDM patients and in healthy controls. The area under the curve (AUC) values of plasma C12 were 279.9 +/- 42.7 mumol in NIDDM patients and 219.7 +/- 14.0 mumol in controls (P = ns). Plasma glucose levels significantly decreased in NIDDM patients during C12 infusion (from 7.8 +/- 0.6 to 5.4 +/- 0.8 mM at the end of the study period, P acids decreased in diabetic patients from the beginning until the end of C12 infusion, although this difference did not reach statistical significance. No significant increase was found between basal and final values in VO2 consumption and in the values of nonprotein respiratory quotient in both groups of subjects examined. The experimental data indicate that C12 infusion decreases plasma glucose levels in NIDDM patients to normal range without influencing plasma insulin levels. The balance between pyruvate and lactate was affected by C12 infusion only

  20. Improved arterial blood oxygenation following intravenous infusion of cold supersaturated dissolved oxygen solution.

    Science.gov (United States)

    Grady, Daniel J; Gentile, Michael A; Riggs, John H; Cheifetz, Ira M

    2014-01-01

    One of the primary goals of critical care medicine is to support adequate gas exchange without iatrogenic sequelae. An emerging method of delivering supplemental oxygen is intravenously rather than via the traditional inhalation route. The objective of this study was to evaluate the gas-exchange effects of infusing cold intravenous (IV) fluids containing very high partial pressures of dissolved oxygen (>760 mm Hg) in a porcine model. Juvenile swines were anesthetized and mechanically ventilated. Each animal received an infusion of cold (13 °C) Ringer's lactate solution (30 mL/kg/hour), which had been supersaturated with dissolved oxygen gas (39.7 mg/L dissolved oxygen, 992 mm Hg, 30.5 mL/L). Arterial blood gases and physiologic measurements were repeated at 15-minute intervals during a 60-minute IV infusion of the supersaturated dissolved oxygen solution. Each animal served as its own control. Five swines (12.9 ± 0.9 kg) were studied. Following the 60-minute infusion, there were significant increases in PaO2 and SaO2 (P dissolved oxygen solution may be intravenously administered to improve arterial blood oxygenation and ventilation parameters and induce a mild therapeutic hypothermia in a porcine model.

  1. Serum concentrations of amoxicillin in neonates during continuous intravenous infusion.

    Science.gov (United States)

    van Boekholt, A; Fleuren, H; Mouton, J; Kramers, C; Sprong, T; Gerrits, P; Semmekrot, B

    2016-06-01

    Amoxicillin is commonly used for the treatment of neonatal bacterial infection with intermittent dosing (ID) regimens. However, increasing bacterial resistance, in addition to a lack of new antimicrobial agents, urges the optimization of current therapeutic options. Clinical studies in adults suggest continuous infusion (CI) regimens of beta-lactam antibiotics to be superior to ID. There are as yet no guidelines concerning the CI dosing of amoxicillin. The present study was developed to describe the CI pharmacokinetics and -dynamics of amoxicillin during the first 3 days of life in search of the optimal dosing regimen. Neonates with a gestational age above 34 weeks, at risk of neonatal infection and requiring amoxicillin therapy, were included. Serum concentrations of amoxicillin were measured during CI on days 1 and 3 in the steady state. Twenty-two serum samples of 11 patients were collected. All patients reached and retained serum concentrations of amoxicillin within the therapeutic range without exceeding the toxic concentration (serum concentrations on day 1 mean 55.4 mg/l, range 30.9-69.5, SD 10.5, and on day 3 48.8 mg/l, range 25.5-92.4, SD 18.4). There was no significant decrease in concentration from day 1 to day 3 (p = 0.38). This study showed therapeutic, nontoxic concentrations of amoxicillin in neonates on CI of amoxicillin in the first 3 days of life. Randomized controlled trials should reveal whether the clinical benefits of the CI of amoxicillin exceed those of ID regimens.

  2. Intravenous infusion of hyperosmotic NaCl solution induces acute cor pulmonale in anesthetized rats.

    Science.gov (United States)

    Abe, Chikara; Tsuru, Yoshiharu; Iwata, Chihiro; Ogihara, Ryosuke; Morita, Hironobu

    2013-01-01

    Intravenous hyperosmotic NaCl infusion is an effective treatment for circulatory shock. However, a fast infusion rate (2 mL/kg at the rate of 1 mL/s) induces transient hypotension. This response has been reported to be due to decreased total peripheral resistance and/or decreased cardiac performance. Although the hypotension is transient and recovers within 2 min without detrimental consequences, it is important to understand the associated hemodynamics and mechanisms. We found that the hypotensive effect was larger with intravenous NaCl infusion than with intra-aortic infusion, indicating that change in cardiac performance played a more significant role than change in peripheral resistance. NaCl infusion induced an increase in pulmonary vascular resistance and central venous pressure and a decrease in right ventricular dP/dt max, suggesting acute cor pulmonale. Diastolic ventricular crosstalk-induced left ventricular failure was also observed. Hyperosmotic NaCl-induced hypotension was therefore mainly due to a combination of acute cor pulmonale and left ventricular failure.

  3. Hepatic and Extrahepatic Insulin Clearance Are Differentially Regulated: Results From a Novel Model-Based Analysis of Intravenous Glucose Tolerance Data.

    Science.gov (United States)

    Polidori, David C; Bergman, Richard N; Chung, Stephanie T; Sumner, Anne E

    2016-06-01

    Insulin clearance is a highly variable and important factor that affects circulating insulin concentrations. We developed a novel model-based method to estimate both hepatic and extrahepatic insulin clearance using plasma insulin and C-peptide profiles obtained from the insulin-modified frequently sampled intravenous glucose tolerance test. Data from 100 African immigrants without diabetes (mean age 38 years, body weight 81.7 kg, fasting plasma glucose concentration 83 mg/dL, and fasting insulin concentration 37 pmol/L) were used. Endogenous insulin secretion (calculated by C-peptide deconvolution) and insulin infusion rates were used as inputs to a new two-compartment model of insulin kinetics and hepatic and extrahepatic clearance parameters were estimated. Good agreement between modeled and measured plasma insulin profiles was observed (mean normalized root mean square error 6.8%), and considerable intersubject variability in parameters of insulin clearance among individuals was identified (the mean [interquartile range] for hepatic extraction was 25.8% [32.7%], and for extrahepatic insulin clearance was 20.7 mL/kg/min [11.7 mL/kg/min]). Parameters of insulin clearance were correlated with measures of insulin sensitivity and acute insulin response to glucose. The method described appears promising for future research aimed at characterizing variability in insulin clearance and the mechanisms involved in the regulation of insulin clearance.

  4. Effect of Insulin Infusion on insulin-like growth factor I (IGF-I) during Hemodialysis

    DEFF Research Database (Denmark)

    Reinhard, Mark; Frystyk, Jan; Bjerre, Mette

    2012-01-01

    Background: Hemodialysis (HD) is a catabolic procedure probably contributing to the high frequency of protein-energy wasting among patients on maintenance HD. The aim was to investigate the effect of insulin infusion on insulin-like growth factor I (IGF-I) during HD compared with a meal alone...... infusion and followed by the only meal allowed during the study. Results: Data are presented as mean±SD. From baseline to end of HD session we observed an overall increase in both serum bioactive IGF-I (from 0.83±0.27 to 1.01±0.34 µg/L, p... in the change between the groups (p=0.43). Conclusion: A meal at the beginning of a HD session leads to an increase in bioactive IGF-I thereby assumingly counteracting the catabolic effects of HD. However, according to changes in bioactive IGF-I neither glucose nor glucose-insulin infusion during HD appear...

  5. Effect of prolonged intravenous glucose and essential amino acid infusion on nitrogen balance, muscle protein degradation and ubiquitin-conjugating enzyme gene expression in calves

    Directory of Open Access Journals (Sweden)

    Scaife Jes R

    2008-02-01

    Full Text Available Abstract Background Intravenous infusions of glucose and amino acids increase both nitrogen balance and muscle accretion. We hypothesised that co-infusion of glucose (to stimulate insulin and essential amino acids (EAA would act additively to improve nitrogen balance by decreasing muscle protein degradation in association with alterations in muscle expression of components of the ubiquitin-proteasome proteolytic pathway. Methods We examined the effect of a 5 day intravenous infusions of saline, glucose, EAA and glucose + EAA, on urinary nitrogen excretion and muscle protein degradation. We carried out the study in 6 restrained calves since ruminants offer the advantage that muscle protein degradation can be assessed by excretion of 3 methyl-histidine and multiple muscle biopsies can be taken from the same animal. On the final day of infusion blood samples were taken for hormone and metabolite measurement and muscle biopsies for expression of ubiquitin, the 14-kDa E2 ubiquitin conjugating enzyme, and proteasome sub-units C2 and C8. Results On day 5 of glucose infusion, plasma glucose, insulin and IGF-1 concentrations were increased while urea nitrogen excretion and myofibrillar protein degradation was decreased. Co-infusion of glucose + EAA prevented the loss of urinary nitrogen observed with EAA infusions alone and enhanced the increase in plasma IGF-1 concentration but there was no synergistic effect of glucose + EAA on the decrease in myofibrillar protein degradation. Muscle mRNA expression of the ubiquitin conjugating enzyme, 14-kDa E2 and proteasome sub-unit C2 were significantly decreased, after glucose but not amino acid infusions, and there was no further response to the combined infusions of glucose + EAA. Conclusion Prolonged glucose infusion decreases myofibrillar protein degradation, prevents the excretion of infused EAA, and acts additively with EAA to increase plasma IGF-1 and improve net nitrogen balance. There was no evidence of

  6. Reducing the Risk of Hypoglycemia Associated With Intravenous Insulin

    Science.gov (United States)

    Sandler, Victoria; Misiasz, Meaghan R.; Jones, Jocelyn

    2014-01-01

    Computerized insulin infusion protocols have facilitated more effective blood glucose (BG) control in intensive care units (ICUs). This is particularly important in light of the risks associated with hypoglycemia. End stage renal disease (ESRD) increases the risk of insulin-induced hypoglycemia. We evaluated BG control in 210 patients in 2 medical ICUs and in 2 surgical ICUs who were treated with a computerized insulin infusion program (CIIP). Our CIIP was programmed for a BG target of 140-180 mg/dL for medical ICU patients or 120-160 mg/dL for surgical ICU patients. In addition, we focused on BG control in the 11% of our patients with ESRD. Mean BG was 147 ± 20 mg/dL for surgical ICU patients and 171 ± 26 mg/dL for medical ICU patients. Of both surgical and medical ICU patients, 17% had 1 or more BG 60-79 mg/dL, while 3% of surgical ICU and 8% of medical ICU patients had 1 or more BG < 60 mg/dL. Mean BG in ESRD patients was 147 ± 16 mg/dL similar to 152 ± 23 mg/dL in patients without ESRD. Of ESRD patients, 41% had 1 or more BG < 79 mg/dL as compared with 17.8% of non-ESRD patients (P < .01). A higher BG target for medical ICU patients as compared with surgical ICU patients yielded comparably low rates of moderate or severe hypoglycemia. However, hypoglycemia among ESRD patients was more common compared to non-ESRD patients, suggesting a need for a higher BG target specific to ESRD patients. PMID:25172875

  7. Lower dose basal insulin infusion has positive effect on glycaemic control for children with type I diabetes on continuous subcutaneous insulin infusion therapy

    NARCIS (Netherlands)

    Schulten, Ron J; Piet, Jessica; Bruijning-Verhagen, Patricia; de Waal, Wouter J

    2017-01-01

    Objective: The aim of our study was to explore a possible relationship between proportion of basal insulin dose (%BD/T) and glycaemic control in children with type I diabetes on continuous subcutaneous insulin infusion (CSII) therapy. Methods: All patients under the age of 18 with type I diabetes

  8. Discrepancy between plasma C-peptide and insulin response to oral and intravenous glucose

    DEFF Research Database (Denmark)

    Madsbad, S; Kehlet, H; Hilsted, J;

    1983-01-01

    Plasma insulin, proinsulin, and C-peptide responses to 25 g glucose orally and intravenously administered were measured in 10 healthy males. Plasma insulin response was higher during the oral load in accordance with the "incretin" concept. However, the actual amount of insulin secreted, as measur...... partially to a lower hepatic extraction of insulin....

  9. Clinical Effects of Arsenic Trioxide by Slowing-intravenous Infusion on Acute Promyelocyte Leukemia

    Institute of Scientific and Technical Information of China (English)

    Jin Zhou; Ran Meng; Bao-feng Yang

    2005-01-01

    @@ Although As2O3 is effective in the treatment of acute promyelocytic leukemia (APL), some side effects, such as leukocytosis which can increase the incidence of cerebral hemorrhage and early death rate, often occur during the early stage of As2O3 treatment. In this paper, the advantages of continuously slow intravenous As2O3 infusion on relieving leukocytosis and decreasing the incidence of cerebral hemorrhage and early death rate were observed clinically.

  10. Histamine and Nt-methylhistamine in the circulation during intravenous infusion of histamine in normal volunteers.

    Science.gov (United States)

    Sheinman, B D; Devalia, J L; Wylie, G; Davies, R J

    1988-12-01

    Plasma levels of histamine and Nt-methylhistamine were measured simultaneously by high performance liquid chromatography during the intravenous infusion of histamine acid phosphate in six normal volunteers. Progressive, dose-related increases in plasma histamine were noted, reaching a maximum value of 3.1 +/- 0.14 ng ml-1 corresponding to a maximum infusion rate of 180 ng kg-1 min-1 (means +/- SEM). Increases in plasma histamine were accompanied by a significant dose-related fall in mean diastolic blood pressure (baseline 74.0 +/- 4.4 mm Hg falling to 60.0 +/- 3.3 mm Hg at maximum infusion rate, p less than 0.001) and an increase in pulse rate (baseline 76.3 +/- 2.8 beats min-1 rising to 89.24 beats min-1 at maximum infusion rate, p less than 0.05). All subjects exhibited facial flushing, the threshold plasma histamine level for this effect being 1.3 +/- 0.15 ng ml-1 corresponding to an infusion rate of 60 ng kg-1 min-1. Elevation of plasma Nt-methylhistamine was seen in only one subject, who exhibited a level of 0.5 ng ml-1 at the highest infusion rate. These results suggest that measurements of plasma Nt-methylhistamine are unlikely to provide a useful index of histamine release into the circulation.

  11. Treatment of metastatic renal cell carcinoma by continuous intravenous infusion of recombinant interleukin-2

    DEFF Research Database (Denmark)

    Geertsen, P F; Hermann, G G; von der Maase, H;

    1992-01-01

    PURPOSE: A single-center phase II study was performed to evaluate the efficacy of recombinant interleukin-2 (rIL-2) administered by continuous infusion to patients with metastatic renal cell carcinoma (RCC). PATIENTS AND METHODS: Thirty-one patients with RCC were entered onto the study. rIL-2...... (Proleukin; Eurocetus Corp, Amsterdam, The Netherlands) was administered intravenously in a dose of 18 x 10(6) IU/m2 per 24 hours. A maximum of two induction cycles and four maintenance cycles were given. Each induction cycle consisted of two rIL-2 infusion periods of 120 hours and 108 hours duration......, respectively; these were separated by a 6-day rest period. Each maintenance cycle consisted of a 120 hours rIL-2 infusion period. RESULTS: Six of 30 assessable patients (20%) responded; two (7%) with a complete response (CR) and four (13%) with a partial response (PR). The response duration for patients...

  12. Analysis of 72-hour sterility of common pediatric continuous intravenous infusions.

    Science.gov (United States)

    Piro, Christina C; Davis, Jennifer; Frelix, Arlesia; Grisso, Alison G; Sinclair-Pingel, Julie; Willingham, Harold; Wright, Lorianne; Potts, Amy L

    2009-01-01

    Patient morbidity and mortality associated with contaminated and improperly prepared sterile products has captured national attention. In response, both the United States Pharmacopeia (USP) and Centers for Disease Control (CDC) have published recommendations in an effort to minimize the risk of infection. While the CDC recommends that administration sets are not changed more frequently than every 72 hours, the USP recommends a maximum beyond use date of 48 hours. Neither organization provides specific guidance on expiration dating once the intravenous drug is dispensed. Likewise, neither addresses the length of time that a bag containing medication for continuous infusion may hang once administration to the patient has begun. We evaluated the sterility of medications that are commonly administered by continuous infusion to pediatric patients. Because frequent manipulation of infusion and administration sets may predispose the patient to adverse events, we evaluated sterility for extended beyond use dating up to 72 hours. Thirty-five common intravenous (IV) continuous infusions using 94 standard concentrations and diluents were identified. IV solutions were mixed using sterile technique in the laminar flow hood in accordance with USP guidelines. Medications were excluded for short stability, short durations of use or high cost. A sample from each solution was tested for contamination or bacterial growth at 72 hours. Any visible discoloration suggesting physical instability was also evaluated. None of the syringes or chambers resulted in contamination, bacterial growth or discoloration after 72 hours. This study provides sufficient data that these compounded sterile products may be stored using a beyond use date up to 72 hours for a number of commonly used continuous IV infusions in pediatric patients. In our institution, this allows for a more convenient and consistent change of both administration sets and continuous infusions at 72 hours to potentially minimize

  13. The Effects of Preoperative Oral Pregabalin and Perioperative Intravenous Lidocaine Infusion on Postoperative Morphine Requirement in Patients Undergoing Laparatomy

    Directory of Open Access Journals (Sweden)

    Senniye Ulgen Zengin

    2015-01-01

    Full Text Available OBJECTIVES: To evaluate and compare the effects of preoperative oral pregabalin and perioperative intravenous lidocaine infusion on postoperative morphine requirement, adverse effects, patients’ satisfaction, mobilization, time to first defecation and time to discharge in patients undergoing laparotomy.

  14. The disposition of lidocaine during a 12-hour intravenous infusion to postoperative horses.

    Science.gov (United States)

    Milligan, M; Kukanich, B; Beard, W; Waxman, S

    2006-12-01

    Lidocaine is administered as an intravenous infusion to horses for a variety of reasons, but no study has assessed plasma lidocaine concentrations during a 12-h infusion to horses. The purpose of this study was to evaluate the plasma concentrations and pharmacokinetics of lidocaine during a 12-h infusion to postoperative horses. A second purpose of the study was to evaluate the in vitro plasma protein binding of lidocaine in equine plasma. Lidocaine hydrochloride was administered as a loading dose, 1.3 mg/kg over 15 min, then by a constant rate IV infusion, 50 microg/kg/min to six postoperative horses. Lidocaine plasma concentrations were measured by a validated high-pressure liquid chromatography method. One horse experienced tremors and collapsed 5.5 h into the study. The range of plasma concentrations during the infusion was 1.21-3.13 microg/mL. Lidocaine plasma concentrations were significantly increased at 0.5, 4, 6, 8, 10 and 12 h compared with 1, 2 and 3 h. The in vitro protein binding of lidocaine in equine plasma at 2 microg/mL was 53.06+/-10.28% and decreased to 27.33+/-9.72% and 29.52+/-6.44% when in combination with ceftiofur or the combination of ceftiofur and flunixin, respectively. In conclusion, a lower lidocaine infusion rate may need to be administered to horses on long-term lidocaine infusions. The in vitro protein binding of lidocaine is moderate in equine plasma, but highly protein bound drugs may displace lidocaine increasing unbound concentrations and the risk of lidocaine toxicity.

  15. Psychopathology and Continuous Subcutaneous Insulin Infusion in Type 1 Diabetes

    Directory of Open Access Journals (Sweden)

    Francesco Rotella

    2013-01-01

    Full Text Available Aim. Continuous subcutaneous insulin infusion (CSII is used as an option in patients with diabetes failing to multiple daily injections (MDI. Psychological factors may play a relevant role in the failure to attain therapeutic goals in patients on MDI. This could lead to an overrepresentation of psychopathology in patients treated with CSII. Methods. A consecutive series of 100 patients with type 1 diabetes was studied, collecting main clinical parameters and assessing psychopathology with the self-reported questionnaire Symptom Checklist 90-revised. Patients on CSII were then compared with those on MDI. Results. Of the 100 enrolled patients, 44 and 56 were on CSII and MDI, respectively. Among men, those on CSII were younger than those on MDI; conversely, no difference in age was observed in women. Women on CSII showed higher scores on most Symptom Checklist 90 subscales than those on MDI, whereas no differences were observed in men. Conclusion. Women with type 1 diabetes treated with CSII display higher levels of psychopathology than those on MDI. This is probably the consequence of the fact that patients selected for CSII are those failing to MDI. Higher levels of psychopathology could represent a limit for the attainment and maintenance of therapeutic goals with CSII.

  16. Effect of dexamethasone, feeding time, and insulin infusion on leptin concentrations in stallions.

    Science.gov (United States)

    Cartmill, J A; Thompson, D L; Storer, W A; Crowley, J C; Huff, N K; Waller, C A

    2005-08-01

    Three experiments tested the hypotheses that daily cortisol rhythm, feeding time, and/or insulin infusion affect(s) leptin secretion in stallions. Ten mature stallions received ad libitum hay and water and were fed a grain concentrate once daily at 0700. In Exp. 1, stallions received either a single injection of dexamethasone (125 microg/kg BW i.m.; n = 5) or vehicle (controls; n = 5) at 0700 on d -1. Starting 24 h later, blood samples were collected every 2 h for 36 h via jugular venipuncture. Cortisol in control stallions varied (P infusion of insulin (1.2 mIU.kg BW(-1).min(-1)) for 180 min, which was gradually decreased to 0 by 240 min; sufficient glucose was infused to maintain euglycemia. Plasma insulin increased (P infused with insulin and glucose (to approximately 75 microIU/mL), but insulin remained low (10 microIU/mL or less) when they were not fed. The increases in insulin were paralleled by gradual increases (P infused with insulin and glucose. When stallions were not fed, leptin concentrations remained low. These results demonstrate that feeding time, and more specifically the insulin increase associated with a meal, not cortisol rhythm, drives the postprandial increase in plasma leptin concentrations in horses.

  17. [Treatment of diabetic ketoacidosis and hyperosmolality with low dose insulin infusion (author's transl)].

    Science.gov (United States)

    Duclos, F; François, P; Dumon, P; Altmann, J J

    1978-06-03

    Fifteen patients were treated with low-dose (5 u/hour) insulin infusion, including 10 cases of ketoacidosis, 3 cases of hyperglycemia without acidosis in severely affected diabetics, and 2 cases with hyperosmolality. The treatment was successful in all cases. Insulin was infused at a constant rate, during 12 hours as a mean value. Blood glucose fell regularly and no hypoglycemia occured. Serum potassium varied within narrow limits, and no accident related to hypokalemia was observed. The correction of ketoacidosis was delayed, as compared to that of hyperglycemia. The two elderly patients with hyperosmolality recovered quickly and completely. The method of low-dose insulin infusion seems thus effective and easily applicable, at least in an intensive care unit. Our experience prompted us to increase (10 u/h) rather than to decrease the insulin infusion rate, with the aim to obtain a faster correction of ketoacidosis.

  18. Intravenous sodium valproate versus diazepam infusion for the control of refractory status epilepticus in children: a randomized controlled trial.

    Science.gov (United States)

    Mehta, Vishal; Singhi, Pratibha; Singhi, Sunit

    2007-10-01

    An open-label, randomized controlled study was conducted at a tertiary care teaching hospital to compare efficacy and safety of intravenous sodium valproate versus diazepam infusion for control of refractory status epilepticus. Forty children with refractory status epilepticus were randomized to receive either intravenous sodium valproate or diazepam infusion. Refractory status epilepticus was controlled in 80% of the valproate and 85% of the diazepam patients. The median time to control refractory status epilepticus was less in the valproate group (5 minutes) than the diazepam group (17 minutes; P diazepam group 60% required ventilation and 50% developed hypotension after starting diazepam infusion. No adverse effects on liver functions were seen with valproate. It is concluded that intravenous sodium valproate is an effective alternative to diazepam infusion in controlling refractory status epilepticus in children and is free of respiratory depression and hypotension.

  19. A small-dose naloxone infusion alleviates nausea and sedation without impacting analgesia via intravenous tramadol

    Institute of Scientific and Technical Information of China (English)

    JIA Dong-lin; NI Cheng; XU Ting; ZHANG Li-ping; GUO Xiang-yang

    2010-01-01

    Background Early studies showed that naloxone infusion decreases the incidence of morphine-related side effects from intravenous patient-controlled analgesia. This study aimed to determine whether naloxone preserved analgesia while minimizing side effects caused by intravenous tramadol administration. Methods Eighty patients undergoing general anesthesia for cervical vertebrae surgery were randomly divided into four groups. All patients received 1 mg/kg tramadol 30 minutes before the end of surgery, followed by a continuous infusion with 0.3 mgkg-1·h-1 tramadol with no naloxone (group I, n=20), 0.05 μg-kg-1·h-1 naloxone (group II, n=20), 0.1 μg·kg-1·h-1 naloxone (group III, n=20) and 0.2 μg·kg-1·h-1 naloxone (group IV, n=20). Visual analog scales (VAS) for pain during rest and cough, nausea five-point scale (NFPS) for nausea and vomiting, and ramsay sedation score (RSS) for sedation were assessed at 2, 6,12, 24 and 48 hours postoperatively. Analgesia and side effects were evaluated by blinded observers. Results Seventy-eight patients were included in this study. The intravenous tramadol administration provided the satisfied analgesia. There was no significant difference in either resting or coughing VAS scores among naloxone groups and control group. Compared with control group, sedation was less in groups II, III, and IV at 6, 12, and 24 hours (P <0.05); nausea was less in groups II, III and IV than group I at 2, 6, 12, 24 and 48 hours postoperatively (P <0.05). The incidence of vomiting in the control group was 35% vs. 10% for the highest dose naloxone group (group IV) (P<0.01). Conclusion A small-dose naloxone infusion could reduce tramadol induced side effects without reversing its analgesic effects.

  20. First-pass metabolism of ethanol in human beings: effect of intravenous infusion of fructose

    DEFF Research Database (Denmark)

    Parlesak, Alexandr; Billinger, MH; Schäfer, C.

    2004-01-01

    Intravenous infusion of fructose has been shown to enhance reduced form of nicotinamide adenine dinucleotide reoxidation and, thereby, to enhance the metabolism of ethanol. In the current study, the effect of fructose infusion on first-pass metabolism of ethanol was studied in human volunteers....... A significantly higher first-pass metabolism of ethanol was obtained after administration of fructose in comparison with findings for control experiments with an equimolar dose of glucose. Because fructose is metabolized predominantly in the liver and can be presumed to have virtually no effects in the stomach......, results of the current study support the assumption that only a negligible part of first-pass metabolism of ethanol occurs in the stomach....

  1. Effects of Intravenous Ketamine Infusions in a Neuropathic Pain Patient with Lichen Sclerosus et Atrophicus

    Science.gov (United States)

    Hanna, Ashraf F.; Armstrong, Josh S.; Smith, Adam J.

    2016-01-01

    A patient reported to the Florida Spine Institute (Clearwater, Fla., USA) with severe lichen sclerosus of the anogenital region and legs. The patient's pain presentation was neuropathic with hypersensitivity, allodynia, swelling, and weakness. The patient had failed multiple pain management modalities including opioid therapy, anticonvulsants, and antidepressants. The patient completed a standard intravenous ketamine infusion regimen developed at the Florida Spine Institute and reported complete abolishment of her pain syndrome. For the first time, we report that ketamine infusions also dramatically improved a patient's lichen sclerosus. That ketamine is known to have immunomodulatory properties, and given the clinical observations described in this case report, suggests that ketamine should be explored as a possible new therapeutic option for managing lichen sclerosus, especially in cases that are refractory to conventional therapies. PMID:27462225

  2. Perioperative intravenous lidocaine infusion on postoperative pain relief in patients undergoing upper abdominal surgery.

    Science.gov (United States)

    Baral, B K; Bhattarai, B K; Rahman, T R; Singh, S N; Regmi, R

    2010-12-01

    Due to unpleasant nature and physiological consequences of postoperative pain, search of safe and effective modalities for its management has remained a subject of interest to clinical researchers. Analgesic action of lidocaine infusion in patients with chronic neuropathic pain is well known but its place in relieving postoperative pain is yet to be established. The study aimed to assess the effectiveness of perioperative intravenous lidocaine infusion on postoperative pain intensity and analgesic requirement. Sixty patients undergoing major upper abdominal surgery were recruited in this randomized double blinded study. Thirty patients received lidocaine 2.0% (intravenous bolus 1.5 mg/kg followed by an infusion of 1.5 mg/kg/h), and 30 patients received normal saline according to randomization. The infusion started 30 min before skin incision and stopped 1 h after the end of surgery. Postoperative pain intensity and analgesic (diclofenac) requirement were assessed at the interval 15 minutes for 1 hour then 4 hourly up to 24 hours. The pain intensity at rest and movement as well as the total postoperative analgesic (diclofenac) requirement were significantly lower (142.50 +/- 37.80 mg vs.185.00 +/- 41.31 mg, Plidocaine group. The extubation time was significantly longer in lidocaine group (14.43 +/- 3.50 minutes vs. 6.73 +/- 1.76 minutes, Plidocaine group (60.97 +/- 18.05 minutes vs.15.73 +/- 7.46 minutes, Plidocaine decreases the intensity of postoperative pain, reduces the postoperative analgesic consumption, without causing significant adverse effects in patients undergoing upper abdominal surgery.

  3. Continuous intraperitoneal insulin infusion in the treatment of type 1 diabetes mellitus : glycaemia and beyond

    NARCIS (Netherlands)

    van Dijk, Peter R.

    2015-01-01

    Continuous intraperitoneal insulin infusion (CIPII) with an implantable pump is a last-resort treatment option for selected patients with type 1 diabetes mellitus (T1DM). As compared to the most commonly used forms of insulin administration -injections and an externally placed pump- which deliver in

  4. Treatment with continuous subcutaneous insulin infusion is associated with lower arterial stiffness

    DEFF Research Database (Denmark)

    Vestergaard Rosenlund, Signe; Theilade, Simone; Hansen, Tine Willum;

    2014-01-01

    AIMS: To investigate the relationship between arterial stiffness and insulin treatment mode [continuous subcutaneous insulin infusion (CSII) versus multiple daily injections (MDI)] in type 1 diabetes patients. METHODS: Cross-sectional study, from 2009 to 2011, including 601 Caucasian type 1...

  5. Continuous intraperitoneal insulin infusion in the treatment of type 1 diabetes mellitus : glycaemia and beyond

    NARCIS (Netherlands)

    van Dijk, Peter R.

    2015-01-01

    Continuous intraperitoneal insulin infusion (CIPII) with an implantable pump is a last-resort treatment option for selected patients with type 1 diabetes mellitus (T1DM). As compared to the most commonly used forms of insulin administration -injections and an externally placed pump- which deliver

  6. The analysis and countermeasures of intravenous infusion operation assessment results analysis in nursing students at different levels

    Directory of Open Access Journals (Sweden)

    Jiao-rong ZHAO

    2013-11-01

    Full Text Available Objective:To analyze the problems existed in nursing students at different levels in the process of intravenous infusion, to make judgmental guide towards common problems in clinical teaching, to standardize nursing students’ operations at intravenous infusion, and to avoid errors and disputes. Methods: The authors analyzed the problems in secondary, tertiary, undergraduate nursing students in three levels at a provincial hospital from 2010 to 2012 during intravenous infusion therapy; and the clinical teaching administration means were also discussed. Results: the difference of the problems existed in nursing students at different levels is not significant. P values were greater than 0.05. The top five projects that lost scores are consistent. Conclusion: The key problems that can easily cause errors and disputes are those that mostly occurred in nursing students at intravenous infusion operations. In clinical teaching, judgmental guide on common problems should be emphasized, nursing students’ operations at intravenous infusion should be standardized, the critical awareness towards clinical operations should be developed, errors and disputes should be avoided, and nursing students’ sense of professionalism should be enhanced.

  7. [Clinical study of astromicin administered by intravenous drip infusion against chronic complicated urinary tract infections].

    Science.gov (United States)

    Suzuki, K; Takanashi, K; Nagakubo, I; Kiyosaki, H; Naide, Y

    1987-07-01

    Astromicin (ASTM) was administered by intravenous drip infusion (i.v.d.) to 22 patients with chronic complicated urinary tract infections and the clinical efficacy and safety of this drug were evaluated. The overall clinical efficacy rate obtained was 71.4% (excellent 6; moderate 9) of 21 evaluable cases by the UTI committee's criteria. Concerning the response on clinical isolates, the drug was highly effective especially against strains of Escherichia coli, indole positive Proteus and Serratia marcescens. It was not effective, however, against 2 strains of Pseudomonas aeruginosa. As for adverse reactions, there was one case which complained of headache on the 3rd day after starting treatment. In this case the drug administration was discontinued at the 5th day. The symptom disappeared within 24 hours without any treatment. No any other adverse reactions were noted. With regard to clinical test values for peripheral blood, liver and renal functions, no abnormality was observed in any of the cases treated with the drug. In conclusion, ASTM was found to be a highly effective and safe drug when administered by intravenous drip infusion in the treatment of chronic complicated urinary tract infections.

  8. Intravenous paracetamol infusion versus intramuscular tramadol as an intra-partum labor analgesic

    Directory of Open Access Journals (Sweden)

    Rashmi Patil

    2016-09-01

    Full Text Available We read with interest the article and ldquo;Intravenous paracetamol infusion versus intramuscular tramadol as an intra-partum labor analgesic and rdquo; by Mohan H et al published in November - December 2015, volume 4 issue 6 of International Journal of Reproduction, Contraception, Obstetrics and Gynecology.1 As we read it, we realized that the article is quite similar to another article and ldquo;Intravenous paracetamol infusion versus intramuscular tramadol as an intra-partum labor analgesic and rdquo; by Lallar M et al.2 Although the authors quote this article as their reference, the degree of similarity between the two articles is beyond our acceptance. Hence we would like to bring it to your notice. We know that any original research should be encouraged to be published, but the authenticity in style of writing the same should be maintained and plagiarism to such a high extent is not acceptable. [Int J Reprod Contracept Obstet Gynecol 2016; 5(9.000: 3268-3268

  9. Urinary iron excretion induced by intravenous infusion of deferoxamine in ß-thalassemia homozygous patients

    Directory of Open Access Journals (Sweden)

    Boturão-Neto E.

    2002-01-01

    Full Text Available The purpose of the present study was to identify noninvasive methods to evaluate the severity of iron overload in transfusion-dependent ß-thalassemia and the efficiency of intensive intravenous therapy as an additional tool for the treatment of iron-overloaded patients. Iron overload was evaluated for 26 ß-thalassemia homozygous patients, and 14 of them were submitted to intensive chelation therapy with high doses of intravenous deferoxamine (DF. Patients were classified into six groups of increasing clinical severity and were divided into compliant and non-compliant patients depending on their adherence to chronic chelation treatment. Several methods were used as indicators of iron overload. Total gain of transfusion iron, plasma ferritin, and urinary iron excretion in response to 20 to 60 mg/day subcutaneous DF for 8 to 12 h daily are useful to identify iron overload; however, urinary iron excretion in response to 9 g intravenous DF over 24 h and the increase of urinary iron excretion induced by high doses of the chelator are more reliable to identify different degrees of iron overload because of their correlation with the clinical grades of secondary hemochromatosis and the significant differences observed between the groups of compliant and non-compliant patients. Finally, the use of 3-9 g intravenous DF for 6-12 days led to a urinary iron excretion corresponding to 4.1 to 22.4% of the annual transfusion iron gain. Therefore, continuous intravenous DF at high doses may be an additional treatment for these patients, as a complement to the regular subcutaneous infusion at home, but requires individual planning and close monitoring of adverse reactions.

  10. Intravenous midazolam infusion for sedation of infants in the neonatal intensive care unit.

    Science.gov (United States)

    Ng, Eugene; Taddio, Anna; Ohlsson, Arne

    2017-01-31

    Proper sedation for neonates undergoing uncomfortable procedures may reduce stress and avoid complications. Midazolam is a short-acting benzodiazepine that is used increasingly in neonatal intensive care units (NICUs). However, its effectiveness as a sedative in neonates has not been systematically evaluated. Primary objeciveTo assess the effectiveness of intravenous midazolam infusion for sedation, as evaluated by behavioural and/or physiological measurements of sedation levels, in critically ill neonates in the NICU. Secondary objectivesTo assess effects of intravenous midazolam infusion for sedation on complications including the following.1. Incidence of intraventricular haemorrhage (IVH)/periventricular leukomalacia (PVL).2. Mortality.3. Occurrence of adverse effects associated with the use of midazolam (hypotension, neurological abnormalities).4. Days of ventilation.5. Days of supplemental oxygen.6. Incidence of pneumothorax.7. Length of NICU stay (days).8. Long-term neurodevelopmental outcomes. We selected for review randomised and quasi-randomised controlled trials of intravenous midazolam infusion for sedation in infants aged 28 days or younger. We abstracted data regarding the primary outcome of level of sedation. We assessed secondary outcomes such as intraventricular haemorrhage, periventricular leukomalacia, death, length of NICU stay and adverse effects associated with midazolam. When appropriate, we performed meta-analyses using risk ratios (RRs) and risk differences (RDs), and if the RD was statistically significant, we calculated the number needed to treat for an additional beneficial outcome (NNTB) or an additional harmful outcome (NNTH), along with their 95% confidence intervals (95% CIs) for categorical variables, and weighted mean differences (WMDs) for continuous variables. We assessed heterogeneity by performing the I-squared (I2) test. We included in the review three trials enrolling 148 neonates. We identified no new trials for this update

  11. Platelet transfusion in chemotherapy patients: comparison of the effect of intravenous infusion pumps versus gravity transfusion.

    Science.gov (United States)

    Meess, A

    2015-01-01

    Platelet concentrates are given to patients suffering with severe thrombocytopenia usually by a gravity transfusion procedure. Increasing patient numbers that are in need of this treatment increase the pressure on hospital staff and space. In order to combat time issues, the use of medical devices such as intravenous infusion pumps are thought to be beneficial for time and simultaneously for safety in transfusion practices. By using infusion pumps, platelet concentrates can be transfused in less time and provide accurate volume measurements. Manufacturers of infusion pumps claim that these devices are safe to be used for blood products including platelet concentrates. However, published studies were performed on older models and newer devices are on the market now. The purpose of this study is to evaluate infusion pumps, which are claimed to be suitable for blood products and to investigate the impact the pumps had on platelets. Furthermore, the study revealed if the intravenous infusion pumps are safe to be used for platelet transfusion as claimed by manufacturers. A simulated transfusion was performed using the Carefusion Alaris GP Plus volumetric pump and Fresenius Kabi Volumat Agilia infusion pump. Samples were taken from expired platelet concentrates before and after passage through the pump. All samples were investigated for full blood count that included platelet count, mean platelet volume (MPV), platelet distribution width (PDW) and a plateletcrit (PCT). The samples were then centrifuged to achieve platelet-poor plasma and then tested for lactate dehydrogenase (LDH). A power calculation performed on the statistical power analysis program G*power indicated a requirement of 82 samples for a power of 80%. Statistical analysis was performed with the IBM SPSS statistic software. A paired sample t-test was used to calculate mean, standard deviation and P values for the infusion pumps used. The Wilcoxon Signed Rank Test was used to evaluate results that had a non

  12. INFLUENCE OF INTRAVENOUS DEXMEDETOMIDINE INFUSION ON SUBARACHNOID BLOCK WITH BUPIVACAINE IN ADULT INGUINAL HERNIORRHAPHIES

    Directory of Open Access Journals (Sweden)

    Suhara

    2014-09-01

    Full Text Available INTRODUCTION: Central neuraxial blocks with local anaesthetics are popular techniques of anaesthesia which have been extensively used for lower abdominal surgery. Subarachnoid block is a simple technique which requires a small dose of local anaesthetic to provide rapid and reliable surgical anaesthesia and minimal risk of drug toxicity. Duration of spinal anaesthesia may be prolonged by addition of opioids, clonidine, neostigmine, or vasoconstrictor agents to the local anesthetic drug for better post-op pain relief. Intrathecal addition of a low dose of α2-agonist like clonidine or dexmedetomidine results in significant prolongation of the duration of the sensory and motor blockade induced by hyperbaric bupivacaine. This study is designed to investigate the effects of intravenous dexmedetomidine on the duration of sensory and motor blockade induced by intrathecal administration of bupivacaine, and its associated adverse events. AIMS AND OBJEVCTIVES: To determine effect of intravenous Dexmedetomidine on the duration of analgesia with spinal Bupivacaine for adult patients undergoing herniorrhaphy and to assess the incidence of intra operative side effects, if any. STUDY SETTING: This study was done under the department of Anaesthesiology, Azeezia Medical College from March 2013 to October 2013. STUDY DESIGN: A double blind prospective randomized control study was done.50 adults aged 20 to 60 years scheduled for herniorrhaphies were allocated into two study groups, named A and B using computer generated randomization. INTERPRETATIONS AND CONCLUSION: The duration of analgesia of subarachnoid block with heavy 0.5% bupivacaine with intravenous infusion of saline and dexmedetomidine were compared. Post-operative pain was evaluated by Visual Analogue Scale. Duration of analgesia is the time taken from the administration of the drug to the time when the patient complains of pain of > 50 in Visual Analogue Scale. The duration of analgesia was longest in

  13. Effect of intravenous infusion of glyceryl trinitrate on gastric and small intestinal motor function in healthy humans

    DEFF Research Database (Denmark)

    Madsen, Jan Lysgård; Fuglsang, Stefan; Graff, J

    2006-01-01

    : To examine the effect of intravenous infusion of glyceryl trinitrate on gastric and small intestinal motor function after a meal in healthy humans. METHODS: Nine healthy volunteers participated in a placebo-controlled, double-blind, crossover study. Each volunteer was examined during intravenous infusion...... of glyceryl trinitrate 1 microg/kg x min or saline. A gamma camera technique was used to measure gastric emptying and small intestinal transit after a 1600-kJ mixed liquid and solid meal. Furthermore, duodenal motility was assessed by manometry. RESULTS: Glyceryl trinitrate did not change gastric mean...... emptying time, gastric half emptying time, gastric retention at 15 min or small intestinal mean transit time. Glyceryl trinitrate did not influence the frequency of duodenal contractions, the amplitude of duodenal contractions or the duodenal motility index. CONCLUSIONS: Intravenous infusion of glyceryl...

  14. Stability of ranitidine hydrochloride at dilute concentration in intravenous infusion fluids at room temperature.

    Science.gov (United States)

    Galante, L J; Stewart, J T; Warren, F W; Johnson, S M; Duncan, R

    1990-07-01

    The stability of ranitidine at low concentration (0.05 mg/mL) in five intravenous infusion solutions (0.9% sodium chloride, 5% dextrose, 10% dextrose, 5% dextrose with 0.45% sodium chloride, and 5% dextrose with lactated Ringer's injections) was studied. Admixtures were stored for seven days at room temperature in 150-mL and 1-L polyvinyl chloride infusion bags. Ranitidine stability in 0.9% sodium chloride injection and in 5% dextrose injection was also examined for up to 28 days, and these data were compared with data obtained at higher ranitidine concentrations (0.5-2.0 mg/mL). At intervals during the storage periods, color, clarity, and solution pH were examined and ranitidine content was determined by a stability-indicating high-performance liquid chromatographic assay. Ranitidine content remained greater than 90% of the initial concentration for more than 48 hours in all infusion fluids except 5% dextrose with lactated Ringer's injection. No visual changes or appreciable changes in pH were observed for any of the solutions. At the dilute concentration, ranitidine was markedly more stable after eight hours in 0.9% sodium chloride injection than in 5% dextrose injection. In 0.9% sodium chloride injection, ranitidine concentrations remained above 95% for up to 28 days, but drug concentrations in 5% dextrose injection fell below 90% after seven days. Stability in 5% dextrose injection improved as ranitidine concentrations increased from 0.05 to 2.0 mg/mL. Ranitidine (0.05 mg/mL) is stable for at least 48 hours at room temperature in all infusion fluids tested except 5% dextrose with lactated Ringer's injection.

  15. [Guidelines concerning insulin dosage in children and adolescents with type 1 diabetes on continuous subcutaneous insulin infusion].

    Science.gov (United States)

    Szypowska, Agnieszka; Pańkowska, Ewa; Lipka, Maria

    2006-01-01

    The treatment of diabetes mellitus with a continuous subcutaneous insulin infusion (CSII) has become very popular and is well accepted by diabetic patients. Pump therapy mimics the physiological insulin secretion and has been shown to be a safe and effective method of insulin administration alternative to the method of multiple injections. Continuous insulin infusion provides greater flexibility in the timing of meals and snacks with higher treatment satisfaction. Programmed basal rates improve nocturnal glycemic control and help to minimize a pre-breakfast increase of blood glucose level (the dawn phenomenon). Moreover, CSII can reduce exercise-induced and nocturnal hypoglycemia. Insulin pump therapy is effective in lowering glycated hemoglobin levels without higher risk of severe hypoglycaemia and ketoacidosis. To achieve a proper metabolic control with this method of treatment, the patient and his family requires appropriate education including knowledge of diet management, insulin therapy and manual competence of pump device. Here we present general guidelines for patients education concerning insulin dosage, programming of basal insulin rates and meal boluses based on carbohydrates and protein-fat exchanges.

  16. Effects of abomasal infusion of tallow or camelina oil on responses to glucose and insulin in dairy cows during late pregnancy.

    Science.gov (United States)

    Salin, S; Taponen, J; Elo, K; Simpura, I; Vanhatalo, A; Boston, R; Kokkonen, T

    2012-07-01

    Late pregnancy is associated with moderate insulin resistance in ruminants. Reduced suppression of lipolysis by insulin facilitates mobilization of nonesterified fatty acids (NEFA) from adipose tissue, resulting in elevated plasma NEFA concentrations. Decrease in dry matter intake (DMI) before parturition leads to accelerated lipomobilization and increases plasma NEFA, which may further impair insulin sensitivity. The aim of the study was to evaluate the effects of elevation of plasma NEFA concentration by abomasal infusions tallow (TAL) or camelina oil (CAM) on whole-body responses to exogenous glucose and insulin. We further assessed whether CAM, rich in C18:3n-3, enhances whole-body insulin sensitivity compared with TAL. Six late-pregnant, second-parity, rumen-cannulated dry Ayrshire dairy cows fed grass silage to meet 95% of metabolizable energy requirements were used in a replicated 3 × 3 Latin square with 5-d periods and 5 recovery days between each period. Treatments consisted of abomasal infusion of 500 mL/d (430 g of lipids/d) of water (control), TAL, or CAM administered in 10 equal doses daily. Intravenous glucose tolerance test (IVGTT) and i.v. insulin challenge (IC) were performed on d 5 after 98 and 108 h of treatment infusions, respectively. Infusion of lipids increased basal plasma NEFA concentrations on d 5 (CAM: 0.25; TAL: 0.28; control: 0.17 mmol/L). Following glucose injection, the rate of glucose clearance (CR) was lower in lipid-treated cows (CAM: 1.34; TAL: 1.48; control: 1.74%/min) and time to reach half-maximal glucose concentration (T(1/2)) was longer (CAM: 54; TAL: 47; control: 42 min). Similar responses were observed after insulin injection. Increased plasma NEFA concentration tended to decrease insulin secretion in IVGTT. Infusion of CAM increased plasma C18:3n-3 content (CAM: 26.4; TAL: 16.1; control: 20.9 g/100g of fatty acids). Data suggest that CAM had an insulin-sensitizing effect, because the disposition index and insulin

  17. Responses of Blood Glucose, Insulin, Glucagon, and Fatty Acids to Intraruminal Infusion of Propionate in Hanwoo

    Directory of Open Access Journals (Sweden)

    Y. K. Oh

    2015-02-01

    Full Text Available This study was carried out to investigate the effects of intraruminal infusion of propionate on ruminal fermentation characteristics and blood hormones and metabolites in Hanwoo (Korean cattle steers. Four Hanwoo steers (average body wt. 270 kg, 13 month of age equipped with rumen cannula were infused into rumens with 0.0 M (Water, C, 0.5 M (37 g/L, T1, 1.0 M (74 g/L, T2 and 1.5 M (111 g/L, T3 of propionate for 1 hour per day and allotted by 4×4 Latin square design. On the 5th day of infusion, samples of rumen and blood were collected at 0, 60, 120, 180, and 300 min after intraruminal infusion of propionate. The concentrations of serum glucose and plasma glucagon were not affected (p>0.05 by intraruminal infusion of propionate. The serum insulin concentration at 60 min after infusion was significantly (p<0.05 higher in T3 than in C, while the concentration of non-esterified fatty acid (NEFA at 60 and 180 min after infusion was significantly (p<0.05 lower in the propionate treatments than in C. Hence, intraruminal infusion of propionate stimulates the secretion of insulin, and decreases serum NEFA concentration rather than the change of serum glucose concentration.

  18. Non-ST Elevation Myocardial Infraction after High Dose Intravenous Immunoglobulin Infusion

    Directory of Open Access Journals (Sweden)

    Meir Mizrahi

    2009-01-01

    Full Text Available Intravenous immunoglobulins (IVIgs are used for several indications, including autoimmune conditions. IVIg treatment is associated with several possible adverse reactions including induction of a hypercoagulable state. We report a 76-year-old woman treated with IVIg for myasthenia gravis, which developed chest pain and weakness following IVIg infusion. The symptoms were associated with ST segment depression in V4–6 and elevated troponin levels. The patient was diagnosed with non-ST elevation myocardial infarction (NSTEMI. The patient had no significant risk factor besides age and a cardiac perfusion scan was interpreted as normal (the patient refused to undergo cardiac catheterization. This case is compatible with IVIg-induced hypercoagulability resulting in NSTEMI. Cardiac evaluation should therefore be considered prior to initiation of IVIg treatment especially in patients with multiple cardiovascular risks.

  19. Intravenous phentolamine infusion alleviates the pain of abdominal visceral cancer, including pancreatic carcinoma.

    Science.gov (United States)

    Yasukawa, Masako; Yasukawa, Ken'ichi; Kamiizumi, You; Yokoyama, Ryouji

    2007-01-01

    This case report series describes eight patients (four patients with pancreatic carcinoma, one patient with hepatocellular carcinoma, one patient with gastric and rectal carcinoma, one with sigmoid colon cancer, and one with rectal cancer), whose abdominal cancer pain was treated with intravenous phentolamine infusion at 80 mg x day(-1) for 2 days. All but one of the patients had already been treated with opioids. All eight patients complained of severe abdominal pain; in five patients the pain radiated to the back, and there was associated anal pain in two patients. Analgesia was achieved in three patients; pain alleviation was obtained in four patients, but was not sustained in two of these four patients; and the treatment in one patient could not be judged for efficacy because epidural morphine was used together with the phentolamine. Adverse effects of phentolamine were tachycardia and/or hypotension.

  20. Lipid and insulin infusion-induced skeletal muscle insulin resistance is likely due to metabolic feedback and not changes in IRS-1, Akt, or AS160 phosphorylation.

    Science.gov (United States)

    Hoy, Andrew J; Brandon, Amanda E; Turner, Nigel; Watt, Matthew J; Bruce, Clinton R; Cooney, Gregory J; Kraegen, Edward W

    2009-07-01

    Type 2 diabetes is characterized by hyperlipidemia, hyperinsulinemia, and insulin resistance. The aim of this study was to investigate whether acute hyperlipidemia-induced insulin resistance in the presence of hyperinsulinemia was due to defective insulin signaling. Hyperinsulinemia (approximately 300 mU/l) with hyperlipidemia or glycerol (control) was produced in cannulated male Wistar rats for 0.5, 1 h, 3 h, or 5 h. The glucose infusion rate required to maintain euglycemia was significantly reduced by 3 h with lipid infusion and was further reduced after 5 h of infusion, with no difference in plasma insulin levels, indicating development of insulin resistance. Consistent with this finding, in vivo skeletal muscle glucose uptake (31%, P lipid infusion. Despite the development of insulin resistance, there was no difference in the phosphorylation state of multiple insulin-signaling intermediates or muscle diacylglyceride and ceramide content over the same time course. However, there was an increase in cumulative exposure to long-chain acyl-CoA (70%) with lipid infusion. Interestingly, although muscle pyruvate dehydrogenase kinase 4 protein content was decreased in hyperinsulinemic glycerol-infused rats, this decrease was blunted in muscle from hyperinsulinemic lipid-infused rats. Decreased pyruvate dehydrogenase complex activity was also observed in lipid- and insulin-infused animals (43%). Overall, these results suggest that acute reductions in muscle glucose metabolism in rats with hyperlipidemia and hyperinsulinemia are more likely a result of substrate competition than a significant early defect in insulin action or signaling.

  1. Significant air embolism: A possibility even with collapsible intravenous fluid containers when used with rapid infuser system.

    Science.gov (United States)

    Pant, Deepanjali; Narani, Krishan Kumar; Sood, Jayashree

    2010-01-01

    Significant venous air embolism may develop acutely during the perioperative period due to a number of causes such as during head and neck surgery, spinal surgery, improper central venous and haemodialysis catheter handling, etc. The current trend of using self collapsible intravenous (IV) infusion bags instead of the conventional glass or plastic bottles has several advantages, one of thaem being protection against air embolism. We present a 56-year-old man undergoing kidney transplantation, who developed a near fatal venous air embolism during volume resuscitation with normal saline in collapsible IV bags used with rapid infuser system. To our knowledge, this problem with collapsible infusion bags has not been reported earlier.

  2. Impact of intravenous lidocaine infusion on postoperative analgesia and recovery from surgery: a systematic review of randomized controlled trials.

    Science.gov (United States)

    McCarthy, Grace C; Megalla, Sohair A; Habib, Ashraf S

    2010-06-18

    Postoperative pain continues to be inadequately managed. While opioids remain the mainstay for postoperative analgesia, their use can be associated with adverse effects, including ileus, which can prolong hospital stay. A number of studies have investigated the use of perioperative intravenous lidocaine infusion for improving postoperative analgesia and enhancing recovery of bowel function. This systematic review was performed to determine the overall efficacy of intravenous lidocaine infusion on postoperative analgesia and recovery from surgery in patients undergoing various surgical procedures. We searched the databases of MEDLINE, CINAHL and the Cochrane Library from 1966 to December 2009. We searched for randomized controlled comparisons of lidocaine infusion with placebo in the surgical setting and reporting on postoperative analgesia and other aspects of patient recovery from surgery. The quality of all included studies was assessed using the Modified Oxford Scale. Information on postoperative pain intensity and analgesic requirements was extracted from the trials and compared qualitatively. Other relevant data such as return of bowel function, length of hospital stay, intraoperative anaesthetic requirement and adverse effects were also compared. Sixteen trials were included. A total of 395 patients received intravenous lidocaine with 369 controls. In open and laparoscopic abdominal surgery, as well as in ambulatory surgery patients, intravenous perioperative infusion of lidocaine resulted in significant reductions in postoperative pain intensity and opioid consumption. Pain scores were reduced at rest and with cough or movement for up to 48 hours postoperatively. Opioid consumption was reduced by up to 85% in lidocaine-treated patients when compared with controls. Infusion of lidocaine also resulted in earlier return of bowel function, allowing for earlier rehabilitation and shorter duration of hospital stay. First flatus occurred up to 23 hours earlier

  3. Effect of peri-operative intravenous infusion of lignocaine on haemodynamic responses to intubation, extubation and post-operative analgesia

    Institute of Scientific and Technical Information of China (English)

    Yu-Mei Peng; An-Min Shao

    2016-01-01

    Objective: To study the effect of peri-operative intravenous infusion of lignocaine on haemodynamic responses to intubation, extubation and post-operative analgesia. Methods:A total of 90 patients performed with elective laparoscopic cholecystectomy under total anesthesia were randomly divided into three groups with 30 patients in each group. In Group A, patients received 6 mL normal saline as bolus over 10 min followed by 6 mL/h infusion, whereas in Group B, patients were intravenously injected with 2%lignocaine at the rate of 1 mg/kg intravenous injection, 10 min later, conducting intravenous infusion at the rate of 1 mg/kg/h until an hour after operation. In Group C, patients were intravenously injected with 2%lignocaine at a rate of 1.5 mL/kg intravenous injection, 10 min later, conducting intravenous infusion at a rate of 1.5 mL/kg/h until an hour after operation. We recorded the heart rate (HR)and mean arterial pressure (MAP)of before infusion lignocaine (T0), before induction (T1), intubation (T2), 3 min after intubation (T3), 10 min after intubation (T4), extubation (T5), 3 min after extubation (T6)and 10 min after extubation (T7). We also recorded the total injection dosage of ketorolac and pentazocine. Results:The HR and MAP of Group A on T2 and T5 were higher than T0, whereas, the HR and MAP in Groups B and C on T2 and T5 were lower than that of in Group A. The pain-free period in Groups B and C was longer than Group A. The ketorolac and pentazocine requirement in Groups B and C were lower than Group A. Conclusions:Patients were administrated with 2%lignocaine before operation at a rate of 1 mg/kg intravenous injection bolus, 10 min later at the rate of 1 mL/kg/h or 1.5 mL/kg intravenous infusion until an hour after operation. Administration of lignocaine can effectively prevent the change of haemodynamics resulting from intubation and extubation. Furthermore, it can significantly relieve the postoperative pain and reduce the usage amount of analgesic

  4. Increasing plasma [K+] by intravenous potassium infusion reduces NCC phosphorylation and drives kaliuresis and natriuresis.

    Science.gov (United States)

    Rengarajan, Srinivas; Lee, Donna H; Oh, Young Taek; Delpire, Eric; Youn, Jang H; McDonough, Alicia A

    2014-05-01

    Dietary potassium loading results in rapid kaliuresis, natriuresis, and diuresis associated with reduced phosphorylation (p) of the distal tubule Na(+)-Cl(-) cotransporter (NCC). Decreased NCC-p inhibits NCC-mediated Na(+) reabsorption and shifts Na(+) downstream for reabsorption by epithelial Na(+) channels (ENaC), which can drive K(+) secretion. Whether the signal is initiated by ingesting potassium or a rise in plasma K(+) concentration ([K(+)]) is not understood. We tested the hypothesis, in male rats, that an increase in plasma [K(+)] is sufficient to reduce NCC-p and drive kaliuresis. After an overnight fast, a single 3-h 2% potassium (2%K) containing meal increased plasma [K(+)] from 4.0 ± 0.1 to 5.2 ± 0.2 mM; increased urinary K(+), Na(+), and volume excretion; decreased NCC-p by 60%; and marginally reduced cortical Na(+)-K(+)-2Cl(-) cotransporter (NKCC) phosphorylation 25% (P = 0.055). When plasma [K(+)] was increased by tail vein infusion of KCl to 5.5 ± 0.1 mM over 3 h, significant kaliuresis and natriuresis ensued, NCC-p decreased by 60%, and STE20/SPS1-related proline alanine-rich kinase (SPAK) phosphorylation was marginally reduced 35% (P = 0.052). The following were unchanged at 3 h by either the potassium-rich meal or KCl infusion: Na(+)/H(+) exchanger 3 (NHE3), NHE3-p, NKCC, ENaC subunits, and renal outer medullary K(+) channel. In summary, raising plasma [K(+)] by intravenous infusion to a level equivalent to that observed after a single potassium-rich meal triggers renal kaliuretic and natriuretic responses, independent of K(+) ingestion, likely driven by decreased NCC-p and activity sufficient to shift sodium reabsorption downstream to where Na(+) reabsorption and flow drive K(+) secretion.

  5. Maintenance of increased coronary blood flow in excess of demand by nisoldipine administered as an intravenous infusion

    NARCIS (Netherlands)

    A.L. Soward; P.J. de Feyter (Pim); P.G. Hugenholtz (Paul); P.W.J.C. Serruys (Patrick)

    1986-01-01

    textabstractSystemic and hemodynamic effects of nisoldipine, administered as a 4.5-micrograms/kg intravenous bolus over 3 minutes followed immediately by an infusion of 0.2 microgram/kg/min over 30 minutes, were studied in 13 patients undergoing diagnostic catheterization for suspected coronary arte

  6. Vincristine, doxorubicin and dexamethasone (VAD) administered as rapid intravenous infusion for first-line treatment in untreated multiple myeloma

    NARCIS (Netherlands)

    Segeren, CM; Sonneveld, P; van der Holt, B; Baars, JW; Biesma, DH; Cornellissen, JJ; Croockewit, AJ; Dekker, AW; Fibbe, WE; Lowenberg, B; Kooy, MV; van Oers, MHJ; Richel, DJ; Vellenga, E; Verhoef, GEG; Wijermans, PW; Wittebol, S; Lokhorst, HM

    1999-01-01

    We examined the feasibility of achieving a rapid response in patients with previously untreated multiple myeloma by administering vincristine 0.4mg and doxorubicin 9 mg/m(2) as a rapid intravenous infusion for 4d together with intermittent high-dose dexamethasone 40 mg (VAD) for remission induction

  7. Evaluation of first phase insulin secretion by a nateglinide-intravenous glucose insulin release test in newly diagnosed type 2 diabetics

    Institute of Scientific and Technical Information of China (English)

    罗国春

    2006-01-01

    Objective To evaluate the function of the first phase of insulin secretion of pancreatic B cells in newly diagnosed type 2 diabetics using nateglinide-intravenous glucose insulin release test (NG-IVGIRT). Methods NG-IVGIRT and intravenous glucose insulin release test (IVGIRT) were done in 8 patients with newly diagnosed type 2 diabetes mellitus and NG-IVGIRT was done in 8 normal people. Insulin and glucose of blood were deter-

  8. Alfaxalone for maintenance of anaesthesia in ponies undergoing field castration: continuous infusion compared with intravenous boluses.

    Science.gov (United States)

    Deutsch, Julia; Ekiri, Abel; de Vries, Annemarie

    2017-04-14

    To compare alfaxalone as continuous intravenous (IV) infusion with intermittent IV injections for maintenance of anaesthesia in ponies undergoing castration. Prospective, randomized, 'blinded' clinical study. A group of 33 entire male Welsh ponies undergoing field castration. After preanaesthetic medication with IV detomidine (10 μg kg(-1)) and butorphanol (0.05 mg kg(-1)), anaesthesia was induced with IV diazepam (0.05 mg kg(-1)) followed by alfaxalone (1 mg kg(-1)). After random allocation, anaesthesia was maintained with either IV alfaxalone 2 mg kg(-1) hour(-1) (group A; n = 16) or saline administered at equal volume (group S; n = 17). When necessary, additional alfaxalone (0.2 mg kg(-1)) was administered IV. Ponies were breathing room air. Using simple descriptive scales, surgical conditions and anaesthesia recovery were scored. Total amount of alfaxalone, ponies requiring additional alfaxalone and time to administration, time from induction to end of infusion and end of infusion to standing were noted. Indirect arterial blood pressure, pulse and respiratory rates, end-expiratory carbon dioxide partial pressure and arterial haemoglobin oxygen saturation were recorded every 5 minutes. Data were analysed using Student t, Mann-Whitney U and chi-square tests, where appropriate (p < 0.05). Total amount of alfaxalone administered after induction of anaesthesia (0.75 ± 0.27 versus 0.17 ± 0.23 mg kg(-1); p < 0.0001) and time to standing (14.8 ± 4 versus 11.6 ± 4 minutes; p = 0.044) were higher in group A compared to group S. Ponies requiring additional alfaxalone boluses [four (group A) versus seven (group S)] and other measured variables were similar between groups; five ponies required oxygen supplementation [three (group A) versus two (group S)]. Continuous IV infusion and intermittent administration of alfaxalone provided similar anaesthesia quality and surgical conditions in ponies undergoing field castration. Less alfaxalone

  9. Does overnight normalization of plasma glucose by insulin infusion affect assessment of glucose metabolism in Type 2 diabetes?

    DEFF Research Database (Denmark)

    Staehr, P; Højlund, Kurt; Hother-Nielsen, O

    2003-01-01

    AIMS: In order to perform euglycaemic clamp studies in Type 2 diabetic patients, plasma glucose must be reduced to normal levels. This can be done either (i) acutely during the clamp study using high-dose insulin infusion, or (ii) slowly overnight preceding the clamp study using a low-dose insulin...... infusion. We assessed whether the choice of either of these methods to obtain euglycaemia biases subsequent assessment of glucose metabolism and insulin action. METHODS: We studied seven obese Type 2 diabetic patients twice: once with (+ ON) and once without (- ON) prior overnight insulin infusion. Glucose...... turnover rates were quantified by adjusted primed-constant 3-3H-glucose infusions, and insulin action was assessed in 4-h euglycaemic, hyperinsulinaemic (40 mU m-2 min-1) clamp studies using labelled glucose infusates (Hot-GINF). RESULTS: Basal plasma glucose levels (mean +/- sd) were 5.5 +/- 0.5 and 10...

  10. Insulin Analogs Applied with Continuous Subcutaneous Insulin Infusion (Pump in the Treatment of Diabetes

    Directory of Open Access Journals (Sweden)

    Ercan Tuncel

    2015-03-01

    Full Text Available Diabetes mellitus (DM is an important health problem that should be treated efficiently because of its high prevalence and high morbidity and mortality due to its complications. In patients with DM, the application of a treatment which provides physiologic insulin secretion as such in healthy individuals is directly related with the prevention of diabetes complications. Insulin analogs, which were developed in recent years and shown to have pharmacokinetic and pharmacodynamic superiority to human insulin, have made it possible to obtain natural insulin pattern in the body. In addition to development of insulin analogs, introduction of insulin application method of “continuous subcutaneous insulin infusion” (insulin pump has led a new era in the treatment of DM. In this review, treatment of type 1 and 2 DM patients with insulin analogs, particularly insulin aspart, applied with insulin pump was discussed in the light of the current literature.

  11. The analgesic efficacy of intravenous lidocaine infusion after laparoscopic fundoplication: a prospective, randomized, double-blind, placebo-controlled trial

    Directory of Open Access Journals (Sweden)

    Dale GJ

    2016-12-01

    Full Text Available Gregory J Dale,1 Stephanie Phillips,2 Gregory L Falk3 1Westmead Hospital Clinical School, The University of Sydney, 2Sydney Adventist Hospital Clinical School, The University of Sydney, 3Concord Clinical School, The University of Sydney, Sydney, Australia Abstract: This study aimed to determine if intravenous lidocaine infusion reduces postoperative pain intensity following laparoscopic fundoplication surgery and to also validate the safety of intravenous lidocaine at the dose tested. This was an equally randomized, double-blind, placebo-controlled, parallel-group, single center trial. Adult patients undergoing laparoscopic fundoplication were recruited. The intervention group received 1 mg/kg intravenous lidocaine bolus prior to induction of anesthesia, then an intravenous infusion at 2 mg/kg/h for 24 hours. The primary outcome was pain, measured using a numeric rating scale for 30 hours postoperatively. Secondary outcomes were nausea and vomiting, opioid requirements, adverse events, serum lidocaine concentration, and length of hospital stay. The study was terminated after an interim analysis of 24 patients showed evidence of futility. There was no difference in postoperative pain scores (lidocaine versus control, mean ± standard deviation at rest (2.0 ± 2.7 vs 2.1 ± 2.4, P=0.286 or with movement (2.0 ± 2.6 vs 2.6 ± 2.7, P=0.487. Three adverse events occurred in the lidocaine group (25% of patients. Intravenous lidocaine did not provide clinically significant analgesia to patients undergoing laparoscopic fundoplication. The serum lidocaine concentration of patients who experienced adverse events were within the therapeutic range. This trial cannot confirm the safety of intravenous lidocaine at the dose tested. Keywords: analgesia, local anesthetics, intravenous infusions, pharmacokinetics

  12. Surgical aspects and complications of continuous intraperitoneal insulin infusion with an implantable pump

    NARCIS (Netherlands)

    Haveman, Jan Willem; Logtenberg, Susan J. J.; Kleefstra, Nanne; Groenier, Klaas H.; Bilo, Henk J. G.; Blomme, Adri M.

    2010-01-01

    Continuous intraperitoneal insulin infusion (CIPII) with an implantable pump is safe and effective in selected subjects with diabetes. Our aim was to assess surgical experience and complications with CIPII. We performed a retrospective longitudinal observational cohort study of patients that started

  13. Evaluation of pharmacokinetic model designs for subcutaneous infusion of insulin aspart

    DEFF Research Database (Denmark)

    Mansell, Erin J.; Schmidt, Signe; Docherty, Paul D.

    2017-01-01

    included a range of modelled behaviours, parameters and complexity. The models were compared using clinical data from subjects with type 1 diabetes with continuous subcutaneous insulin infusion. Performance of the models was compared through several analyses: R2 for goodness of fit; the Akaike Information...

  14. Surgical aspects and complications of continuous intraperitoneal insulin infusion with an implantable pump

    NARCIS (Netherlands)

    Haveman, Jan Willem; Logtenberg, Susan J. J.; Kleefstra, Nanne; Groenier, Klaas H.; Bilo, Henk J. G.; Blomme, Adri M.

    Continuous intraperitoneal insulin infusion (CIPII) with an implantable pump is safe and effective in selected subjects with diabetes. Our aim was to assess surgical experience and complications with CIPII. We performed a retrospective longitudinal observational cohort study of patients that started

  15. Potential therapeutic application of intravenous autologous bone marrow infusion in patients with alcoholic liver cirrhosis.

    Science.gov (United States)

    Saito, Takafumi; Okumoto, Kazuo; Haga, Hiroaki; Nishise, Yuko; Ishii, Rika; Sato, Chikako; Watanabe, Hisayoshi; Okada, Akio; Ikeda, Motoki; Togashi, Hitoshi; Ishikawa, Tsuyoshi; Terai, Shuji; Sakaida, Isao; Kawata, Sumio

    2011-09-01

    The present study was conducted to evaluate the application and efficacy of autologous bone marrow infusion (ABMi) for improvement of liver function in patients with alcoholic liver cirrhosis (ALC). Five subjects and 5 control patients with ALC who had abstained from alcohol intake for 24 weeks before the study were enrolled. Autologous bone marrow cells were washed and injected intravenously, and the changes in serum liver function parameters, and the level of the type IV collagen 7S domain as a marker of fibrosis, were monitored for 24 weeks. The distribution of activated bone marrow was assessed by indium-111-chloride bone marrow scintigraphy. The number of cells infused was 8.0±7.3×10(9) (mean±standard error). The serum levels of albumin and total protein and the prothrombin time were significantly higher during the follow-up period after ABMi than during the observation period in treated patients, whereas no such changes were observed in the controls. In the patients who received ABMi, the Child-Pugh score decreased in all 3 who were classified as class B; the serum levels of type IV collagen 7S domain improved in 4 of the 5 patients; and bone marrow scintigraphy demonstrated an increase of indium-111-chloride uptake in 3 of the 4 patients tested. ABMi for patients with ALC helps improve liver function parameters in comparison with observation during abstinence and ameliorates the degree of fibrosis in terms of serum markers and bone marrow activation in most cases.

  16. The regulatory system for diabetes mellitus: Modeling rates of glucose infusions and insulin injections

    Science.gov (United States)

    Yang, Jin; Tang, Sanyi; Cheke, Robert A.

    2016-08-01

    Novel mathematical models with open and closed-loop control for type 1 or type 2 diabetes mellitus were developed to improve understanding of the glucose-insulin regulatory system. A hybrid impulsive glucose-insulin model with different frequencies of glucose infusions and insulin injections was analyzed, and the existence and uniqueness of the positive periodic solution for type 1 diabetes, which is globally asymptotically stable, was studied analytically. Moreover, permanence of the system for type 2 diabetes was demonstrated which showed that the glucose concentration level is uniformly bounded above and below. To investigate how to prevent hyperinsulinemia and hyperglycemia being caused by this system, we developed a model involving periodic intakes of glucose with insulin injections applied only when the blood glucose level reached a given critical glucose threshold. In addition, our numerical analysis revealed that the period, the frequency and the dose of glucose infusions and insulin injections are crucial for insulin therapies, and the results provide clinical strategies for insulin-administration practices.

  17. 静脉输液技术发展沿革%Development History of Intravenous Infusion Technology

    Institute of Scientific and Technical Information of China (English)

    封宇飞; 裴艺芳; 倪倩

    2014-01-01

    Objective: To provide evidences for building of Pharmacy Intravenous Admixture Services(PIVAS)and insurances of clinical safe medication. The development history of intravenous infusion technology was reviewed in this paper. Methods:The latest articles related to the development of intravenous infusion, the changes of package forms and materials were collected. Results and Conclusion:Packaging forms of intravenous infusion have gone through the development of open,semi-open and closed ones, and packaging materials changed from glass bottle, plastic bottle to nonPVC soft bag.%目的:综述静脉输液的技术进展,旨在为静脉药物集中配置的建设和临床安全用药提供参考。方法:收集相关最新发表的文献,对静脉输液的技术进展进行回顾。结果与结论:静脉输液的包装形式经历了开放式、半开放式和密闭式的发展,包装材料也从玻璃瓶、塑料瓶发展到了非PVC输液软袋。

  18. Feasibility of adjacent insulin infusion and continuous glucose monitoring via the Medtronic Combo-Set.

    Science.gov (United States)

    O'Neal, David N; Adhya, Sumona; Jenkins, Alicia; Ward, Glenn; Welsh, John B; Voskanyan, Gayane

    2013-03-01

    Subcutaneously infused insulin may interfere with the function of nearby glucose-sensing electrodes and vice versa. The prototype of the Combo-Set device (Medtronic) incorporates a subcutaneous insulin delivery catheter and continuous glucose monitoring (CGM) sensor assembled on the same platform and separated by 11 mm. We aim to evaluate Combo-Set's insulin delivery and glucose-sensing functions. Ten subjects with type 1 diabetes wore a Combo-Set and a Sof-Sensor inserted subcutaneously in contralateral abdominal areas connected to iPro recorders (Medtronic) for 53.25 ± 0.75 h (mean ± standard deviation). The Combo-Set delivered insulin diluent except during meal tests on days 1 and 3 when insulin lispro was delivered as a meal bolus and postmeal basal. Venous plasma samples were collected at the following time points from meal start: 0, 30, 60, 120, and 180 min for insulin measurements. The accuracy of the Combo-Set sensors was evaluated and compared with that of the Sof-Sensor, with each referenced against capillary glucose values (Contour Link Meter, Bayer). Accuracy of the Combo-Set sensor was comparable to that of the Sof-Sensor. Clarke error grid analysis showed that 97% of Combo-Set and 93% of Sof-Sensor values were in the A+B regions (p = .20, not significant). The Combo-Set showed the expected postbolus peak insulin time (67 ± 9 min, mean ± standard error). One "no delivery" alarm occurred during the 21 patient days of use. A device providing for simultaneous adjacent placement of an insulin infusion catheter and a CGM sensor is feasible and functions within acceptable limits. The low "no delivery" alarm rate was similar to that of other infusion sets. © 2013 Diabetes Technology Society.

  19. Mesenchymal stem cells are short-lived and do not migrate beyond the lungs after intravenous infusion

    Directory of Open Access Journals (Sweden)

    Elke eEggenhofer

    2012-09-01

    Full Text Available Mesenchymal stem cells (MSC are under investigation as a therapy for a variety of disorders. Although animal models show long term regenerative and immunomodulatory effects of MSC, the fate of MSC after infusion remains to be elucidated. In the present study the localization and viability of MSC was examined by isolation and re-culture of intravenously infused MSC. C57BL/6 MSC (500,000 constitutively expressing DsRed-fluorescent protein and radioactively labeled with Cr-51 were infused via the tail vein in wild type C57BL/6 mice. After 5min, 1h, 24h or 72h, mice were sacrificed and blood, lungs, liver, spleen, kidneys and bone marrow removed. One hour after MSC infusion the majority of Cr-51 was found in the lungs, whereas after 24h Cr-51 was mainly found in the liver. Tissue cultures demonstrated that viable donor MSC were present in the lungs up to 24h after infusion, after which they disappeared. No viable MSC were found in the other organs examined at any time. The induction of ischemia-reperfusion injury in the liver did not trigger the migration of viable MSC to the liver. These results demonstrate that MSC are short-lived after i.v. infusion and that viable MSC do not pass the lungs. Cell debris may be transported to the liver. Long term immunomodulatory and regenerative effects of infused MSC must therefore be mediated via other cell types.

  20. Continuous subcutaneous insulin infusion versus multiple daily injections of insulin for pregnant women with diabetes.

    Science.gov (United States)

    Farrar, Diane; Tuffnell, Derek J; West, Jane; West, Helen M

    2016-06-07

    Diabetes results in a rise in blood glucose above normal physiological levels; if untreated this may cause damage to many systems including the cardiovascular and renal systems. Pregnancy increases resistance to insulin action; for those women who have pre-gestational diabetes, this results in an increasing insulin requirement. There are several methods of administering insulin. Conventionally, insulin has been administered subcutaneously, formally referred to as intensive conventional treatment, but now more usually referred to as multiple daily injections (MDI). An alternative method of insulin administration is the continuous subcutaneous insulin infusion pump (CSII). To compare CSII with MDI of insulin for pregnant women with pre-existing and gestational diabetes. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 March 2016) and reference lists of retrieved studies. Randomised trials comparing CSII with MDI for pregnant women with diabetes. Three review authors independently assessed studies and two review authors extracted data. Disagreements were resolved through discussion with the third author. We assessed the quality of the evidence using the GRADE approach. We included five single-centre trials (undertaken in Italy) with 153 women and 154 pregnancies in this review.There were no clear differences in the primary outcomes reported between CSII and MDI in the included trials: caesarean section (risk ratio (RR) 1.09, 95% confidence interval (CI) 0.66 to 1.77; three trials, 71 women, evidence graded very low), large-for-gestational age (RR 4.15, 95% CI 0.49 to 34.95; three trials, 73 infants; evidence graded very low), and perinatal mortality (RR 2.33, 95% CI 0.38 to 14.32; four trials, 83 infants, evidence graded very low). Other primary outcomes were not reported in these trials (hypertensive disorders of pregnancy, development of type 2 diabetes, composite outcome of serious neonatal outcomes, and neurosensory disability

  1. Lower dose basal insulin infusion has positive effect on glycaemic control for children with type I diabetes on continuous subcutaneous insulin infusion therapy.

    Science.gov (United States)

    Schulten, Ron J; Piet, Jessica; Bruijning, Patricia Cjl; de Waal, Wouter J

    2017-02-01

    The aim of our study was to explore a possible relationship between proportion of basal insulin dose (%BD/T) and glycaemic control in children with type I diabetes on continuous subcutaneous insulin infusion (CSII) therapy. All patients under the age of 18 with type I diabetes mellitus, treated in a general hospital in Utrecht, The Netherlands, who were on CSII therapy between 2000 and 2011 were selected for inclusion. All data as recorded during outpatient visits were retrospectively collected from patients' charts. Analyses were performed using R Statistical Software. Data of 847 outpatient visits of 78 patients [31 males (39.7%) and 47 females (60.3%)] were analyzed. Mean age at diagnosis was 7.1 ± 3.7 yr, mean age at start of pump therapy 10.1 ± 3.8 yr. Mean HbA1c before pump start was 8.3 ± 1.0%, median BMI standard deviation score for age and gender was 0.64 (-1.89-3.79). Median follow-up time per patient was 29 months with an average of 10 visits (range: 3-25). Multivariate analysis revealed that a change of 10% in %BD/T resulted in a decrease or increase of HbA1c of 0.22% [95% confidence interval (CI): 0.15-0.29). No significant effect was observed from SDS BMI, sex, or duration of diabetes. Low dose basal insulin infusion as a percentage of total insulin dose has a positive effect on metabolic outcome as expressed in HbA1c-levels. A change of 10% in %BD/T results in a decrease or increase of HbA1c of 0.22%. This supports the tendency to aim at the lowest basal insulin requirements in pump setting strategy. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. Pharmacokinetic-pharmacodynamic relationships of cognitive and psychomotor effects of intravenous buprenorphine infusion in human volunteers.

    Science.gov (United States)

    Jensen, Mette L; Sjøgren, Per; Upton, Richard N; Foster, David J R; Bonde, Peter; Graae, Christian; Skram, Ulrik; Stevner, Lene; Christrup, Lona L

    2008-07-01

    The main objective of the present study was to characterize the pharmacokinetic/pharmacodynamic (PK/PD) relationship of the effects of buprenorphine on cognitive functioning in healthy volunteers. Twenty-three male volunteers received 0.6 mg buprenorphine as an intravenous infusion over 150 min. The cognitive and psychomotor performance was evaluated before and at various times after drug administration by a test battery consisting of trail-making test for visual information processing, finger-tapping test for psychomotor speed, and continuous reaction time for attention. Non-linear mixed effect modelling was used in the analysis of the PK/PD relationships. Buprenorphine caused significant deficits in cognitive and psychomotor functioning. The time course of cognitive and psychomotor impairment was found to have a slow distribution to the biophase from plasma with PK/PD models involving an effect compartment providing the best descriptions of the time course of the data. The values for half-life of biophase equilibration were consistent between the neuropsychological tests in the range of 66.6-84.9 min. The time to onset and duration of the cognitive and psychomotor impairment of buprenorphine was determined by a slow distribution to the biophase.

  3. Effects of dihydroergotamine on the feline cardiovascular response to intravenous infusion of live Escherichia coli bacteria.

    Science.gov (United States)

    Arvidsson, S; Lindblad, B; Esquivel, C; Fält, K; Lindström, C; Bergqvist, D; Haglund, U

    1984-01-01

    A septic shock state was induced in cats by intravenous infusion of live Escherichia coli bacteria. Cats pretreated with an unspecific 5-HT blocker, dihydroergotamine (DHE), or with a specific 5-HT blocker, ketanserin, were compared with a series receiving bacteria without pretreatment. DHE pretreatment prevented the reduction in systemic arterial blood pressure found in the other series during the 2-hour period of septic shock. Pretreatment could not influence the increased vascular resistance in the pulmonary vascular bed or the early increase in pulmonary arterial blood pressure. Peripheral blood flow distribution was studied using radioactive labelled microspheres. Compared to bacteremia without pretreatment, the 5-HT blockers increased CNS blood flow and ketanserin also prevented the reduction in pancreatic blood flow. Gastric blood flow and gastric mucosal blood flow remained unchanged in all series as did the small intestinal total blood flow. Small intestinal mucosal blood flow, however, was reduced after 2 h of bacteremia. Microscopy revealed no gastric epithelial damage while the jejunal mucosa was characteristically damaged. There was no correlation between the changes in the small intestinal blood flow and the degree of mucosal damage, however, supporting the countercurrent theory for the pathogenesis of these lesions.

  4. The Effectiveness of Intravenous Morphine Infusion as Preemptive Analgesia in Preventing Phantom Limb Pain Following Lower Limb Amputation

    Directory of Open Access Journals (Sweden)

    KC Chong

    2010-11-01

    Full Text Available hantom limb pain may reduce ambulation and mobility in amputees, resulting in diminished quality of life. We conducted a prospective study to compare the perioperative analgesic use of intravenous morphine infusion in 27 patients (Group A and intramuscular diclofenac sodium in 28 patients (Group B in patients undergoing lower limb amputation. All patients underwent amputation under spinal anaesthesia and reported a Modified Verbal Numerical Pain Score of less than two prior to the procedure. Presence of phantom pain was assessed on the first, second, third and seventh day as well as at the third month and sixth month post-operatively. Twelve (44 % patients from group A and 21 patients (75 % from group B developed phantom limb pain following amputation, a statistically significant difference between groups (p<0.05. We conclude that intravenous morphine infusion is more effective than intramuscular diclofenac sodium in preventing the occurrence of phantom limb pain following amputation.

  5. Therapeutic effect of intravenous infusion of perfluorocarbon emulsion on LPS-induced acute lung injury in rats.

    Science.gov (United States)

    Hou, Shike; Ding, Hui; Lv, Qi; Yin, Xiaofeng; Song, Jianqi; Landén, Ning Xu; Fan, Haojun

    2014-01-01

    Acute lung injury (ALI) and its more severe form, acute respiratory distress syndrome (ARDS) are the leading causes of death in critical care. Despite extensive efforts in research and clinical medicine, mortality remains high in these diseases. Perfluorocarbon (PFC), a chemical compound known as liquid ventilation medium, is capable of dissolving large amounts of physiologically important gases (mainly oxygen and carbon dioxide). In this study we aimed to investigate the effect of intravenous infusion of PFC emulsion on lipopolysaccharide (LPS) induced ALI in rats and elucidate its mechanism of action. Forty two Wistar rats were randomly divided into three groups: 6 rats were treated with saline solution by intratracheal instillation (control group), 18 rats were treated with LPS by intratracheal instillation (LPS group) and the other 18 rats received PFC through femoral vein prior to LPS instillation (LPS+PFC group). The rats in the control group were sacrificed 6 hours later after saline instillation. At 2, 4 and 6 hours of exposure to LPS, 6 rats in the LPS group and 6 rats in LPS+PFC group were sacrificed at each time point. By analyzing pulmonary pathology, partial pressure of oxygen in the blood (PaO2) and lung wet-dry weight ratio (W/D) of each rat, we found that intravenous infusion of PFC significantly alleviated acute lung injury induced by LPS. Moreover, we showed that the expression of pulmonary myeloperoxidase (MPO), intercellular adhesion molecule-1 (ICAM-1) of endothelial cells and CD11b of polymorphonuclear neutrophils (PMN) induced by LPS were significantly decreased by PFC treatment in vivo. Our results indicate that intravenous infusion of PFC inhibits the infiltration of PMNs into lung tissue, which has been shown as the core pathogenesis of ALI/ARDS. Thus, our study provides a theoretical foundation for using intravenous infusion of PFC to prevent and treat ALI/ARDS in clinical practice.

  6. Therapeutic effect of intravenous infusion of perfluorocarbon emulsion on LPS-induced acute lung injury in rats.

    Directory of Open Access Journals (Sweden)

    Shike Hou

    Full Text Available Acute lung injury (ALI and its more severe form, acute respiratory distress syndrome (ARDS are the leading causes of death in critical care. Despite extensive efforts in research and clinical medicine, mortality remains high in these diseases. Perfluorocarbon (PFC, a chemical compound known as liquid ventilation medium, is capable of dissolving large amounts of physiologically important gases (mainly oxygen and carbon dioxide. In this study we aimed to investigate the effect of intravenous infusion of PFC emulsion on lipopolysaccharide (LPS induced ALI in rats and elucidate its mechanism of action. Forty two Wistar rats were randomly divided into three groups: 6 rats were treated with saline solution by intratracheal instillation (control group, 18 rats were treated with LPS by intratracheal instillation (LPS group and the other 18 rats received PFC through femoral vein prior to LPS instillation (LPS+PFC group. The rats in the control group were sacrificed 6 hours later after saline instillation. At 2, 4 and 6 hours of exposure to LPS, 6 rats in the LPS group and 6 rats in LPS+PFC group were sacrificed at each time point. By analyzing pulmonary pathology, partial pressure of oxygen in the blood (PaO2 and lung wet-dry weight ratio (W/D of each rat, we found that intravenous infusion of PFC significantly alleviated acute lung injury induced by LPS. Moreover, we showed that the expression of pulmonary myeloperoxidase (MPO, intercellular adhesion molecule-1 (ICAM-1 of endothelial cells and CD11b of polymorphonuclear neutrophils (PMN induced by LPS were significantly decreased by PFC treatment in vivo. Our results indicate that intravenous infusion of PFC inhibits the infiltration of PMNs into lung tissue, which has been shown as the core pathogenesis of ALI/ARDS. Thus, our study provides a theoretical foundation for using intravenous infusion of PFC to prevent and treat ALI/ARDS in clinical practice.

  7. Proportional Insulin Infusion in Closed-Loop Control of Blood Glucose

    Science.gov (United States)

    Grasman, Johan

    2017-01-01

    A differential equation model is formulated that describes the dynamics of glucose concentration in blood circulation. The model accounts for the intake of food, expenditure of calories and the control of glucose levels by insulin and glucagon. These and other hormones affect the blood glucose level in various ways. In this study only main effects are taken into consideration. Moreover, by making a quasi-steady state approximation the model is reduced to a single nonlinear differential equation of which parameters are fit to data from healthy subjects. Feedback provided by insulin plays a key role in the control of the blood glucose level. Reduced β-cell function and insulin resistance may hamper this process. With the present model it is shown how by closed-loop control these defects, in an organic way, can be compensated with continuous infusion of exogenous insulin. PMID:28060898

  8. Significant air embolism: A possibility even with collapsible intravenous fluid containers when used with rapid infuser system

    Directory of Open Access Journals (Sweden)

    Deepanjali Pant

    2010-01-01

    Full Text Available Significant venous air embolism may develop acutely during the perioperative period due to a number of causes such as during head and neck surgery, spinal surgery, improper central venous and haemodialysis catheter handling, etc. The current trend of using self collapsible intravenous (IV infusion bags instead of the conventional glass or plastic bottles has several advantages, one of thaem being protection against air embolism. We present a 56-year-old man undergoing kidney transplantation, who developed a near fatal venous air embolism during volume resuscitation with normal saline in collapsible IV bags used with rapid infuser system. To our knowledge, this problem with collapsible infusion bags has not been reported earlier.

  9. Efficacy of intravenous lidocaine to reduce pain and distress associated with propofol infusion in pediatric patients during procedural sedation.

    Science.gov (United States)

    Depue, Kent; Christopher, Norman C; Raed, Mona; Forbes, Michael L; Besunder, James; Reed, Michael D

    2013-01-01

    Research suggests that young children experience an increased incidence and severity of discomfort during propofol infusion. Evaluations of varied interventions to reduce or eliminate this discomfort with adult subjects suggest that premedication with intravenously administered lidocaine (0.5 mg/kg) offers the best overall effectiveness. Because this regimen's efficacy in a pediatric population is undocumented, we conducted a randomized, double-blind, placebo-controlled study to determine the effectiveness of intravenous lidocaine pretreatment to alleviate pain in pediatric subjects before propofol infusion. Subjects (aged 2-7 years) scheduled for painless diagnostic procedures received either a saline placebo or 1 of 2 lidocaine doses before administering propofol. To capture the patient's baseline behavioral state, a trained observer administered the validated face, legs, activity, cry, consolability pain assessment scale before propofol infusion. During deep sedation induction, the sedating physician, a trained research assistant, and the patient's parent documented maximum distress using a 100-mm visual analog scale (VAS). Ninety-one subjects participated. We found no difference in VAS pain scores between groups pretreated with lidocaine 0.25 mg/kg, lidocaine 0.5 mg/kg, and placebo. Statistical analysis also found no interrater differences between parents, physician, or observer VAS scores. Our data do not support using lidocaine pretreatment to alleviate pain/discomfort in pediatric patients during propofol infusion.

  10. Efficacy of stiripentol in the intravenous pentylenetetrazol infusion seizure model in the rat.

    Science.gov (United States)

    Shen, D D; Levy, R H; Moor, M J; Savitch, J L

    1990-01-01

    The potential effectiveness of stiripentol, a new allylic alcohol anticonvulsant, against generalized epilepsy of the absence type was evaluated in the intravenous pentylenetetrazol (PTZ) infusion seizure model in the rat. The ability of stiripentol to elevate the threshold dose of PTZ in eliciting clonic seizure (i.e., ratio of the post-drug threshold dose to the baseline threshold dose) was measured. Dose-response studies were performed after acute intraperitoneal injection and subacute oral drug treatment. Concentrations of stiripentol in plasma and whole brain were determined. Significant elevation in PTZ threshold dose was observed at a single 300 mg/kg intraperitoneal dose of stiripentol or at plasma levels exceeding 35 micrograms/ml. Maximal anticonvulsant response (i.e., a dose ratio of 3) was reached with doses at or above 450 mg/kg (or plasma concentration greater than or equal to 120 micrograms/ml), along with the appearance of neurotoxicity. Subacute treatment consisted of 9 consecutive oral doses of stiripentol over a 3 day period, until steady-state plasma stiripentol concentration was attained. Response data were obtained at dosage levels of 150, 400 and 800 mg/kg with respective mean steady-state levels of 33.2 +/- 7.8, 61.4 +/- 20.7, and 116 +/- 14 micrograms/ml. Maximal anticonvulsant effect was not reached even at the highest dose of 800 mg/kg. Correlation of threshold dose ratio with plasma and brain stiripentol concentrations showed an approximate 40% loss in anticonvulsant potency during subacute treatment. However, the animals also became more resistant to drug-induced neurotoxicity; about 40% higher plasma or brain stiripentol concentrations had to be reached for a given degree of neurotoxicity.(ABSTRACT TRUNCATED AT 250 WORDS)

  11. Analysis of factors that influence the outcomes of labor induction with intravenous synthetic oxytocin infusion in term pregnancy with favourable bishop score

    Directory of Open Access Journals (Sweden)

    Mahmut Kuntay Kokanali

    2015-06-01

    Conclusion: Nulliparity, shorter gestation period, persistent occiput posterior presentation and greater birth weight increase the failure risk of labor induction with intravenous synthetic oxytocin infusion. [Cukurova Med J 2015; 40(2.000: 317-325

  12. Supporting patients with type 1 diabetes using continuous subcutaneous insulin infusion therapy: Difficulties, disconnections, and disarray.

    Science.gov (United States)

    Perry, Lin; James, Steven; Gallagher, Robyn; Dunbabin, Janet; Steinbeck, Katharine; Lowe, Julia

    2017-08-01

    Use of continuous subcutaneous insulin infusion therapy in type 1 diabetes management is high. However, the incorporation of this technology into self-care is not without challenges, and the support of an appropriately skilled health care team is recommended. This study aimed to examine the support context for patients using continuous subcutaneous insulin infusion therapy from the health care professional perspective, as well as contextual influences for health care professionals and their patients. This ethnographic qualitative study was undertaken in New South Wales, Australia. Recruitment occurred using a snowball sampling technique, beginning with members of an established diabetes service group. Data were collected through the use of semistructured interviews undertaken by telephone and analysed using thematic analysis. Data were obtained from 26 interviews with staff from diverse professional backgrounds. An overarching theme of difficulties, disconnections, and disarray emerged, with findings indicating that participants perceived difficulties in relation to shortages of health care professional continuous subcutaneous insulin infusion-related expertise, and disconnected and disarrayed service structures and process, with barriers to access to these devices. Individual health care professionals were left to manage somehow or opted not to engage with related care. Findings provide insights from health care professionals' perspectives into the complexity of providing support for patients using continuous subcutaneous insulin infusion therapy across diverse contexts, and provide a platform for further research and service development. The need for consistent and coordinated care, and the infrastructure to facilitate this, flags an opportunity to drive integration of care and teamworking across as well as within settings and disciplines. © 2017 John Wiley & Sons, Ltd.

  13. Specification and simulation of behavior of the Continuous Infusion Insulin Pump system.

    Science.gov (United States)

    Babamir, Seyed Morteza; Dehkordi, Mehdi Borhani

    2014-01-01

    Continuous Infusion Insulin Pump (CIIP) system is responsible for monitoring diabetic blood sugar. In this paper, we aim to specify and simulate the CIIP software behavior. To this end, we first: (1) presented a model consisting of the CIIP system behavior in response to its environment (diabetic) behavior and (2) we formally defined the safety requirements of the system environment (diabetic) in the Z formal modeling language. Such requirements should be satisfied by the CIIP software. Finally, we programmed the model and requirements.

  14. Blood glucose control in healthy subject and patients receiving intravenous glucose infusion or total parenteral nutrition using glucagon-like peptide 1

    DEFF Research Database (Denmark)

    Nauck, Michael A; Walberg, Jörg; Vethacke, Arndt

    2004-01-01

    It was the aim of the study to examine whether the insulinotropic gut hormone GLP-1 is able to control or even normalise glycaemia in healthy subjects receiving intravenous glucose infusions and in severely ill patients hyperglycaemic during total parenteral nutrition.......It was the aim of the study to examine whether the insulinotropic gut hormone GLP-1 is able to control or even normalise glycaemia in healthy subjects receiving intravenous glucose infusions and in severely ill patients hyperglycaemic during total parenteral nutrition....

  15. Glycemic control in cardiac surgery: implementing an evidence-based insulin infusion protocol.

    Science.gov (United States)

    Hargraves, Joelle D

    2014-05-01

    Acute hyperglycemia following cardiac surgery increases the risk of deep sternal wound infection, significant early morbidity, and mortality. Insulin infusion protocols that target tight glycemic control to treat hyperglycemia have been linked to hypoglycemia and increased mortality. Recently published studies examining glycemic control in critical illness and clinical practice guidelines from professional organizations support moderate glycemic control. To measure critical care nurses' knowledge of glycemic control in cardiac surgery before and after education. To evaluate the safety and effectiveness of an evidence-based insulin infusion protocol targeting moderate glycemic control in cardiac surgery patients. This evidence-based practice change was implemented in the cardiovascular unit in a community teaching hospital. Nurses completed a self-developed questionnaire to measure knowledge of glycemic control. Blood glucose data, collected (retrospectively) from anesthesia end time through 11:59 PM on postoperative day 2, were compared from 2 months before to 2 months after the practice change. Nurses' knowledge (test scores) increased significantly after education (pretest mean = 53.10, SD = 11.75; posttest mean = 79.10, SD = 12.02; t54 = -8.18, P nurses' knowledge of glycemic control and implementing an insulin infusion protocol targeting moderate glycemic control were effective for treating acute hyperglycemia following cardiac surgery with decreased incidence of hypoglycemia.

  16. A Pediatric Diabetic Ketoacidosis Management Protocol Incorporating a Two-Bag Intravenous Fluid System Decreases Duration of Intravenous Insulin Therapy.

    Science.gov (United States)

    Veverka, Megan; Marsh, Kourtney; Norman, Susan; Brock, Michael Alan; Peng, Monica; Shenk, Jennifer; Chen, Jerome Gene

    2016-01-01

    OBJECTIVES: Diabetic ketoacidosis (DKA) is a leading cause of morbidity and mortality in children with type 1 diabetes. We implemented a standardized DKA management protocol by using a 2-bag intravenous (IV) fluid system. The purpose of the study was to examine if the protocol improved clinical outcomes and process efficiency. METHODS: This was a retrospective study of patients who did and did not undergo the protocol. Patients were included if they were 18 years of age or younger, were diagnosed with DKA, admitted to an intensive care unit or stepdown unit, and received continuous IV insulin. RESULTS: Of 119 encounters evaluated, 46 (38.7%) received treatment with the protocol and 73 (61.3%) did not. The median time to normalization of ketoacidosis was 9 hours (IQR 5-12) and 9 hours (IQR 6.5-13) for protocol and non-protocol groups, respectively (p = 0.14). The median duration of IV insulin therapy was 16.9 hours (IQR 13.7-21.5) vs. 21 hours (IQR 15.3-26) for protocol and non-protocol groups (p = 0.03). The median number of adjustments to insulin drip rate was 0 (IQR 0-1) and 2 (IQR 0-3) for protocol and non-protocol groups (p = 0.0001). There was no difference in the incidence of hypokalemia, hypoglycemia, or cerebral edema. CONCLUSIONS: The protocol did not change time to normalization of ketoacidosis but did decrease the duration of insulin therapy, number of adjustments to insulin drip rate, and number of wasted IV fluid bags without increasing the incidence of adverse events.

  17. The effect of glucagon infusion on kidney function in short-term insulin-dependent juvenile diabetics

    DEFF Research Database (Denmark)

    Parving, H H; Christiansen, J S; Noer, I;

    1980-01-01

    with the high dose (p reversible elevation of glomerular filtration rate typically found in poorly regulated insulin-dependent diabetics, but not to the moderate......Kidney function was studied in nine, metabolically well controlled, short-term insulin-dependent male diabetics before and during glucagon infusion of 4 to 5 and 8 to 10 ng/kg/min. Glomerular filtration rate, effective renal plasma flow (steady-state infusion technique, with urinary collections...... elevation found in well controlled diabetics....

  18. Insulin levels after portal and systemic insulin infusion differ in a dose-dependent fashion

    NARCIS (Netherlands)

    de Vos, P.; de Haan, Bart; Vegter, D.; Hillebrands, J.L.; Strubbe, J.H.; Bruggink, Jan; Schilfgaarde, R. van

    1998-01-01

    The role of the liver in the regulation of systemic insulin levels is not well understood. The reported extraction rates vary between 0 to 85%, and extraction of a constant fraction of 50% of the portally delivered insulin is generally assumed. In the present study, we have investigated the role of

  19. Serum lipase activity and concentration during intravenous infusions of GLP‐1 and PYY3‐36 and after ad libitum meal ingestion in overweight men

    National Research Council Canada - National Science Library

    Schmidt, Julie B; Sjödin, Anders; Stevner, Lene S; Ritz, Christian; Michaelsen, Natasha B; Thomsen, Anne B; Holst, Jens J; Astrup, Arne

    2016-01-01

    ...‐min intravenous infusion of either (1) 0.8 pmol/kg/min PYY 3‐36 , (2) 1.0 pmol/kg/min GLP ‐1, (3) 1 + 2, or (4) placebo. Samples were collected throughout the infusion and after intake of an ad...

  20. Intravenous labetolol in treating hypertensive crisis following dexmedetomidine infusion for procedural sedation.

    Science.gov (United States)

    Muthiah, Thilaka; Moni, Amarnath; Mathews, Lailu; Balaji, Sudarshan

    2016-03-01

    Dexmedetomidine is widely used for procedural sedation because of its unique combination of sedation, analgesia, and anxiolysis with minimal respiratory depression. Transient hypertension has been reported during the use of dexmedetomidine which is usually benign and is taken over by the hypotensive response on continuing the infusion. We report a case of hypertensive crisis following dexmedetomidine infusion used for procedural sedation, necessitating discontinuation of the infusion and treatment of hypertension. The dilemmas involved in treating hypertension caused by dexmedetomidine are discussed.

  1. A Case of Malignant Melanoma with In-Transit Metastasis That Responded to Intravenous Infusion of Interferon-β

    Directory of Open Access Journals (Sweden)

    Masaru Arima

    2014-03-01

    Full Text Available A 77-year-old man with a history of surgical resection of malignant melanoma involving the fifth toe of his left foot 14 years ago presented at the Kariya Toyota General Hospital with a 3-month history of skin ulcer at the same site and red nodules on the lower left leg. Malignant melanoma was suspected, and the patient was referred to our department. On examination, a skin ulcer measuring 25 × 20 mm was observed at the amputation site on the left foot. In addition, multiple red nodules were observed on the lower left leg. Skin biopsies of the ulcer and nodules revealed recurrent malignant melanoma with in-transit metastasis. Two weeks later, he developed acute myocardial infarction and was hospitalized at the Kariya Toyota General Hospital. One month later, the myocardial infarction ameliorated, and he was transferred to our department. As the myocardial infarction had decreased the patient's tolerance to surgery, interferon-β was administered by intravenous infusion. The skin ulcer and red nodules on the lower left leg disappeared 26 weeks after infusion had been initiated. The patient's progress has been satisfactory, with no evidence of recurrence or metastasis at 1 year and 9 months after the initiation of intravenous infusion.

  2. Use of continuous subcutaneous insulin infusion by a portable insulin pump during pregnancy in women with type 1 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Zorić Svetlana

    2006-01-01

    Full Text Available Background/aim: Diabetes mellitus is associated with an increased risk for neonatal morbidity and mortality. One of the most important goals in treating pregnancies complicated with diabetes is keeping glucose level within the normal range, especially in the first trimester. A portable insulin pump for continuous subcutaneous insulin infusion (CSII represents the best form of therapy for patients with type 1 diabetes mellitus during pregnancy. The aim of our study was to evaluate the effects of therapy with a portable insulin pump for continuous subcutaneous insulin infusion during the first trimester of pregnancy on the quality of glycoregulation and pregnancy outcome in women with type 1 diabetes mellitus. Methods. A total of 17 newly diagnosed pregnant women with type 1 diabetes mellitus were treated with CSII therapy for three months. The parameters of glycoregulation (hemoglobin A, glycosylated - HbA1c, mean blood glucose value in daily profiles - MBG, daily requirement for insulin - IJ/kg BM, lipid levels, blood pressure and renal function were estimated before and after the therapy. These parameters were correlated with parameters of pregnancy outcome: fetal weight, APGAR score, duration of pregnancy. Results. There was a significant improvement in HbA1c (8.94±1.62 vs. 6.90±1.22 %, p < 0.05, MBG (9.23±2.22 vs. 6.41±1.72 mmol/l, p < 0.01, and daily requirement for insulin (0.66±0.22 vs. 0.55±0.13 IJ/kg BM, p < 0.05 during the CSII therapy. There were significant correlations between fetal weight and HbA1c (r = -0.60, p < 0.05, triglyceride levels (r = −0.63, p < 0.01, and the number of pregnancies (r = −0.62, p < 0.01, as well as between APGAR score and MBG (r = −0.52, p < 0.05 and cholesterol levels (r = −0.65, p < 0,01 before a portable insulin pump was applicated. Conclusions. There was a significant improvement in the quality of glycoregulation during CSII therapy in the pregnant women with type 1 diabetes mellitus. The

  3. Non-return valves do not prevent backflow and bacterial contamination of intravenous infusions

    NARCIS (Netherlands)

    Ellger, B.; Kiski, D.; Diem, E.; van den Heuvel, I.; Freise, H.; Van Aken, H.; Hinder, F.; Friedrich, A. W.

    2011-01-01

    Non-return valves (NRVs) are designed to avoid backflow of infusion fluid against the designated direction of flow (DDF) when more than one infusion is delivered via one venous access. We tested in vitro whether NRVs reliably prevent flow against the DDF at clinically relevant low flow rates. Since

  4. Comparison of continuous subcutaneous insulin infusion and multiple daily insulin injections in Chinese patients with type 2 diabetes mellitus.

    Science.gov (United States)

    Yang, Honghong; Heng, Xueyuan; Liang, Cuige; Liu, Xiaomeng; Du, Wenhua; Li, Shoujie; Wang, Yueli; Dong, Qingyu; Li, Wenxia; Pan, Zhenyu; Gong, Qian; Gao, Guanqi

    2014-08-01

    To investigate prospectively the insulin dose requirements of Chinese patients with type 2 diabetes mellitus treated with either multiple daily insulin injections (MDI) or continuous subcutaneous insulin infusion (CSII) therapy during a 2-week therapeutic intervention. Patients with type 2 diabetes mellitus were randomly assigned to MDI or CSII therapy. The effects of the two treatment methods were determined based on blood glucose parameters, total daily insulin dose and rates of hypoglycaemia. A total of 609 patients were enrolled in the study. Glycaemic goals were achieved after a mean ± SD of 6.90 ± 2.10 and 5.44 ± 2.22 days' treatment in the MDI and CSII groups, respectively. Once stabilized, the mean ± SD total daily insulin doses were 37.12 ± 10.19 IU and 32.58 ± 8.78 IU for the MDI and CSII groups, respectively. Once stabilized, the mean ± SD total basal and bolus doses were 19.46 ± 7.95 IU/day and 17.66 ± 3.53 IU/day for the MDI group, and 22.79 ± 7.55 IU/day and 9.81 ± 2.64 IU/day for the CSII group, respectively. There were significant differences in the total, basal and bolus insulin doses between the two groups. CSII therapy may be considered as an effective method to achieve good glycaemic control in Chinese patients with type 2 diabetes mellitus. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  5. Intravenous Bolus versus Continuous Infusion of Famotidine or Ranitidine on 24 H Intragastric Acidity in Fasting Healthy Volunteers

    Directory of Open Access Journals (Sweden)

    ABR Thomson

    1995-01-01

    Full Text Available Infusions of H2-receptor antagonists may be clinically indicated to maintain intragastric pH above 4 to reduce acute gastric mucosal lesions or to treat patients with bleeding peptic ulcers. Eight fasting healthy volunteers were randomly assigned to receive ranitidine infusion alone (150 mg/day, ranitidine infusion plus 50 mg bolus injection of ranitidine (total of 200 mg/day, famotidine infusion alone (40 mg/day or famotidine infusion plus 40 mg bolus injection of famotidine (total of 80 mg/day. Gastric fluid contents were aspirated for 24 h and collected as half-hourly samples in which pH measurements were made. Measures analyzed were mean and median pH, percentage pH at or below 3, 4 or 5 for the 24 h period, daytime, evening and nighttime. The data for each of the variables were analyzed as a Latin square crossover design of variance therapy; base pH before treatment administration in each crossover phase was employed as the covariant. Significant differential treatment means were tested by Newman-Keul’s multiple range test at the 5% level of significance. The mean and median evening pH were higher after famotidine than after ranitidine infusion, but all other pH readings were similar when using these doses. The addition of an initial loading bolus of 50 mg ranitidine to the ranitidine infusion did not result in any added differences in pH, whereas the addition of an initial loading bolus of 40 mg famotidine to the famotidine infusion resulted in a higher 24 h median pH, as well as a lower percentage of pH values of 4 or below, 16.6% versus 28.5%, P<0.05. However, the loading doses of ranitidine and famotidine were not equivalent in potency, and studies are needed to compare the potency of equivalent doses of ranitidine and famotidine when given by bolus plus infusion. Also the clinical relevance of these findings needs to be explored further in the type of individuals potentially requiring intravenous H2-receptor antagonists.

  6. 静脉留置针输液护理体会%The experience of intravenous catheter infusion nursing

    Institute of Scientific and Technical Information of China (English)

    冯丽秀

    2011-01-01

    As the alternative products of scalp acupuncture, the advantages of using intravenous catheter are operating simply, easy to use, safety, reducing repeated punctural suffering, protecting blood vessels, easy to fix, ensuring the needs of infusion , blood transfusion and rescuing the accidental patients effectively and rapidly, reducing the probability of infusion accidental infection. High sense of responsibility, good psychological quality, skilled venous puncture , careful nursing are the important factors of successful venipuncture and reducing the patients pain.%静脉留置针作为头皮钟的换代产品,它的优点是操作简单,使用方便、安全、能减少反复穿刺的痛苦,保护血管,便于固定,还能有效迅速地保障输液、输血和意外抢救的需要,可减少输液意外感染的机率.

  7. Impact of intravenous infusion time on AAV8 vector pharmacokinetics, safety, and liver transduction in cynomolgus macaques

    Directory of Open Access Journals (Sweden)

    Jenny A Greig

    2016-01-01

    Full Text Available Systemically delivered adeno-associated viral (AAV vectors are now in early-phase clinical trials for a variety of diseases. While there is a general consensus on inclusion and exclusion criteria for each of these trials, the conditions under which vectors are infused vary significantly. In this study, we evaluated the impact of intravenous infusion rate of AAV8 vector in cynomolgus macaques on transgene expression, vector clearance from the circulation, and potential activation of the innate immune system. The dose of AAV8 vector in terms of genome copies per kilogram body weight and its concentration were fixed, while the rate of infusion varied to deliver the entire dose over different time periods, including 1, 10, or 90 minutes. Analyses during the in-life phase of the experiment included sequential evaluation of whole blood for vector genomes and appearance of proinflammatory cytokines. Liver tissues were analyzed at the time of necropsy for enhanced green fluorescent protein (eGFP expression and vector genomes. The data were remarkable with a relative absence of any statistically significant effect of infusion time on vector transduction, safety, and clearance. However, some interesting and unexpected trends did emerge.

  8. Effect of perioperative intravenous lidocaine infusion on postoperative recovery following laparoscopic Cholecystectomy-A randomized controlled trial.

    Science.gov (United States)

    Song, Xiaoli; Sun, Yanxia; Zhang, Xiaomei; Li, Tianzuo; Yang, Binbin

    2017-09-01

    Intravenous lidocaine infusion has been shown to facilitate postoperative recovery after major abdominal surgery. The current randomized controlled study was performed to assess the effect of perioperative intravenous lidocaine infusion on pain intensity, bowel function and cytokine response after larparoscopic cholecystectomy. Eighty patients undergoing laparoscopic cholecystectomy were randomly allocated to receive intravenous lidocaine (bolus injection of 1.5 mg/kg lidocaine at induction of anesthesia, then a continuous infusion of 2 mg/kg/h until the end of surgery) or an equal volume of saline. Patients, anesthesiologists, and study personnel were blinded, and anesthesia and multimodal perioperative analgesia were standardized. Blood cytokines were measured at scheduled times within 48 h. Pain scores, opioid consumption, time to first flatus and time to first bowel movement were also measured after surgery. Seventy-one of the 80 patients who were recruited completed the study protocol. Patient demographics were similar in the two groups. Lidocaine significantly reduced pain intensity [visual analogue scale (VAS), 0-10 cm] at 2 h (lidocaine 3.01 ± 0.65 cm vs. placebo 4.27 ± 0.58 cm, p = 0.01) and 6 h (lidocaine 3.38 ± 0.42 cm vs. placebo 4.22 ± 0.67 cm, p = 0.01) and total fentanyl consumption 24 h after surgery (lidocaine 98.27 ± 16.33 μg vs. placebo 187.49 ± 19.76 μg, p = 0.005). Time to first flatus passage (lidocaine 20 ± 11 h vs. placebo 29 ± 10 h, p = 0.01) and time to first bowel movement (lidocaine 41 ± 16 h vs. placebo 57 ± 14 h, p = 0.01) were also significantly shorter in patients who received lidocaine. Intravenous lidocaine infusion experienced less cytokine release than the control group. This study indicates that perioperative systemic lidocaine improves postoperative recovery and attenuates the initiation of excessive inflammatory response following laparoscopic cholecystectomy

  9. Guidelines for Application of Continuous Subcutaneous Insulin Infusion (Insulin Pump) Therapy in the Perioperative Period

    Science.gov (United States)

    Boyle, Mary E; Seifert, Karen M; Beer, Karen A; Apsey, Heidi A; Nassar, Adrienne A; Littman, Stephanie D; Magallanez, Janice M; Schlinkert, Richard T; Stearns, Joshua D; Hovan, Michael J; Cook, Curtiss B

    2012-01-01

    Case reports indicate that diabetes patients receiving outpatient insulin pump therapy have been allowed to continue treatment during surgical procedures. Although allowed during surgery, there is actually little information in the medical literature on how to manage patients receiving insulin pump therapy during a planned surgical procedure. A multidisciplinary work group reviewed current information regarding the use of insulin pumps in the perioperative period. Although the work group identified safety issues specific to surgical scenarios, it believed that with the use of standardized guidelines and a checklist, continuation of insulin pump therapy during the perioperative period is feasible. A sample set of protocols have been developed and are summarized. A policy outlining clear procedures should be established at the institutional level to guide physicians and other staff if the devices are to be employed during the perioperative period. Additional clinical experience with the technology in surgical scenarios is needed, and consensus should be developed for insulin pump use in the perioperative phases of care. PMID:22401338

  10. Safety, Pharmacokinetics, Pharmacodynamics, and Plasma Lipoprotein Distribution of Eritoran (E5564) during Continuous Intravenous Infusion into Healthy Volunteers

    Science.gov (United States)

    Rossignol, Daniel P.; Wasan, Kishor M.; Choo, Eugene; Yau, Edwin; Wong, Nancy; Rose, Jeffrey; Moran, Jeffrey; Lynn, Melvyn

    2004-01-01

    Eritoran, a structural analogue of the lipid A portion of lipopolysaccharide (LPS), is an antagonist of LPS in animal and human endotoxemia models. Previous studies have shown that low doses (350 to 3,500 μg) of eritoran have demonstrated a long pharmacokinetic half-life but a short pharmacodynamic half-life. The present study describes the safety, pharmacokinetics and pharmacodynamics, and lipid distribution profile of eritoran during and after a 72-h intravenous infusion of 500, 2,000, or 3,500 μg/h into healthy volunteers. Except for the occurrence of phlebitis, eritoran administration over 72 h was safe and well tolerated. Eritoran demonstrated a slow plasma clearance (0.679 to 0.930 ml/h/kg of body weight), a small volume of distribution (45.6 to 49.8 ml/kg), and a relatively long half-life (50.4 to 62.7 h). In plasma, the majority (∼55%) of eritoran was bound to high-density lipoproteins. During infusion and for up to 72 h thereafter, ex vivo response of blood to 1- or 10-ng/ml LPS was inhibited by ≥85%, even when the lowest dose of eritoran (500 μg/h) was infused. Inhibition of response was dependent on eritoran dose and the concentration of LPS used as an agonist. Finally, in vitro analysis with purified lipoprotein and protein fractions from plasma obtained from healthy volunteers indicated that eritoran is inactivated by high-density but not low-density lipoproteins, very-low-density lipoproteins, or albumin. From these results, we conclude that up to 252 mg of eritoran can be safely infused into normal volunteers over 72 h and even though it associates extensively with high-density lipoproteins, antagonistic activity is maintained, even after infusion ceases. PMID:15328078

  11. Needle and catheter colonization in pregnant diabetic patients using the continuous subcutaneous insulin infusion pump.

    Science.gov (United States)

    Rivera-Alsina, M E; Willis, S

    1984-01-01

    The incidence of bacterial colonization and risk of infection associated with the use of continuous insulin infusion pump (CIIP) was examined in 11 pregnant diabetic patients. All patients received instruction on specific aspects of CIIP and needle insertion technique according to the protocol used in our institution. A total of 220 cultures was performed on the subcutaneous needle and connective tubing. There was no clinical evidence of infection. In conclusion, the risk of infectious cutaneous complications in the pregnant diabetic patient using CIIP is not increased over the nonpregnant diabetic population.

  12. Effect of intravenous infusion of iodinated contrast media on the coronary blood flow in dogs

    OpenAIRE

    Abd, Thura T; Asim I. Shafique; Hayder S. Yasir; Jung-Hee Seo; George, Richard T.; Rajat Mittal; Lardo, Albert C.

    2016-01-01

    Background: Coronary computed tomography angiography (CCTA) is obtained using peripheral intravenous iodinated contrast agents (ICA) injection. There is continuing attempts to derive coronary physiological information like coronary blood flow (CBF) and/or fractional flow reserve from CCTA images. However, no data is available regarding the effect of peripheral intravenous injection of ICA on CBF. Methods: A series of 4 experiments was performed using healthy mongrel dogs. All dogs underwen...

  13. A Model for the Application of Target-Controlled Intravenous Infusion for a Prolonged Immersive DMT Psychedelic Experience

    Science.gov (United States)

    Gallimore, Andrew R.; Strassman, Rick J.

    2016-01-01

    The state of consciousness induced by N,N-dimethyltryptamine (DMT) is one of the most extraordinary of any naturally-occurring psychedelic substance. Users consistently report the complete replacement of normal subjective experience with a novel “alternate universe,” often densely populated with a variety of strange objects and other highly complex visual content, including what appear to be sentient “beings.” The phenomenology of the DMT state is of great interest to psychology and calls for rigorous academic enquiry. The extremely short duration of DMT effects—less than 20 min—militates against single dose administration as the ideal model for such enquiry. Using pharmacokinetic modeling and DMT blood sampling data, we demonstrate that the unique pharmacological characteristics of DMT, which also include a rapid onset and lack of acute tolerance to its subjective effects, make it amenable to administration by target-controlled intravenous infusion. This is a technology developed to maintain a stable brain concentration of anesthetic drugs during surgery. Simulations of our model demonstrate that this approach will allow research subjects to be induced into a stable and prolonged DMT experience, making it possible to carefully observe its psychological contents, and provide more extensive accounts for subsequent analyses. This model would also be valuable in performing functional neuroimaging, where subjects are required to remain under the influence of the drug for extended periods. Finally, target-controlled intravenous infusion of DMT may aid the development of unique psychotherapeutic applications of this psychedelic agent. PMID:27471468

  14. A Model for the Application of Target-Controlled Intravenous Infusion for a Prolonged Immersive DMT Psychedelic Experience

    Directory of Open Access Journals (Sweden)

    Andrew Robert Gallimore

    2016-07-01

    Full Text Available The state of consciousness induced by N,N-dimethyltryptamine (DMT is one of the most extraordinary of any naturally-occurring psychedelic substance. Users consistently report the complete replacement of normal subjective experience with a novel alternate universe, often densely populated with a variety of strange objects and other highly complex visual content, including what appear to be sentient beings. The phenomenology of the DMT state is of great interest to psychology and calls for rigorous academic enquiry. The extremely short duration of DMT effects—less than 20 minutes—militates against single dose administration as the ideal model for such enquiry. Using pharmacokinetic modelling and DMT blood sampling data, we demonstrate that the unique pharmacological characteristics of DMT, which also include a rapid onset and lack of acute tolerance to its subjective effects, make it amenable to administration by target-controlled intravenous infusion. This is a technology developed to maintain a stable brain concentration of anaesthetic drugs during surgery. Simulations of our model demonstrate that this approach will allow research subjects to be induced into a stable and prolonged DMT experience, making it possible to carefully observe its psychological contents, and provide more extensive accounts for subsequent analyses. This model would also be valuable in performing functional neuroimaging, where subjects are required to remain under the influence of the drug for extended periods. Finally, target-controlled intravenous infusion of DMT may aid the development of unique psychotherapeutic applications of this psychedelic agent.

  15. A Model for the Application of Target-Controlled Intravenous Infusion for a Prolonged Immersive DMT Psychedelic Experience.

    Science.gov (United States)

    Gallimore, Andrew R; Strassman, Rick J

    2016-01-01

    The state of consciousness induced by N,N-dimethyltryptamine (DMT) is one of the most extraordinary of any naturally-occurring psychedelic substance. Users consistently report the complete replacement of normal subjective experience with a novel "alternate universe," often densely populated with a variety of strange objects and other highly complex visual content, including what appear to be sentient "beings." The phenomenology of the DMT state is of great interest to psychology and calls for rigorous academic enquiry. The extremely short duration of DMT effects-less than 20 min-militates against single dose administration as the ideal model for such enquiry. Using pharmacokinetic modeling and DMT blood sampling data, we demonstrate that the unique pharmacological characteristics of DMT, which also include a rapid onset and lack of acute tolerance to its subjective effects, make it amenable to administration by target-controlled intravenous infusion. This is a technology developed to maintain a stable brain concentration of anesthetic drugs during surgery. Simulations of our model demonstrate that this approach will allow research subjects to be induced into a stable and prolonged DMT experience, making it possible to carefully observe its psychological contents, and provide more extensive accounts for subsequent analyses. This model would also be valuable in performing functional neuroimaging, where subjects are required to remain under the influence of the drug for extended periods. Finally, target-controlled intravenous infusion of DMT may aid the development of unique psychotherapeutic applications of this psychedelic agent.

  16. (-)-Epigallocatechin-3-gallate (EGCG) modulates neurological function when intravenously infused in acute and, chronically injured spinal cord of adult rats.

    Science.gov (United States)

    Renno, Waleed M; Al-Khaledi, Ghanim; Mousa, Alyaa; Karam, Shaima M; Abul, Habib; Asfar, Sami

    2014-02-01

    Spinal cord injury (SCI) causes severe and long lasting motor and sensory deficits, chronic pain, and autonomic dysreflexia. (-)-epigallocatechin-3-gallate (EGCG) has shown to produce neuroprotective effect in a broad range of neurodegenerative disease animal models. This study designed to test the efficacy of intravenous infusion of EGCG for 36 h, in acutely injured rats' spinal cord: within first 4 h post-injury and, in chronically SC injured rats: after one year of injury. Functional outcomes measured using standard BBB scale, The Louisville Swim Scale (LSS) and, pain behavior assessment tests. 72 Female adult rats subjected to moderate thoracic SCI using MASCIS Impactor, blindly randomized as the following: (I) Acute SCI + EGCG (II) Acute SCI + saline. (III) Chronic SCI + EGCG. (IV) Chronic SCI + saline and, sham SCI animals. EGCG i.v. treatment of acute and, chronic SCI animals resulted in significantly better recovery of motor and sensory functions, BBB and LSS (P spinal cord increased (P < 0.001). Percent areas of GAP-43 and GFAP immunohistochemistry showed significant (P < 0.05) increase. We conclude that the therapeutic window of opportunity for EGCG to depict neurological recovery in SCI animals, is viable up to one year post SCI when intravenously infused for 36 h.

  17. BLOOD PRESSURE CHANGES OF ELDERLY HYPERTENSIVE PATIENTS DURING DENTAL EXTRACTION UNDER SEDATION WITH CONTINUOUS INTRAVENOUS INFUSION OF MIDAZOLAM

    Institute of Scientific and Technical Information of China (English)

    Ji-zhi Zhao; Kuo Wan; Quan Jing; Xi Chen

    2007-01-01

    Objective To evaluate the changes in blood pressure (BP) of elderly hypertensive patients having dental extraction under sedation with continuous intravenous infusion of midazolam.Methods One hundred elderly hypertensive patients undergoing dental extraction were recruited for this single-blind , randomized, controlled study. Patients in intervention group (n - 50) were given midazolam dissolved in glucose solution and patients in control group (n = 50) were given glucose solution only with communication technique. Systolic BP (SBP) and diastolic BP (DBP) were recorded in five time points.Results Under basal conditions, intervention group did not show significant difference in BP compared with control group. Before sedation, mean values of SBP and DBP (especially SBP) significantly increased compared with basal conditions in both groups (P< 0. 05). During dental extraction sessions, mean values of BP in intervention group significantly decreased than control group (P< 0. 05), but coefficient of variation did show significant difference in both groups.Conclusion Continuous intravenous infusion of midazolam has been proved to be very successful in controlling BP of elderly patients having dental extraction.

  18. Short-lasting systemic and regional benefits of early crystalloid infusion after intravenous inoculation of dogs with live Escherichia coli

    Directory of Open Access Journals (Sweden)

    Garrido A.G.

    2005-01-01

    Full Text Available We investigated the systemic and regional hemodynamic effects of early crystalloid infusion in an experimental model of septic shock induced by intravenous inoculation with live Escherichia coli. Anesthetized dogs received an intravenous infusion of 1.2 x 10(10 cfu/kg live E. coli in 30 min. After 30 min of observation, they were randomized to controls (no fluids; N = 7, or fluid resuscitation with lactated Ringer's solution, 16 ml/kg (N = 7 or 32 ml/kg (N = 7 over 30 min and followed for 120 min. Cardiac index, portal blood flow, mean arterial pressure, systemic and regional oxygen-derived variables, blood lactate, and gastric PCO2 were assessed. Rapid and progressive cardiovascular deterioration with reduction in cardiac output, mean arterial pressure and portal blood flow (~50, ~25 and ~70%, respectively was induced by the live bacteria challenge. Systemic and regional territories showed significant increases in oxygen extraction and in lactate levels. Significant increases in venous-arterial (~9.6 mmHg, portal-arterial (~12.1 mmHg and gastric mucosal-arterial (~18.4 mmHg PCO2 gradients were also observed. Early fluid replacement, especially with 32 ml/kg volumes of crystalloids, promoted only partial and transient benefits such as increases of ~76% in cardiac index, of ~50% in portal vein blood flow and decreases in venous-arterial, portal-arterial, gastric mucosal-arterial PCO2 gradients (7.2 ± 1.0, 7.2 ± 1.3 and 9.7 ± 2.5 mmHg, respectively. The fluid infusion promoted only modest and transient benefits, unable to restore the systemic and regional perfusional and metabolic changes in this hypodynamic septic shock model.

  19. Effect of hepatic glucose production on acute insulin resistance induced by lipid-infusion in awake rats

    Institute of Scientific and Technical Information of China (English)

    Ling Li; Gang-Yi Yang

    2004-01-01

    AIM: To explore the influence of hepatic glucose production on acute insulin resistance induced by a lipid infusion in awake rats.METHODS: A hyperinsulinaemic-euglycaemic clamp was established in awake chronically catheterized rats. Two groups of rats were studied either with a 4-h intraarterial infusion of lipid/heparin or saline. Insulin-mediated peripheral and hepatic glucose metabolism was assessed by hyperinsulinaemiceuglycaemic clamp combined with [3-3H]-glucose infusion.RESULTS: During hyperinsulinaemic-euglycaemic clamp,there was a significant increase in plasma free fatty acid (FFA, from 741.9±50.6 to 2346.4±238.5 μmol/L, P<0.01) in lipid-infused group. The glucose infusion rates (GIR) in the lipid infusion rats, compared to control rats, were significantly reduced (200-240 min average: lipid infusion; 12.6±1.5 vs control; 34.0±1.6 mg/kg.min, P<0.01), declining to - 35%of the corresponding control values during the last time of the clamp (240 min: lipid infusion; 12.0±1.9 vs control;34.7±1.7 mg/kg.min, P<0.0001). At the end of clamp study,the hepatic glucose production (HGP) in control rats was significantly suppressed (88%) from 19.0±4.5 (basal) to 2.3±0.9 mg/kg.min (P<0.01). The suppressive effect of insulin on HGP was significantly blunted in the lipid-infused (P<0.05). The rate of glucose disappearance (GRd) was a slight decrease in the lipid-infused rats compared with controls during the clamp.CONCLUSION: These data suggest that lipid infusion could induces suppression of hepatic glucose production, impairs the abilities of insulin to suppress lipolysis and mediate glucose utilization in peripheral tissue. Therefore, we conclude that lipid-infusion induces an acute insulin resistance in vivo.

  20. Effects of amino acids infused into the vein on ghrelin-induced GH, insulin and glucagon secretion in lactating cows.

    Science.gov (United States)

    Fukumori, Rika; Yokotani, Akinori; Sugino, Toshihisa; Itoh, Fumiaki; Kushibiki, Shiro; Shingu, Hiroyuki; Moriya, Naoko; Hasegawa, Yoshihisa; Kojima, Masayasu; Kangawa, Kenji; Obitsu, Taketo; Taniguchi, Kohzo

    2011-04-01

    To investigate the effects of amino acids on ghrelin-induced growth hormone (GH), insulin and glucagon secretion in lactating dairy cattle, six Holstein cows were randomly assigned to two infusion treatments in a cross-over design. Mixture solution of amino acids (AMI) or saline (CON) was continuously infused into the left side jugular vein via catheter for 4 h. At 2 h after the start of infusion, synthetic bovine ghrelin was single injected into the right side jugular vein through the catheter. Ghrelin injection immediately increased plasma GH, glucose and non-esterified fatty acids (Pghrelin injection in both treatments. The peak value of plasma insulin concentration was greater in AMI compared with CON (Pghrelin action which in turn enhances insulin and glucagon secretions in lactating cows.

  1. Effects of intraruminal infusion of propionate on the concentrations of ammonia and insulin in peripheral blood of cows receiving an intraruminal infusion of urea.

    Science.gov (United States)

    Choung, J J; Chamberlain, D G

    1995-11-01

    To test the hypothesis that propionate can reduce hepatic capacity to detoxify ammonia, effects of the inclusion of propionate in intraruminal infusions of urea on the concentrations of ammonia, other metabolites and insulin in peripheral blood were investigated in two experiments with non-lactating dairy cows. Both experiments were of a 4 x 4 Latin square design with four animals, four treatments and four experimental periods of 7 d; feed was given in two equal meals each day, all intraruminal infusions were given for 1 h at the time of the morning feed, and propionic acid was partly neutralized with NaOH. In Expt 1, the treatments were a basal diet of pelleted lucerne and chopped hay alone or with the following infusions (g/d): urea 80, propionic acid 350, urea 80 plus propionic acid 350. The inclusion of propionate in the urea infusion markedly increased (P infusion of urea alone. Moreover, the inclusion of urea with the propionate infusion abolished (P infusion of propionate alone. In Expt 2, less severe treatments were imposed, the aim being to reproduce metabolic loads of propionate and ammonia that might be expected from a diet of high-protein grass silage rich in lactic acid. The treatments were a basal diet of grass silage alone or with the following infusions (g/d): NaCl 145, NaCl 145 plus urea 50, propionic acid 200, urea 50 plus propionic acid 200. Effects were less pronounced than in Expt 1 but, in the period immediately after infusion, similar effects were seen. It is concluded that propionate-ammonia interactions may have potentially important effects on milk production especially for diets with high proportions of grass silage containing high levels of protein and lactic acid.

  2. Post-reconstitution Stability of Telavancin with Commonly Used Diluents and Intravenous Infusion Solutions

    Directory of Open Access Journals (Sweden)

    Zhengtian Gu, PhD

    2015-12-01

    Conclusions: These results are supportive of a total hold time for reconstituted telavancin in vials plus the time in IV infusion solutions in polyvinyl chloride bags to not exceed 12 hours under ambient conditions and 7 days under refrigeration.

  3. Continuous intravenous infusion of ampicillin and gentamicin during parenteral nutrition in 88 newborn infants

    DEFF Research Database (Denmark)

    Colding, H; Møller, S; Andersen, G E

    1982-01-01

    Ampicillin and gentamicin were dissolved once a day in an L-amino acid solution especially prepared for parenteral nutrition of newborn infants and infused continuously to 88 infants in whom septicaemia was suspected or had been proved. The mean dosages were 162 and 5.3 mg/kg per 24 hours...

  4. Continuous intravenous infusion of ampicillin and gentamicin during parenteral nutrition in 88 newborn infants

    DEFF Research Database (Denmark)

    Colding, H; Møller, S; Andersen, G E

    1982-01-01

    Ampicillin and gentamicin were dissolved once a day in an L-amino acid solution especially prepared for parenteral nutrition of newborn infants and infused continuously to 88 infants in whom septicaemia was suspected or had been proved. The mean dosages were 162 and 5.3 mg/kg per 24 hours...

  5. A randomized trial evaluating low doses of propofol infusion after intravenous ketamine for ambulatory pediatric magnetic resonance imaging

    Directory of Open Access Journals (Sweden)

    Divya Sethi

    2014-01-01

    Full Text Available Objective: Our study compared the discharge time after pediatric magnetic resonance imaging (MRI following sedation with propofol infusion dose of 100, 75 and 50 mcg/kg/min given after a bolus dose of ketamine and propofol. Materials and Methods: One hundred children of American Society of Anesthesiologists status 1/2, aged 6 months to 8 years, scheduled for elective MRI were enrolled and randomized to three groups to receive propofol infusion of 100, 75 or 50 mcg/kg/min (Groups A, B, and C, respectively. After premedicating children with midazolam 0.05 mg/kg intravenous (i.v., sedation was induced with bolus dose of ketamine and propofol (1 mg/kg each and the propofol infusion was connected. During the scan, heart rate, noninvasive blood pressure, respiratory rate, and oxygen saturation were monitored. Results: The primary outcome that is, discharge time was shortest for Group C (44.06 ± 18.64 min and longest for Group A (60.00 ± 18.66 min, the difference being statistically and clinically significant. The secondary outcomes that is, additional propofol boluses, scan quality and awakening time were comparable for the three groups. The systolic blood pressure at 20, 25 and 30 min was significantly lower in Groups A and B compared with Group C. The incidence of sedation related adverse events was highest in Group A and least in Group C. Conclusion: After a bolus dose of ketamine and propofol (1 mg/kg each, propofol infusion of 50 mcg/kg/min provided sedation with shortest discharge time for MRI in children premedicated with midazolam 0.05 mg/kg i.v. It also enabled stable hemodynamics with less adverse events.

  6. Maintenance time of sedative effects after an intravenous infusion of diazepam:A guide for endoscopy using diazepam

    Institute of Scientific and Technical Information of China (English)

    Takahisa Furuta; Mutsuhiro Ikuma; Akira Hishida; Kyoichi Ohashi; Mitsushige Sugimoto; Akiko Nakamura; Naohito Shirai; Shingen Misaka; Shinya Uchida; Hiroshi Watanabe; Takashi Ishizaki

    2008-01-01

    AIM:To examine whether the sedative effects assessed by psychomotor tests would depend on the cytochrome P450(CYP)2C19 genotypes after an infusion regimen of diazepam commonly used for gastrointestinal endoscopy in Japan.METHODS:Fifteen healthy Japanese volunteers consisting of three different CYP2C19 genotype groups underwent a critical flicker fusion test,an eye movement analysis and a postural sway test as a test for physical sedative effects,and a visual analog scale(VAS)symptom assessment method as a test for mental sedative effects during the 336 h period after the intravenous infusion of diazepam(5 mg).RESULTS:The physical sedative effects assessed by the critical flicker test continued for 1h(t values of 5 min,30 min and 60 min later:4.35,5.00 and 3.19,respectively)and those by the moving radial area of a postural sway test continued for 3h(t values of 5 h,30 h,60 min and 3 h later:-4.05,-3.42,-2.17 and -2.58,respectively),which changed significantly compared with the baseline level before infusion(P<0.05).On the other hand,the mental sedative effects by the VAS method improved within 1 h.The CYP2C19 genotype-dependent differences in the postinfusion sedative effects were not observed in any of the four psychomotor function tests.CONCLUSION:With the psychomotor tests,the objective sedative effects of diazepam continued for 1 h to 3 h irrespective of CYP2C19 genotype status and the subjective sedative symptoms improved within 1 h.Up to 3 h of clinical care appears to be required after the infusion of diazepam,although patients feel subjectively improved.(C)2008 The W3G Press,All rights reserved.

  7. Combination of continuous intravenous infusion using a mixture of guaifenesin-ketamine-medetomidine and sevoflurane anesthesia in horses.

    Science.gov (United States)

    Yamashita, K; Satoh, M; Umikawa, A; Tsuda, A; Yajima, Y; Tsubakishita, S; Seno, T; Katoh, S; Izumisawa, Y; Kotani, T

    2000-03-01

    The anesthetic and cardiovascular effects of a combination of continuous intravenous infusion using a mixture of 100 g/L guaifenesin-4 g/L ketamine-5 mg/L medetomidine (0.25 ml/kg/hr) and oxygen-sevoflurane (OS) anesthesia (GKM-OS anesthesia) in horses were evaluated. The right carotid artery of each of 12 horses was raised surgically into a subcutaneous position under GKM-OS anesthesia (n=6) or OS anesthesia (n=6). The end-tidal concentration of sevoflurane (EtSEV) required to maintain surgical anesthesia was around 1.5% in GKM-OS and 3.0% in OS anesthesia. Mean arterial blood pressure (MABP) was maintained at around 80 mmHg under GKM-OS anesthesia, while infusion of dobutamine (0.39+/-0.10 microg/kg/min) was necessary to maintain MABP at 60 mmHg under OS anesthesia. The horses were able to stand at 36+/-26 min after cessation of GKM-OS anesthesia and at 48+/-19 minutes after OS anesthesia. The cardiovascular effects were evaluated in 12 horses anesthetized with GKM-OS anesthesia using 1.5% of EtSEV (n=6) or OS anesthesia using 3.0% of EtSEV (n=6). During GKM-OS anesthesia, cardiac output and peripheral vascular resistance was maintained at about 70% of the baseline value before anesthesia, and MABP was maintained over 70 mmHg. During OS anesthesia, infusion of dobutamine (0.59+/-0.24 microg/kg/min) was necessary to maintain MABP at 70 mmHg. Infusion of dobutamine enabled to maintaine cardiac output at about 80% of the baseline value; however, it induced the development of severe tachycardia in a horse anesthetized with sevoflurane. GKM-OS anesthesia may be useful for prolonged equine surgery because of its minimal cardiovascular effect and good recovery.

  8. Evaluation of the Effect of Intravenous Lidocaein Infusion on Postoperative Analgesia after Cesarean Section under Spinal Anesthesia

    Directory of Open Access Journals (Sweden)

    M. H. Bakhshaei

    2013-04-01

    Full Text Available Introduction & Objective: Many surgical patients still experience moderate to severe pain after surgery despite efforts to administer new drugs and techniques. Postoperative analgesia clearly enhances patient’s satisfaction and facilitates earlier mobilization and rehabilitation. lidocaein has been introduced as part of post operative pain management and clinical studies revealed analgesic actions in patients with chronic neuropathic pain. Our goal in this study was to determine the effect of intravenous lidocaein on post operative pain of women under-going cesarean section under spinal anesthesia. Materials & Methods: In this double blinded clinical trial study, 72 patients candidate for Ce-sarean section under spinal anesthesia were randomly selected and divided in two groups. In the case group, infusion of1.5 mg/kg lidocaein and in the control group infusion of the same volume normal saline started 15 minutes before the beginning of operation. After spinal anes-thesia with definite technique in both groups, infusion of 1.5 mg/kg/h lidocaein in case group and the same volume normal saline in the control group was administered and continued till 0.5 hour after finishing the operation. Data including systolic and diastolic blood pressure, heart rate, analgesic score according VAS and using of analgesic drugs were recorded during 24 hours after the operation. Results: Pain intensity according to VAS score in the time 2,6,12 hours post operation were significantly lower in the case group ( P2= 0.05, P6 = 0.01, P12= 0.05 .Analgesic consumption in form of suppository & IV,24 hours after surgery, was significantly lower in the case group.(P=0.001. Conclusion: Lidocaein infusion can decrease pain intensity & analgesic consumption after ce-sarean section under spinal anesthesia. (Sci J Hamadan Univ Med Sci 2013; 20 (1:9-14

  9. Acute hypoglycemic, hypocholesterolemic and hypotriglyceridemic effects of continuous intravenous infusion of a lyophilised aqueous extract of Ajuga iva L. Schreber whole plant in streptozotocin-induced diabetic rats.

    Science.gov (United States)

    El-Hilaly, Jaouad; Tahraoui, Adil; Israili, Zafar H; Lyoussi, Badiâa

    2007-10-01

    The hypoglycemic and hypolipidemic effect of continuous intravenous infusion of a lyophilised aqueous extract of the whole plant Ajuga iva (L.) Schreber (Labiatae) (AI-extract) was investigated in anesthetized normal and streptozotocin (STZ)-induced diabetic rats. The AI-extract was administered to a group of rats by continuous intravenous infusion for 4 h at a dose of 4.2 microg/min/100 g body weight; another group was infused with taurine, the reference compound, at the same dose. In normal rats, AI-extract infusion had no effect on plasma glucose or triglycerides, but plasma cholesterol levels were significantly decreased (22%; PAjuga iva appears to be a useful plant in the therapy of diabetes, a condition in which hyperglycemia and dyslipidemia coexist quite often.

  10. Safety and pharmacokinetics of intravenous levetiracetam infusion as add-on in status epilepticus

    NARCIS (Netherlands)

    Uges, Joris W F; van Huizen, Marc D; Engelsman, Jeroen; Wilms, Erik B; Touw, Daniel J; Peeters, Els; Vecht, Charles J

    2009-01-01

    PURPOSE: To evaluate the feasibility and safety of intravenous (iv) levetiracetam (LEV) added to the standard therapeutic regimen in adults with status epilepticus (SE), and as secondary objective to assess a population pharmacokinetic (PK) model for ivLEV in patients with SE. METHODS: In 12 adults

  11. Safety and pharmacokinetics of intravenous levetiracetam infusion as add-on in status epilepticus

    NARCIS (Netherlands)

    Uges, Joris W F; van Huizen, Marc D; Engelsman, Jeroen; Wilms, Erik B; Touw, Daniel J; Peeters, Els; Vecht, Charles J

    PURPOSE: To evaluate the feasibility and safety of intravenous (iv) levetiracetam (LEV) added to the standard therapeutic regimen in adults with status epilepticus (SE), and as secondary objective to assess a population pharmacokinetic (PK) model for ivLEV in patients with SE. METHODS: In 12 adults

  12. Clinical Informatics: Recursive Concurrence Intravenous Medication Administration Systems Protocols for Addressing the Potential Problem of Recessive Lethal Autonomy in Smart Infusion Systems

    OpenAIRE

    Nyagudi, Nyagudi Musandu

    2016-01-01

    Smart Infusion Pumps are vital tools for use in administering a broad range of parenteral/intravenous medications. Safe and effective use of smart infusion pumps depends upon their integration with Pump Servers, Computerized Physician Order Entry Systems, Pharmacy Information Systems, DERS/MERS Dose/Medication Error Reduction Systems( and the digital Drug Libraries that they use), eMARS/electronic Medication Administration Records Systems, etc. More computer systems result in more computer ne...

  13. Renal response to intravenous somatostatin in insulin-dependent diabetic patients and normal subjects

    Energy Technology Data Exchange (ETDEWEB)

    Vora, J.; Owens, D.R.; Luzio, S.; Atiea, J.; Ryder, R.; Hayes, T.M.

    1987-05-01

    The acute effects of iv somatostatin (SRIH; 100 micrograms/h) on the urinary flow (Uvol), effective renal plasma flow (RPF), and glomerular filtration rate (GFR) were compared with those of a control infusion of 0.15 M NaCl in nine insulin-dependent diabetic (IDD) patients of less than 10 yr disease duration and six normal subjects (NS). RPF and GFR were measured using a standard primed constant isotope infusion of (/sup 125/I)iodohippurate and (51Cr)chromium EDTA. Uvol, RPF, and GFR were measured during 20-min clearance periods. During the NaCl infusion mean Uvol, RPF, and GFR were 14.1 +/- 0.2 (+/- SEM), 708 +/- 4, and 150 +/- 1 mL/min in the IDD group and 12.7 +/- 0.4, 568 +/- 5, and 110 +/- 2 mL/min in the NS group, respectively. In the IDD patients Uvol, RPF, and GFR decreased from 16.6 +/- 1.8, 670 +/- 30, 146 +/- 4 mL/min pre-SRIH to 9.2 +/- 1, 553 +/- 25 (P less than 0.001), and 130 +/- 5 mL/min, respectively, at 120 min during the SRIH infusion. Similarly, in the NS group mean Uvol, RPF, and GFR were 14.2 +/- 0.6, 552 +/- 15, and 112 +/- 5 mL/min pre-SRIH and decreased to 7.4 +/- 0.6, 422 +/- 7, and 93 +/- 3 mL/min, respectively, after 120 min of the SRIH infusion. SRIH, therefore, had a profound effect on renal function in both IDD patients and NS, resulting in a reduction in RPF, GFR, and, as a consequence, Uvol.

  14. Performance and acceptability of a combined device for insulin infusion and glucose sensing in the home setting

    DEFF Research Database (Denmark)

    Nørgaard, K.; Shin, J.; Welsh, J. B.

    2015-01-01

    The use of sensor-augmented insulin pump (SAP) therapy is increasing. Currently, glucose sensors and insulin infusion cannulas are inserted separately. A new device, MiniMed Duo, combines sensing and infusion capabilities on the same platform and is intended to simplify device insertion and site...... connected to insulin pumps over 15 days (3 days/device) and test capillary blood glucose (SMBG) 7 times/day. The primary endpoint was the percentage of sensor-SMBG paired values within 20% of one another. Subject experiences were assessed via questionnaires. Overall, 74.8% of sensor-SMBG paired values were...... management. We evaluated the device's performance with respect to insulin delivery and glucose sensing, and its acceptability with patients. Forty-five patients (mean +/- SD age, 45.5 +/- 10.9 years, 48% female) with type 1 diabetes and previous use of SAP participated. Each subject was to wear 5 devices...

  15. Accidental intravenous infusion of a large dose of magnesium sulphate during labor: A case report

    Directory of Open Access Journals (Sweden)

    Kamal Kumar

    2013-01-01

    Full Text Available During labor and child delivery, a wide range of drugs are administered. Most of these medications are high-alert medications, which can cause significant harm to the patient due to its inadvertent use. Errors could be caused due to unfamiliarity with safe dosage ranges, confusion between similar looking drugs, mislabeling of drugs, equipment misuse, or malfunction and communication errors. We report a case of inadvertent infusion of a large dose of magnesium sulphate in a pregnant woman.

  16. Continuous intravenous flumazenil infusion in a patient with chlordiazepoxide toxicity and hepatic encephalopathy

    Directory of Open Access Journals (Sweden)

    Moh′d Al-Halawani

    2015-01-01

    Full Text Available Flumazenil, a benzodiazepine receptor antagonist, is the drug of choice for the diagnosis and treatment of benzodiazepine overdose. We are presenting a patient with chronic alcoholism and alcoholic liver disease, who came with alcohol withdrawal symptoms and treated chlordiazepoxide. Subsequently he developed a prolonged change in mental status that required treatment for benzodiazepine overdose and hepatic encephalopathy with flumazenil infusion for 28 days.

  17. Intraosseous versus intravenous infusion of hydroxocobalamin for the treatment of acute severe cyanide toxicity in a Swine model.

    Science.gov (United States)

    Bebarta, Vikhyat S; Pitotti, Rebecca L; Boudreau, Susan; Tanen, David A

    2014-11-01

    Easily administrated cyanide antidotes are needed for first responders, military troops, and emergency department staff after cyanide exposure in mass casualty incidents or due to smoke inhalation during fires involving many victims. Hydroxocobalamin has proven to be an effective antidote, but cannot be given intramuscularly because the volume of diluent needed is too large. Thus, intraosseous (IO) infusion may be an alternative, as it is simple and has been recommended for the administration of other resuscitation drugs. The primary objective of this study was to compare the efficacy of IO delivery of hydroxocobalamin to intravenous (IV) injection for the management of acute cyanide toxicity in a well-described porcine model. Twenty-four swine (45 to 55 kg) were anesthetized, intubated, and instrumented with continuous mean arterial pressure (MAP) and cardiac output monitoring. Cyanide was continuously infused until severe hypotension (50% of baseline MAP), followed by IO or IV hydroxocobalamin treatment. Animals were randomly assigned to receive IV (150 mg/kg) or IO (150 mg/kg) hydroxocobalamin and monitored for 60 minutes after start of antidotal infusion. The primary outcome measure was the change in MAP after antidotal treatment from onset of hypotension (time zero) to 60 minutes. A sample size of 12 animals per group was determined by group size analysis based on power of 80% to detect a one standard deviation of the mean MAP between the groups with an alpha of 0.05. Whole blood cyanide, lactate, pH, nitrotyrosine (nitric oxide marker) levels, cerebral and renal near infrared spectrometry (NIRS) oxygenation, and inflammatory markers were also measured. Repeated-measures analysis of variance was used to determine statistically significant changes between groups over time. At baseline and at the point of hypotension, physiologic parameters were similar between groups. At the conclusion of the study, 10 out of 12 animals in the IV group and 10 out of 12 in IO

  18. In situ degradation of antibiotic residues in medical intravenous infusion bottles using high energy electron beam irradiation

    Science.gov (United States)

    Wang, Min; Zhang, Lele; Zhang, Guilong; Pang, Tao; Zhang, Xin; Cai, Dongqing; Wu, Zhengyan

    2017-01-01

    This study reported an immediate approach for the degradation of three antibiotic (amoxicillin, ofloxacin, and cefradine) residues in medical intravenous infusion bottles (MIIBs) using high energy electron beam (HEEB) irradiation. The effects of irradiation doses, initial concentrations, initial pH, and scavengers of active radicals on the degradation of three antibiotic residues (ARs) were investigated, and the results displayed that 97.02%, 97.61% and 96.87% of amoxicillin, ofloxacin, and cefradine residues could be degraded in situ through HEEB irradiation respectively. Fourier transform infrared spectroscopy (FTIR) and high performance liquid chromatography-mass spectrometry (HPLC-MS) analysis demonstrated that ARs were mainly decomposed into inorganic ions and alkanes. Typically, the detailed degradation mechanism of ARs was also investigated, and the dominant active particle inducing the degradation of antibiotics during the HEEB irradiation process was demonstrated to be hydroxyl radical.

  19. Serum lipase activity and concentration during intravenous infusions of GLP-1 and PYY3-36 and after ad libitum meal ingestion in overweight men

    DEFF Research Database (Denmark)

    Schmidt, Julie Berg; Sjödin, Anders Mikael; Stevner, Lene Susanne;

    2016-01-01

    To examine the effect on serum lipase activity and protein concentration of intravenous infusions of glucagon-like peptide-1 (GLP-1) and peptide YY (PYY3-36) and of an ad libitum meal in healthy overweight men. Twenty-five healthy, male subjects participated in this randomized, double...... the infusion and after intake of an ad libitum meal for measurement of serum lipase. Serum lipase levels measured by enzyme-linked immunosorbent assay (ELISA) following mono-infusions of GLP-1 and PYY3-36 were comparable to serum lipase levels following placebo (P = 0.054 and P = 0.873, respectively...

  20. Insulin secretion after short- and long-term low-grade free fatty acid infusion in men with increased risk of developing type 2 diabetes

    DEFF Research Database (Denmark)

    Storgaard, Heidi; Jensen, Christine B; Vaag, Allan A;

    2003-01-01

    - and long-term Intralipid infusion is not balanced by an adequate compensatory increase in insulin secretion in IGT relatives or in matched controls. IGT relatives appear to be more sensitive to the deleterious effects of low-grade fat infusion on insulin secretion than normal glucose tolerant control...

  1. Intravenous Infusion of Magnesium Chloride Improves Epicenter Blood Flow during the Acute Stage of Contusive Spinal Cord Injury in Rats

    Science.gov (United States)

    Muradov, Johongir M.

    2013-01-01

    Abstract Vasospasm, hemorrhage, and loss of microvessels at the site of contusive or compressive spinal cord injury lead to infarction and initiate secondary degeneration. Here, we used intravenous injection of endothelial-binding lectin followed by histology to show that the number of perfused microvessels at the injury site is decreased by 80–90% as early as 20 min following a moderate T9 contusion in adult female rats. Hemorrhage within the spinal cord also was maximal at 20 min, consistent with its vasoconstrictive actions in the central nervous system (CNS). Microvascular blood flow recovered to up to 50% of normal volume in the injury penumbra by 6 h, but not at the epicenter. A comparison with an endothelial cell marker suggested that many microvessels fail to be reperfused up to 48 h post-injury. The ischemia was probably caused by vasospasm of vessels penetrating the parenchyma, because repeated Doppler measurements over the spinal cord showed a doubling of total blood flow over the first 12 h. Moreover, intravenous infusion of magnesium chloride, used clinically to treat CNS vasospasm, greatly improved the number of perfused microvessels at 24 and 48 h. The magnesium treatment seemed safe as it did not increase hemorrhage, despite the improved parenchymal blood flow. However, the treatment did not reduce acute microvessel, motor neuron or oligodendrocyte loss, and when infused for 7 days did not affect functional recovery or spared epicenter white matter over a 4 week period. These data suggest that microvascular blood flow can be restored with a clinically relevant treatment following spinal cord injury. PMID:23302047

  2. [Intravenous nitroglycerin infusion suppresses exercise-induced arrhythmia in patients with ischemic cardiopathy: indications for chronic treatment ].

    Science.gov (United States)

    Bonetti, F; Margonato, A; Mailhac, A; Vicedomini, G; Cianflone, D; Scarpazza, P; Chierchia, S L

    1990-05-01

    In patients with ischemic heart disease and arrhythmias, selection of antiarrhythmic treatment is often difficult as it is hard to separate "primary" from ischemic arrhythmias. We studied 20 patients with ischemic heart disease, who developed ventricular arrhythmias consistently during exercise test. Exercise test was performed twice during infusion of placebo and then during intravenous administration of nitroglycerin, titrated to reduce systolic blood pressure by 10 mmHg. Exercise duration was 7.8 +/- 1.7 and 7.9 +/- 1.5 min, in the 2 placebo tests (NS). Angina developed in 5 patients and ischemic ST changes in 10. With nitroglycerin exercise duration increased to 8.4 +/- 20 min (p less than 0.05), diagnostic ST segment depression was observed in 2 patients and only 1 had angina. In all 20 patients, ventricular arrhythmias were consistently present during both tests on placebo, that were markedly reduced by nitroglycerin. In fact, ventricular ectopic beats were 455 (mean 35.8 +/- 16.8) and 418 (mean 34.4 +/- 11.1) in the 2 exercise tests with placebo, and 11 during nitroglycerin infusion (mean 0.6 +/- 0.1; p less than 0.001). Couplets were 28 and 29 during placebo (NS) and 0 during nitroglycerin (p less than 0.001). Ventricular tachycardia was present in 6 and 8 patients during placebo but in none during nitroglycerin (p less than 0.001). Reduction of exercise-induced arrhythmias was maintained during chronic treatment with oral vasodilators. Prevention of exercise-related arrhythmias by nitroglycerin infusion appears a good indicator of their ischemic origin and may provide valuable information for long-term profilaxis with oral vasodilators, then avoiding the use of antiarrhythmic agents and their potential side effects.

  3. Insulin secretion after short- and long-term low-grade free fatty acid infusion in men with increased risk of developing type 2 diabetes

    DEFF Research Database (Denmark)

    Storgaard, Heidi; Jensen, Christine B; Vaag, Allan A

    2003-01-01

    We studied the effect of a low-grade short- and long-term 20% Intralipid infusion (0.4 mL(-1) x kg(-1) x h(-1)) on insulin secretion and insulin action in 15 elderly obese men; 7 glucose intolerant first-degree relatives of type 2 diabetic patients (impaired glucose tolerance [IGT] relatives) and 8...... calculated for the IVGTT. Insulin action was reduced 25% after 2 and 24 hours Intralipid infusion in both groups. In IGT relatives, the beta-cell responsiveness to glucose (measured during DORE) decreased after 2 and 24 hours Intralipid infusion (P=.02), whereas first phase insulin response (measured during...

  4. A nationwide study of continuous subcutaneous insulin infusion (CSII) in Denmark

    DEFF Research Database (Denmark)

    Nørgaard, K

    2003-01-01

    AIMS: To record the number of patients treated with continuous subcutaneous insulin infusion (CSII), the attitude to CSII treatment among diabetes care providers and the characteristics of pump users in Denmark. METHODS: A questionnaire was mailed to all departments of endocrinology, internal...... that no more patients were interested and that it did not significantly improve metabolic control. The mean age of pump users was 48.1 +/- 10.5 years and the mean time wearing a pump 14.1 +/- 6.3 years. Mean HbA1c was 7.9 +/- 1.2% during CSII, with a significant difference among the 15 centres (P ....05) and a tendency to be lower in females (P = 0.07). CONCLUSIONS: CSII is infrequently used in Denmark despite pump users showing reasonably good metabolic control. The most common explanations for these low figures are lack of expertise and funding for CSII. If more patients in Denmark were to be offered pumps...

  5. Continuous intraperitoneal insulin infusion in type 1 diabetes : a 6-year post-trial follow-up

    NARCIS (Netherlands)

    van Dijk, Peter R.; Logtenberg, Susan J. J.; Groenier, Klaas H.; Gans, Rijk. O.B.; Kleefstra, Nanne; Bilo, Henk J. G.

    2014-01-01

    Background: Continuous intraperitoneal insulin infusion (CIPII) with an implantable pump is a treatment option for patients with type 1 diabetes mellitus (T1DM). Aim of the present study was to describe the long-term course of glycaemic control, complications, health related quality of life (HRQOL)

  6. Effect of perioperative insulin infusion on surgical morbidity and mortality: systematic review and meta-analysis of randomized trials.7

    DEFF Research Database (Denmark)

    Gandhi, G.Y.; Murad, M.H.; Flynn, D.N.

    2008-01-01

    OBJECTIVE: To conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the effect of perioperative insulin infusion on outcomes important to patients. PATIENTS AND METHODS: We used 6 search strategies including an electronic database search of MEDLINE, EMBA...

  7. Efficacy and safety of modified Yale insulin infusion protocol in Japanese diabetic patients after open-heart surgery.

    Science.gov (United States)

    Tamaki, Motoyuki; Shimizu, Tomoaki; Kanazawa, Akio; Tamura, Yoshifumi; Hanzawa, Ayame; Ebato, Chie; Itou, Chiharu; Yasunari, Eisuke; Sanke, Haruna; Abe, Hiroko; Kawai, Junko; Okayama, Kaede; Matsumoto, Kazuhisa; Komiya, Koji; Kawaguchi, Minako; Inagaki, Noriko; Watanabe, Takahiro; Kanazawa, Yoshie; Hirose, Takahisa; Kawamori, Ryuzo; Watada, Hirotaka

    2008-09-01

    To our knowledge, there is currently no insulin infusion protocol for critically ill patients especially designed for Asian diabetics although many such protocols are used in Western countries. In this study, we modified the Yale insulin infusion protocol taking into consideration the characteristics of Japanese diabetics and hospital environment. We tested the modified protocol in 40 type 2 diabetic patients after elective open-heart surgery (MY group) comparing with 35 type 2 diabetic patients under empirical blood glucose control (EC group). Analyses of 1656 blood glucose measurements during insulin infusion revealed that percentage of samples that showed achievement of target blood glucose level (80-140 mg/dl) was higher under MY (78+/-15%, n=870) than EC (57+/-23%, n=786, p<0.0001). On the other hand, the percentage of samples in which blood glucose was less than 60 mg/dl was comparable in the two groups (MY: 0.5+/-5.9 per thousand, EC: 5.1+/-18.5 per thousand). None of the patients with hypoglycemia showed significant clinical adverse effects. In conclusion, our modified Yale insulin infusion protocol is effective and safe for tight blood glucose control in Japanese diabetic patients after open-heart surgery.

  8. Continuous intraperitoneal insulin infusion in type 1 diabetes : a 6-year post-trial follow-up

    NARCIS (Netherlands)

    van Dijk, Peter R.; Logtenberg, Susan J. J.; Groenier, Klaas H.; Gans, Rijk. O.B.; Kleefstra, Nanne; Bilo, Henk J. G.

    2014-01-01

    Background: Continuous intraperitoneal insulin infusion (CIPII) with an implantable pump is a treatment option for patients with type 1 diabetes mellitus (T1DM). Aim of the present study was to describe the long-term course of glycaemic control, complications, health related quality of life (HRQOL)

  9. Long-term safety, efficacy and side-effects of continuous subcutaneous insulin infusion treatment for type 1 (insulin-dependent) diabetes mellitus: a one centre experience.

    Science.gov (United States)

    Chantelau, E; Spraul, M; Mühlhauser, I; Gause, R; Berger, M

    1989-07-01

    A follow-up study of 116 Type 1 (insulin-dependent) diabetic patients on long-term continuous subcutaneous insulin infusion was conducted after 4.5 +/- 0.2 years. The average HbA1c-value of these patients decreased by 1% to 6.7 +/- 0.1% during this observation period. Typical side effects of continuous subcutaneous insulin infusion such as skin inflammation at the catheter insertion site occurred with similar frequency as has been reported previously by other authors. Diabetic ketoacidosis (0.14 per patient year) and disabling hypoglycaemia (0.1 per patient year, including 0.05 hypoglycaemic coma per patient-year) occurred at substantially lower rates than in other comparable studies with Type 1 diabetic patients at a similar degree of metabolic control. Subgroup evaluation suggested that a normal (less than 5.6%) HbA1c-value at follow-up was associated with increased incidence of disabling hypoglycaemia, whereas poor metabolic control (HbA1c greater than 7.5%) was associated with increased rates of skin complications and hospital treatment for ketoacidosis. Thus, under the policies of this diabetes centre, continuous subcutaneous insulin infusion has proved to be beneficial to a large proportion of experienced adult Type 1 diabetic patients, who voluntarily had opted for, and continued with, this particular mode of insulin treatment.

  10. Feasibility, efficacy, and safety of a simple insulin infusion protocol in a large volume cardiac surgery unit in India

    Directory of Open Access Journals (Sweden)

    Beena Bansal

    2015-01-01

    Full Text Available Aim: Inpatient hyperglycemia management is essential, but difficult to achieve especially in a large volume cardiac surgery setup, thus necessitating use of nurse-led insulin protocols. A rapid flux of nurses dealing with a huge workload has been a cause for traditionally not using nurse-led protocols in most Indian institutes. The challenges we faced were to have a simple protocol for the nurses to accept it without compromising on glycemic control. Therefore, this observational study was planned to measure the efficacy and safety of the insulin infusion protocol in cardiac surgery patients. Materials and Methods: Insulin protocol was implemented, using seven fixed columns of infusion with the nurse making decisions to initiate and titrate doses based on simple rules. Blood glucose (BG data captured from blood gas analyzers (glucometrics in the intervention group (i.e., after protocol implementation were compared to control group (i.e., before the protocol implementation. Results: The mean BG for the first 48 h was lower in the intervention group as compared to control group, without an increase in the episodes of hypoglycemia. The nurses found the protocol easy to understand, less time-consuming and there was no protocol deviation over 8 months after implementation. Conclusion: A small change in the process, allowing nurses to titrate insulin doses based on some rules and having seven fixed columns of insulin infusion rates, improved glycemic control and efficiency.

  11. Feasibility, efficacy, and safety of a simple insulin infusion protocol in a large volume cardiac surgery unit in India.

    Science.gov (United States)

    Bansal, Beena; Mithal, Ambrish; Carvalho, Pravin; Mehta, Yatin; Trehan, Naresh

    2015-01-01

    Inpatient hyperglycemia management is essential, but difficult to achieve especially in a large volume cardiac surgery setup, thus necessitating use of nurse-led insulin protocols. A rapid flux of nurses dealing with a huge workload has been a cause for traditionally not using nurse-led protocols in most Indian institutes. The challenges we faced were to have a simple protocol for the nurses to accept it without compromising on glycemic control. Therefore, this observational study was planned to measure the efficacy and safety of the insulin infusion protocol in cardiac surgery patients. Insulin protocol was implemented, using seven fixed columns of infusion with the nurse making decisions to initiate and titrate doses based on simple rules. Blood glucose (BG) data captured from blood gas analyzers (glucometrics) in the intervention group (i.e., after protocol implementation) were compared to control group (i.e., before the protocol implementation). The mean BG for the first 48 h was lower in the intervention group as compared to control group, without an increase in the episodes of hypoglycemia. The nurses found the protocol easy to understand, less time-consuming and there was no protocol deviation over 8 months after implementation. A small change in the process, allowing nurses to titrate insulin doses based on some rules and having seven fixed columns of insulin infusion rates, improved glycemic control and efficiency.

  12. Effects of intravenous infusion of guaifenesin on electroencephalographic variables in pigs.

    Science.gov (United States)

    Haga, H A; Moerch, H; Soli, N E

    2000-12-01

    To investigate the sedative effects of guaifenesin in pigs by use of electroencephalography. 10 Norwegian Landrace pigs (5 castrated males and 5 sexually intact females). Guaifenesin (150 mg/kg of body weight, IV) was administered during a 5-minute period. Using a 2-channel referential electrode configuration, electroencephalograms were recorded before, during, and after infusion of guaifenesin. Changes in spectral edge frequency 95% (SEF), median frequency (MED), and total power were evaluated. After administration of guaifenesin, SEF decreased significantly, and total power increased significantly; however, MED did not change significantly. Analysis of the data did not reveal differences between pigs on the basis of sex. We concluded that guaifenesin synchronized the patterns of electroencephalograms. This is a strong indication that the drug has a sedative effect in pigs.

  13. Coefficient of glucose variation is independently associated with mortality in critically ill patients receiving intravenous insulin.

    Science.gov (United States)

    Lanspa, Michael J; Dickerson, Justin; Morris, Alan H; Orme, James F; Holmen, John; Hirshberg, Eliotte L

    2014-04-30

    Both patient- and context-specific factors may explain the conflicting evidence regarding glucose control in critically ill patients. Blood glucose variability appears to correlate with mortality, but this variability may be an indicator of disease severity, rather than an independent predictor of mortality. We assessed blood glucose coefficient of variation as an independent predictor of mortality in the critically ill. We used eProtocol-Insulin, an electronic protocol for managing intravenous insulin with explicit rules, high clinician compliance, and reproducibility. We studied critically ill patients from eight hospitals, excluding patients with diabetic ketoacidosis and patients supported with eProtocol-insulin for coefficient of variation (standard deviation/mean), Charlson comorbidity score, acute physiology score, presence of diabetes, and occurrence of hypoglycemia Coefficient of variation was independently associated with 30-day mortality (odds ratio 1.23 for every 10% increase, P < 0.001), even after adjustment for hypoglycemia, age, disease severity, and comorbidities. The association was higher in non-diabetics (OR = 1.37, P < 0.001) than in diabetics (OR 1.15, P = 0.001). Blood glucose variability is associated with mortality and is independent of hypoglycemia, disease severity, and comorbidities. Future studies should evaluate blood glucose variability.

  14. Regional myocardial lidocaine concentration following continuous intravenous infusion early and later after myocardial infarction

    Energy Technology Data Exchange (ETDEWEB)

    Zito, R.A.; Caride, V.J.; Holford, T.; Zaret, B.L.

    1982-09-01

    The regional concentration of lidocaine using a double constant infusion technique (250 micrograms/kg/min x 15 minutes followed by 35 micrograms/kg/mg/min x 120 minutes) was studied immediately (2 hours) in seven dogs and 24 hours (six dogs) after myocardial infarction. Tissue levels were determined by gas chromatography and related to regional myocardial blood flow as determined by the radioactive microsphere technique in multiple samples. At 2 hours after infarction a significantly higher lidocaine concentration (4.1 +/- 0.42 micrograms/g) was found in zones with greatly reduced blood flow (regional myocardial blood flow less than 0.2 ml/min per g) when compared with that (2.6 +/- 0.19 micrograms/g) in zones with normal blood flow (regional myocardial blood flow greater than 0.8 ml/min per g) (p less than 0.01). In contrast, in the 24 hour model the opposite situation was observed. Although the concentration of lidocaine in the infarct zone was substantial, a significant decline in lidocaine tissue concentration was found in the zones of lowest blood flow (regional myocardial blood flow less than 0.2 ml/min per g) when compared with that in normal zones (1.76 +/- 0.21 versus 3.38 +/- 0.21 micrograms/g, p less than 0.001). In addition, no significant differences in lidocaine concentrations were found between endocardium and epicardium in any of the groups other than those related to regional myocardial blood flow. Thus, with the double constant infusion technique, lidocaine reached normal and ischemic myocardium in concentrations equivalent to therapeutic plasma concentrations, even in lower infarct blood flow zones, with no significant differences between endocardium and epicardium. Of perhaps greater significance, the age of the ischemic insult is an important determinant of lidocaine tissue distribution in infarcted myocardium.

  15. Stability studies of lincomycin hydrochloride in aqueous solution and intravenous infusion fluids

    Directory of Open Access Journals (Sweden)

    Czarniak P

    2016-03-01

    Full Text Available Petra Czarniak, Michael Boddy, Bruce Sunderland, Jeff D Hughes School of Pharmacy, Curtin University, Perth, WA, Australia Purpose: The purpose of this study was to evaluate the chemical stability of Lincocin® (lincomycin hydrochloride in commonly used intravenous fluids at room temperature (25°C, at accelerated-degradation temperatures and in selected buffer solutions.Materials and methods: The stability of Lincocin® injection (containing lincomycin 600 mg/2 mL as the hydrochloride stored at 25°C±0.1°C in sodium lactate (Hartmann’s, 0.9% sodium chloride, 5% glucose, and 10% glucose solutions was investigated over 31 days. Forced degradation of Lincocin® in hydrochloric acid, sodium hydroxide, and hydrogen peroxide was performed at 60°C. The effect of pH on the degradation rate of lincomycin hydrochloride stored at 80°C was determined.Results: Lincomycin hydrochloride was found to maintain its shelf life at 25°C in sodium lactate (Hartmann’s solution, 0.9% sodium chloride solution, 5% glucose solution, and 10% glucose solution, with less than 5% lincomycin degradation occurring in all intravenous solutions over a 31-day period. Lincomycin hydrochloride showed less rapid degradation at 60°C in acid than in basic solution, but degraded rapidly in hydrogen peroxide. At all pH values tested, lincomycin followed first-order kinetics. It had the greatest stability near pH 4 when stored at 80°C (calculated shelf life of 4.59 days, and was least stable at pH 2 (calculated shelf life of 0.38 days.Conclusion: Lincocin® injection was chemically found to have a shelf life of at least 31 days at 25°C when added to sodium lactate (Hartmann’s solution, 0.9% sodium chloride solution, 5% glucose solution, and 10% glucose solution. Solutions prepared at approximately pH 4 are likely to have optimum stability. Keywords: lincomycin, stability, pH, intravenous fluids, IV additives

  16. Managing diabetic ketoacidosis in non-intensive care unit setting: Role of insulin analogs

    OpenAIRE

    Karoli, R.; Fatima, J.; Salman, T.; Sandhu, S.; Shankar, R. (Ravi)

    2011-01-01

    Aim: To compare the efficacy and safety of rapid acting insulin analog lispro given subcutaneously with that of standard low-dose intravenous regular insulin infusion protocolin patients with mild to moderate diabetic ketoacidosis. Materials and Methods: In this prospective, randomized and open trial, 50 consecutive patients of mild to moderate diabetic ketoacidosis were randomly assigned to two groups. The patients in group 1 were treated with intravenous regular insulin infusion and adm...

  17. Intravenous ethanol infusions can mimic the time course of breath alcohol concentrations following oral alcohol administration in healthy volunteers.

    Science.gov (United States)

    Ramchandani, Vijay A; Plawecki, Martin; Li, Ting-Kai; O'Connor, Sean

    2009-05-01

    Our previous studies have used intravenous (IV) clamping methods to demonstrate that family history positive (FHP) subjects exhibit a greater initial response to alcohol than family history negative (FHN) subjects. These results differ from other studies of family history of alcoholism (FHA) influences, most of which have used an oral alcohol challenge, suggesting that the route of administration may influence both the response to alcohol and FHA-related differences in response. To examine this possibility, one approach would be to directly compare responses following oral and IV alcohol administration in the same subjects. There is, however, a 3- to 4-fold variance, between- and within-subjects, in the breath alcohol concentrations (BrACs) following oral alcohol administration. Thus, our objective was to characterize the between-subject variability in the time course of BrACs following oral alcohol administration in healthy volunteers and to develop an IV infusion method to mimic the BrAC-time course attained following oral alcohol in the same subject. This was a 2-session study in young adult, healthy, nondependent drinkers. In the first session, subjects ingested an oral dose of alcohol, based on total body water, to achieve a target peak BrAC of 80 mg%. In the second session, subjects received an IV infusion of ethanol designed to achieve the same BrAC time course as that achieved in the first session. The individualized infusion-rate profile was precomputed using a physiologically-based pharmacokinetic (PBPK) model for alcohol with model parameters adjusted to the individual's physiology. The peak BrACs (C(max)), times of peak BrAC (T(max)), and the areas under the BrAC vs. time curve (AUC) were compared between sessions to assess how closely the BrAC exposure during the IV infusion session mimicked the exposure following oral alcohol. The time course of BrACs following oral alcohol administration showed a high degree of between-subject variability. Mean C

  18. Assessment of right ventricular function by intravenous infusion of krypton-81m

    Energy Technology Data Exchange (ETDEWEB)

    Spielmann, R.P.; Nienaber, C.; Wasmus, G.; Stritzke, P.; Montz, R.; Mathey, D.G.

    1984-01-01

    Kr-81m equilibrium ventriculography was used to assess right ventricular (RV) function at rest (R) and during submaximal bicycle exercise (E) in patients (pts) with different cardiopulmonary disorders. Kr-81 was continuously eluted in 5% dextrose from a portable Rb-81 generator and infused through a peripheral vein. Due to the short half-life (13s) and the free diffusibility of Kr-81 through the alveolar membrane, activity in the left side of the heart is negligible. This allows imaging in a RAO position which provides the best separation between the right atrium and the RV. Determination of RV ejection fraction (RVEF) involved the definition of an endiastolic and an endsystolic region of interest by a semiautomatic computer algorithm. The standard deviation of RVEF determinations by two independent observers was 0.047. Kr-81 RVEF was related to X-ray angiographic (XR) RVEF and hemodynamic measurements. The correlation coefficient between Kr-81 and XR RVEF was 0.82(n=25). When all pts were divided into two groups according to their mean pulmonary artery pressure, significant differences in the RVEF during E between these groups were found with both Kr-81 and XR ventriculography. The correspondence between KR-81 and XR data underlines the potential of Kr-81 as a reliable noninvasive tool in assessing RV function.

  19. In silico evaluation of a control system and algorithm for automated insulin infusion in the ICU setting

    Directory of Open Access Journals (Sweden)

    Olmos Pablo R

    2010-07-01

    Full Text Available Abstract Background It is known that tight control of glucose in the Intensive Care Unit reduces morbidity and mortality not only in diabetic patients but also in those non-diabetics who become transiently hyperglycemic. Taking advantage of a recently marketed subcutaneous glucose sensor we designed an Automatic Insulin Infusion System (AIIS for inpatient treatment, and tested its stability under simulated clinical conditions. Methods The system included: reference glucose, glucose sensor, insulin and glucose infusion controllers and emergency infusion logic. We carried out computer simulations using Matlab/Simulink®, in both common and worst-case conditions. Results The system was capable of controlling glucose levels without entering in a phase of catastrophic instability, even under severe simulated challenges. Care was taken to include in all simulations the 5-10 minute delay of the subcutaneous glucose signal when compared to the real-time serum glucose signal, a well-known characteristic of all subcutaneous glucose sensors. Conclusions When tested in-Silico, a commercially available subcutaneous glucose sensor allowed the stable functioning of a proportional-derivative Automatic Insulin Infusion System, which was able to maintain glucose within acceptable limits when using a well-established glucose response model simulating a patient. Testing of the system in vivo using animal models is now warranted.

  20. Continuous Subcutaneous Insulin Infusion as an Effective Method of Desensitization Therapy for Diabetic Patients with Insulin Allergy: A 4-year Single-center Experience.

    Science.gov (United States)

    Yuan, Tao; Zhao, Weigang; Wang, Lianglu; Dong, Yingyue; Li, Naishi

    2016-11-01

    This article summarizes our experiences in the application of continuous subcutaneous insulin infusion (CSII) as a method of rapid desensitization therapy for diabetic patients with insulin allergy that was subsequently switched to a regimen of multiple-dose injections for long-term insulin therapy. The clinical data of 11 diabetic patients with insulin allergy in Peking Union Medical College Hospital from April 1, 2008, through December 31, 2011, were retrospectively analyzed. All 11 conditions were diagnosed by case history, skin testing, determination of serum specific anti-insulin IgE, and reaction to withdrawal of insulin. Seven patients accepted the traditional injection method of desensitization, and 5 patients accepted CSII with the protocol designed for this study (1 patient accepted CSII after failure by the formal method). Six of the 7 patients who accepted the traditional method and all 5 patients who accepted CSII had successful results. All 5 patients in the CSII group switched to a regimen of multiple dosage injections. In a survey of 28 nurses, both experienced nurses and practical nurses preferred to use CSII as the method of desensitization. It is feasible and effective for diabetic patients with insulin allergy to use CSII as a method of rapid desensitization with subsequent switching to a regimen of multiple-dose injections for long-term insulin therapy. Copyright © 2016 Elsevier HS Journals, Inc. All rights reserved.

  1. Insulin Resistance Is Associated With a Poor Response to Intravenous Thrombolysis in Acute Ischemic Stroke

    Science.gov (United States)

    Calleja, Ana I.; García-Bermejo, Pablo; Cortijo, Elisa; Bustamante, Rosa; Rojo Martínez, Esther; González Sarmiento, Enrique; Fernández-Herranz, Rosa; Arenillas, Juan F.

    2011-01-01

    OBJECTIVE Insulin resistance (IR) may not only increase stroke risk, but could also contribute to aggravate stroke prognosis. Mainly through a derangement in endogenous fibrinolysis, IR could affect the response to intravenous thrombolysis, currently the only therapy proved to be efficacious for acute ischemic stroke. We hypothesized that high IR is associated with more persistent arterial occlusions and poorer long-term outcome after stroke thrombolysis. RESEARCH DESIGN AND METHODS We performed a prospective, observational, longitudinal study in consecutive acute ischemic stroke patients presenting with middle cerebral artery (MCA) occlusion who received intravenous thrombolysis. Patients with acute hyperglycemia (≥155 mg/dL) receiving insulin were excluded. IR was determined during admission by the homeostatic model assessment index (HOMA-IR). Poor long-term outcome, as defined by a day 90 modified Rankin scale score ≥3, was considered the primary outcome variable. Transcranial Duplex-assessed resistance to MCA recanalization and symptomatic hemorrhagic transformation were considered secondary end points. RESULTS A total of 109 thrombolysed MCA ischemic stroke patients were included (43.1% women, mean age 71 years). The HOMA-IR was higher in the group of patients with poor outcome (P = 0.02). The probability of good outcome decreased gradually with increasing HOMA-IR tertiles (80.6%, 1st tertile; 71.4%, 2nd tertile; and 55.3%, upper tertile). A HOMA-IR in the upper tertile was independently associated with poor outcome when compared with the lower tertile (odds ratio [OR] 8.54 [95% CI 1.67–43.55]; P = 0.01) and was associated with more persistent MCA occlusions (OR 8.2 [1.23–54.44]; P = 0.029). CONCLUSIONS High IR may be associated with more persistent arterial occlusions and worse long-term outcome after acute ischemic stroke thrombolysis. PMID:21911778

  2. Intravenous tissue plasminogen activator in patients with stroke increases the bioavailability of insulin-like growth factor-1

    NARCIS (Netherlands)

    Wilczak, Nadine; Elting, Jan Willem; Chesik, Daniel; Kema, Ido P.; De Keyser, Jacques

    2006-01-01

    Background and Purpose-Insulin-like growth factor (IGF)-1 has potent neuroprotective properties. We investigated the effects of intravenous administration of tissue plasminogen activator (tPA) on serum levels of IGF-1 and IGF-binding protein (IGFBP)-3 in patients with acute ischemic stroke. Methods-

  3. Influence of an intravenous infusion of amino acids and glucose on the pancreatic exocrine in rats

    Institute of Scientific and Technical Information of China (English)

    FAN Bo-guang 范博广; (A。)ke Andrén-Sandberg

    2004-01-01

    Background A number of reports based on both animal experiments and clinical investigations have pointed out that total parenteral nutrition (TPN) suppresses the function of the exocrine pancreas. Even though pancreatic hypotrophy and dysfunction resulting from TPN may be explained by several mechanisms, the clinically most important cause is that nutrients in circulation affect pancreatic secretion. The effect of nutrients on the exocrine pancreas is still controversial. The aim of the present study was, therefore, to clarify the influence of intravenous amino acids and hypertonic glucose in TPN solution on the exocrine pancreas. Methods Three mixed TPN solutions, consisting of 30% or 50% glucose or of 14% amino acids, were employed. Twenty-four male Sprague-Dawley rats were randomly divided into four groups, six rats in each group, including a control group and one group receiving each of the three TPN solutions. All animals were killed after 10 days of TPN. Body weight, pancreatic content, and enzyme levels in the pancreas were measured. Results Compared with the control group, pancreatic wet weight was lower in all TPN groups. Glucose significantly decreased the content and concentration of pancreatic protein, but amino acids did not alter the concentration of protein. The level of amylase was lower in all parenterally fed groups, with a greater decrease in the groups treated with amino acids and 30% glucose than with 50% glucose. Trypsin levels in all groups receiving TPN were markedly higher than in the control group. Conclusion TPN results in atrophy of the pancreas, but trypsin levels increase with TPN treatment. Glucose elevates the amylase level in the pancreas, while amino acids suppress pancreatic amylase. Amino acids used as a source of protein maintain normal pancreatic protein levels.

  4. 静脉输液护理风险管理的方法与效果%Method and effects of nursing risk management in intravenous infusion

    Institute of Scientific and Technical Information of China (English)

    陈巧玲; 全小明

    2011-01-01

    目的 探讨静脉输液风险管理的方法与效果.方法 建立静脉输液风险管理组织,完善静脉输液相关制度,规范各环节的管理,每月检查静脉输液质量,对已发生的相关风险事件进行根本原因分析、评价与质量改进,并对全院护士进行强化预防输液风险的意识与能力的培训.结果 与实施前比较,实施后给药错误、静脉炎、导管相关性感染、投诉、药物渗出、滴速与病情不符、护士针刺伤等输液风险事件的发生率降低,差异均具有统计学意义(P<0.01).结论 实施静脉输液风险管理可有效降低输液风险的发生率.%Objective To explore the method and effect of risk management for intravenous infusion.Method The risk management organizational structure for intravenous infusion was established to the intravenous infusion - related regulations,standardize the management of all links and inspect the quality of the intravenous infusion monthly.For the occurred risk events, their root causes were analyzed, evaluated and improved.And the nurses were trained to strengthen their awareness and ability on the prevention of the risk of intravenous infusion.Result After the implementation of these methods, the incidence of the medication errors,phlebitis,catheter - related infections,complaints from patients,drug leakage,dropping speed which does not match with the disease and nurses'needle stick injuries were significautly reduced ( P < 0.01 ).Conclusion The implementation of intravenous infusion risk management can effectively reduce the incidence of risk events.

  5. Computerised insulin dosing calculators for the management of continuous insulin infusions after cardiac surgery: A systematic review and meta-analysis.

    Science.gov (United States)

    Higgs, Megan H; Fernandez, Ritin S

    2017-04-01

    To investigate the effectiveness of computerised insulin dosing calculators for the management of continuous insulin infusions in adult patients who underwent cardiac surgery. A systematic review was conducted. The CINAHL, MEDLINE and Cochrane databases were searched for primary studies that compared a computerised insulin dosing calculator to a paper protocol. The main outcome measures were mean Blood Glucose Level (BGL), time to achieve BGL target range, time spent within BGL target range, the incidence of hyperglycaemia and the incidence of hypoglycaemia. Five studies were included in the final review. Pooled data demonstrated significant improvements in mean BGL (MD -14.24, 95% CI -26.93 to -1.55), p=0.03 and significantly lower rates of hypoglycaemia (OR 0.038, 95% CI: 0.16-0.90), p=0.03 amongst the computer calculator groups in comparison to the paper protocol groups. No significant difference in the incidence of severe hypoglycaemia was demonstrated (OR 0.21, 95% CI 0.02-1.79), p=0.15. No difference was found in time (hours) to reach target blood glucose range (MD -1.47, 95% CI -3.75 to 0.81), p=0.21. There is some evidence to support the use of computerised insulin dosing calculators for insulin infusion management within critical care environments. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. Development of a Computerized Intravenous Insulin Application (AutoCal) at Kaiser Permanente Northwest, Integrated into Kaiser Permanente HealthConnect: Impact on Safety and Nursing Workload

    OpenAIRE

    Olinghouse, Christine

    2012-01-01

    Context: The electronic medical record, HealthConnect, at the Kaiser Sunnyside Medical Center in the Northwest used scanned paper protocols for intravenous insulin administration. A chart review of 15 patients on intravenous insulin therapy using state-of-the-art paper-based column protocols revealed 40% deviation from the protocol. A time study of experienced nurses computing the insulin dose revealed an average of 2 minutes per calculation per hour to complete.

  7. Amino acid concentrations in serum and urine after intravenous infusion of 1.5% glycine in prostatectomy patients.

    Science.gov (United States)

    Hahn, R G

    1992-01-01

    Glycine 1.5% was given by intravenous infusion at a rate of 50 mg/min over 20 min to 10 patients (aged 57-79 years) scheduled for transurethral prostatectomy. The concentrations of amino acids in serum and urine were measured at 0, 10, 20, 50, 80, and 140 min in the experiments in order to study how elderly men handle a glycine load. The results show an increase in the serum concentrations of alanine, proline, glutamine, glycine, serine, and threonine. The apparent distribution volume for the excess glycine was 33 +/- 9 L, the half-life was 41 +/- 7 min, and the total body clearance was 0.56 +/- 0.08 L/min, while the renal clearance for glycine was 36 +/- 14 ml/min (mean +/- SD). There was an increase in the excretion of all amino acids that could be detected in the urine. The renal clearances of urea and creatinine was reduced in some of the patients. The absence of toxic symptoms is consistent with unchanged serum concentrations of ammonia and glutamate.

  8. Report of a 7 year case-control study of continuous intraperitoneal insulin infusion and subcutaneous insulin therapy among patients with poorly controlled type 1 diabetes mellitus : Favourable effects on hypoglycaemic episodes

    NARCIS (Netherlands)

    van Dijk, P. R.; Logtenberg, S. J. J.; Groenier, K. H.; Gans, R. O. B.; Bilo, H. J. G.; Kleefstra, N.

    2014-01-01

    Aims: Continuous intraperitoneal insulin infusion (CIPII) is a last-resort treatment option for patients with type 1 diabetes mellitus (T1DM) who fail to reach adequate glycaemic control with subcutaneous (SC) insulin therapy. Aim was to compare the long-term effects of CIPII and SC insulin therapy

  9. Report of a 7 year case-control study of continuous intraperitoneal insulin infusion and subcutaneous insulin therapy among patients with poorly controlled type 1 diabetes mellitus : Favourable effects on hypoglycaemic episodes

    NARCIS (Netherlands)

    van Dijk, P. R.; Logtenberg, S. J. J.; Groenier, K. H.; Gans, R. O. B.; Bilo, H. J. G.; Kleefstra, N.

    2014-01-01

    Aims: Continuous intraperitoneal insulin infusion (CIPII) is a last-resort treatment option for patients with type 1 diabetes mellitus (T1DM) who fail to reach adequate glycaemic control with subcutaneous (SC) insulin therapy. Aim was to compare the long-term effects of CIPII and SC insulin therapy

  10. Diet liberalization and metabolic control in type I diabetic outpatients treated by continuous subcutaneous insulin infusion.

    Science.gov (United States)

    Chantelau, E; Sonnenberg, G E; Stanitzek-Schmidt, I; Best, F; Altenähr, H; Berger, M

    1982-01-01

    In 10 type I diabetic outpatients treated by continuous subcutaneous insulin infusion (CSII), dietary habits and metabolic control were investigated. Under conditions of a conventional diabetes diet (including 5-6 meals per day and a strictly planned meal intake) as well as under a "less restricted diabetes diet" (e.g., free choice of number, timing, and amount of carbohydrate intake) near normoglycemia could be achieved. Mean daily blood glucose levels did not change significantly when the patients' nutrition was alternated between both diets. During the "less restricted diabetes diet," the patients opted for a rather high fat intake (51 +/- 5% fat, 34 +/- 5% carbohydrate, and 15 +/- 2% protein). Despite this unintended dietary behavior, serum lipids and body weight remained normal after an observation period of 4-6 mo. It is concluded that during permanent near normoglycemia achieved by CSII a partial liberalization of the diabetes diet does not introduce any short-term or long-term metabolic risk factors for cardiovascular diseases.

  11. 静脉留置针用于新生儿静脉输液800例护理体会%Disposable intravenous indwelling intravenous infusion in patients with 800 cases of neonatal nursing

    Institute of Scientific and Technical Information of China (English)

    白振平

    2013-01-01

      Objective To use of disposable intravenous indwelling intravenous infusion in neonatal effect observation. Methods based on 800 cases of neonatal patients one-time vein needle line vein infusion of nursing, Strictly complying with aseptic operation, Choosing the right puncture position firmly and a use normal saline plugging . Results In 800 cases of neonatal patients in intravenous infusion, The use of disposable intravenous indwelling needle, on the one hand, It is safe and economical and practical, on the other hand, reducing the nursing workload, effectively preventing infection and drug waste, And in the case of phlebitis did not happen, no embolism happen. Conclusion the use of disposable vein needle in the newborn venous infusion has the advantage of safety, economy, benefits ,less painful, and fewer complications and so on.%  目的探讨将一次性静脉留置针用于新生儿静脉输液的护理及效果。方法对800例使用一次性静脉留置针行静脉输液的新生儿,严格遵守无菌操作规程,选择合适的穿刺部位,牢固固定,应用生理盐水封管。结果800例新生儿使用一次性静脉留置针静脉输液,减少了护理工作量,有效防止了感染和药物浪费,且无1例发生静脉炎及栓塞。结论使用一次性静脉留置针行新生儿静脉输液安全、经济、实惠,患儿痛苦少,并发症少,值得推广应用。

  12. The importance of active learning and practice on the students' mastery of pharmacokinetic calculations for the intermittent intravenous infusion dosing of antibiotics

    Directory of Open Access Journals (Sweden)

    Mehvar Reza

    2012-11-01

    Full Text Available Abstract Background Estimation of pharmacokinetic parameters after intermittent intravenous infusion (III of antibiotics, such as aminoglycosides or vancomycin, has traditionally been a difficult subject for students in clinical pharmacology or pharmacokinetic courses. Additionally, samples taken at different intervals during repeated dose therapy require manipulation of sampling times before accurate calculation of the patient-specific pharmacokinetic parameters. The main goal of this study was to evaluate the effectiveness of active learning tools and practice opportunities on the ability of students to estimate pharmacokinetic parameters from the plasma samples obtained at different intervals following intermittent intravenous infusion. Methods An extensive reading note, with examples, and a problem case, based on a patient’s chart data, were created and made available to students before the class session. Students were required to work through the case before attending the class. The class session was devoted to the discussion of the case requiring active participation of the students using a random participation program. After the class, students were given additional opportunities to practice the calculations, using online modules developed by the instructor, before submitting an online assignment. Results The performance of students significantly (P P  Conclusions Despite being a difficult subject, students achieve mastery of pharmacokinetic calculations for the topic of intermittent intravenous infusion when appropriate active learning strategies and practice opportunities are employed.

  13. Time Savings with Rituximab Subcutaneous Injection versus Rituximab Intravenous Infusion: A Time and Motion Study in Eight Countries.

    Directory of Open Access Journals (Sweden)

    Erwin De Cock

    Full Text Available Rituximab is a standard treatment for non-Hodgkin lymphoma. The SABRINA trial (NCT01200758 showed that a subcutaneous (SC rituximab formulation did not compromise efficacy or safety compared with intravenous (IV infusion. We aimed to quantify active healthcare professional (HCP time and patient chair time for rituximab SC and IV, including potential time savings.This non-interventional time and motion study was run in eight countries and 30 day oncology units. Rituximab SC data were collected alongside the MabCute trial (NCT01461928; IV data were collected per routine real-world practice. Trained observers recorded active HCP time for pre-specified tasks (stopwatch and chair time (time of day. A random intercept model was used to analyze active HCP time (by task and for all tasks combined in the treatment room and drug preparation area, drug administration duration, chair time and patient treatment room time by country and/or across countries. Active HCP and chair time were extrapolated to a patient's first year of treatment (11 rituximab sessions.Mean active HCP time was 35.0 and 23.7 minutes for IV and SC process, respectively (-32%, p <0.0001. By country, relative reduction in time was 27-58%. Absolute reduction in extrapolated active HCP time (first year of treatment was 1.1-5.2 hours. Mean chair time was 262.1 minutes for IV, including 180.9 minutes infusion duration, vs. 67.3 minutes for SC, including 8.3 minutes SC injection administration (-74%, p <0.0001. By country, relative reduction was 53-91%. Absolute reduction in extrapolated chair time for the first year of treatment was 3.1-5.5 eight-hour days.Compared with rituximab IV, rituximab SC was associated with reduced chair time and active HCP time. The latter could be invested in other activities, whereas the former may lead to more available appointments, reducing waiting lists and increasing the efficiency of day oncology units.ClinicalTrials.gov NCT01200758.

  14. Continuous subcutaneous insulin infusion versus multiple daily injections in individuals with type 1 diabetes: a systematic review and meta-analysis.

    Science.gov (United States)

    Benkhadra, Khalid; Alahdab, Fares; Tamhane, Shrikant U; McCoy, Rozalina G; Prokop, Larry J; Murad, Mohammad Hassan

    2017-01-01

    The relative efficacy of continuous subcutaneous insulin infusion and multiple daily injections in individuals with type 1 diabetes is unclear. We sought to synthesize the existing evidence about the effect of continuous subcutaneous insulin infusion on glycosylated hemoglobin, hypoglycemic events, and time spent in hypoglycemia compared to multiple daily injections. We searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials and Database of Systematic Reviews, and Scopus from January 2008 through November 2015 for randomized controlled trials that enrolled children or adults with type 1 diabetes. Trials identified in a previous systematic review and published prior to 2008 were also included. We included 25 randomized controlled trials at moderate risk of bias. Meta-analysis showed a significant reduction in glycosylated hemoglobin in patients treated with continuous subcutaneous insulin infusion compared to multiple daily injections (mean difference 0.37; 95 % confidence interval, 0.24-0.51). This effect was demonstrated in both children and adults. There was no significant difference in minor or severe hypoglycemic events. Continuous subcutaneous insulin infusion was associated with lower incidence of nocturnal hypoglycemia. There was no significant difference in the time spent in hypoglycemia. In children and adults with type 1 diabetes and compared to multiple daily injections, continuous subcutaneous insulin infusion is associated with a modest reduction in glycosylated hemoglobin. There was no difference in severe or minor hypoglycemia, but likely a lower incidence of nocturnal hypoglycemia with continuous subcutaneous insulin infusion.

  15. Interaction between plastic catheter tubings and regular insulin preparations used for continuous subcutaneous insulin-infusion therapy.

    Science.gov (United States)

    Chantelau, E; Lange, G; Gasthaus, M; Boxberger, M; Berger, M

    1987-01-01

    In search of possible interactions between plastic tubings used for insulin-pump treatment and commercial regular insulin preparations, various catheter sets made from polyvinyl chloride (PVC), polyethylene (PE), and nylon plastics were perfused at 30 degrees C in a laboratory setting for up to 72 h. The perfused insulin solutions were analyzed by high-performance liquid chromatography and atomic absorption spectroscopy. Although no plasticizer, e.g., dioctyl phthalate, or nickel or chromium ions were found in the perfusates, substantial interactions between the plastics and the insulin solutions were detected, extraction of bacteriostatic additives from the insulin solutions in particular. The PVC retained up to 88% of the bacteriostatics from the insulin preparations, whereas PE tubings retained only 10-15%. Whether the loss of preservatives during perfusion through PVC catheters predisposes to cutaneous infections during insulin-pump therapy remains to be shown.

  16. [A case of Wernicke-Korsakoff syndrome with dramatic improvement in consciousness immediately after intravenous infusion of thiamine].

    Science.gov (United States)

    Kikuchi, A; Chida, K; Misu, T; Okita, N; Nomura, H; Konno, H; Takase, S; Takeda, A; Itoyama, Y

    2000-01-01

    A 68-year-old man was hospitalized on March 4, 1998 for disturbances in consciousness. In 1995, he had received proximal subtotal gastrectomy and reconstructive surgery of the jejunal interposition for gastric cancer. Thereafter he had been taking enough food without the habit of taking liquor. In October 1997, his short term memory was becoming gradually worse. On February 12, 1998, he suffered from numbness in the feet, and then dysphagia, unsteady gait, and diplopia developed gradually. On February 26, brain MRI showed no abnormalities. On March 3, he had a fever of 38.5 degrees C and his consciousness became unclear. Neurological examination revealed semi-coma, total ophthalmoplegia, and absence of doll's eye movement. Deep tendon reflexes were absent. The serum thiamine level was 9 ng/ml (normal range: 20-50). Brain MRI demonstrated symmetrical high intensity lesions in the periaqueductal area of the midbrain, dorsomedial nuclei of bilateral thalami, and vestibular nuclei. About 30 seconds after intravenous infusion of thiamine, his consciousness improved dramatically, but returned to semi-coma after about two minutes. Wernicke-Korsakoff syndrome usually occurs acutely. In the present case, however, the disease showed slow onset, chronic progression, and then rapid worsening after fever. Reconstructive surgery of the jejunal interposition might have caused the slow onset of Wernicke-Korsakoff syndrome, and fever might have facilitated the rapid progression of the disease. An immediate high concentration of thiamine modifies the kinetics of acetylcholine receptor ion channels, thereby maintaining wakefulness, and the level of consciousness may change dramatically.

  17. Effect of intravenous infusion of dexmedetomidine on perioperative haemodynamic changes and postoperative recovery: A study with entropy analysis

    Directory of Open Access Journals (Sweden)

    Chirag Ramanlal Patel

    2012-01-01

    Full Text Available Background: Dexmedetomidine, an α2 agonist, when used as an adjuvant in general anaesthesia attenuates stress response to various noxious stimuli, maintains perioperative haemodynamic stability and provides sedation without significant respiratory depression postoperatively. Methods: Sixty patients were randomly divided into two groups of 30 each. In group A, fentanyl 2 μg/kg and in group B dexmedetomidine were given intravenously as loading dose of 1 μg/kg over 10 min prior to induction. After induction with thiopentone, in group B, dexmedetomidine was given as infusion at a dose of 0.2-0.8 μg/kg. Sevoflurane was used as inhalation agent in both groups. Haemodynamic variables and entropy (response entropy and state entropy were recorded continuously. Postoperative sedation and recovery were assessed by sedation score and modified Aldrete′s score, respectively. Results: Dexmedetomidine significantly attenuates stress response at intubation with lesser increase in heart rate (10% vs. 17%, systolic blood pressure (6% vs. 23% and diastolic blood pressure (7% vs. 20% as compared to the control group (P<0.05. Intraoperatively, an average of 8% fall in systolic blood pressure and 8.16% fall in diastolic pressure in the test group as compared to 3.6% rise in systolic and 3.3% in diastolic pressure of the control group was observed. Postoperatively, the test group showed significant sedation at 2 h as compared to the control group (P=0.00 and recovery was better in the control group for the first 2 h post extubation. Conclusion: Dexmedetomidine attenuates various stress responses during surgery and maintains the haemodynamic stability when used as an adjuvant in general anaesthesia. Also, the sedative action of dexmedetomidine delays recovery for the first few hours post extubation.

  18. Treatment Efficacy of Subcutaneous Insulin Infusion Therapy In Type 1 Diabetic Patients - Orijinal Article

    Directory of Open Access Journals (Sweden)

    Soner

    2010-12-01

    Full Text Available Objective: Current goals of treatment of diabetes are to achieve near-normal glycemia, minimize the risk of severe hypoglycemia, limit excessive weight gain, and to improve quality of life. Insulin pump or continuous subcutaneous insulin infusion (CSII therapy provides a treatment option to aid in achieving all of these goals. CSII is a viable alternative to multiple daily injections (MDI therapy for patients with diabetes who are capable and motivated. In this study, we aimed to compare the diabetic control and treatment satisfaction in our patients using CSII and MDI. Materials and Methods: Fifty patients with type 1 diabetes, who had been followed between 2005-2008, were enrolled in the study. Changes in biomedical outcomes (glycated haemoglobin; HbA1c, hypoglycaemia, and weigth gain pre-CSII, during the last year and at the end of the study were analyzed retrospectively. For treatment satisfaction and compliance, we used a questionnaire containing 12 questions. The patients were divided into two groups according to MDI or CSII therapy use for least one year: Group 1 using CSII (n:27 and Group 2 using MDI (n:23. Results: There was no significant difference between the last HbA1c levels in both groups. In CSII group, decrease in HbA1c was 0.79% for average follow-up of 1.66 years ( 9.19%±2.23; 8.40%±1.17. When the two groups were compared in terms of hypoglycemia rates and weight gain over the last year, no statistically significant difference was found, but in CSII group, hypoglycemia rates were lower. Finally, CSII group demonstrated a higher treatment satisfaction rate and higher compliance, while a negative correlation was detected between frequency of home blood glucose monitoring and HbA1c levels in all patients. Conclusion: CSII therapy is effective in improving glycemic control with higher treatment satisfaction when compared with MDI therapy in selected type 1 diabetic patients. Turk Jem 2010; 14: 80-4

  19. Intracerebroventricular neuropeptide Y infusion precludes inhibition of glucose and VLDL production by insulin.

    NARCIS (Netherlands)

    Hoek, A.M. van den; Voshol, P.J.; Karnekamp, B.N.; Buijs, R.M.; Romijn, J.A.; Havekes, L.M.; Pijl, H.

    2004-01-01

    Recent evidence demonstrates that hypothalamic insulin signaling is required for inhibition of endogenous glucose production. The downstream mechanisms that are responsible for the effects of hypothalamic insulin receptor activation on hepatic fuel flux remain to be determined. To establish whether

  20. Possible activation of auto-immune thyroiditis from continuous subcutaneous infusion of genapol-containing insulin.

    Science.gov (United States)

    Chantelau, E

    2000-09-01

    A case of a type 1 diabetic woman with auto-immune thyroiditis is reported, in whom repeated exposure to insulin containing Genapol(R) (polyethylen-polypropylenglycol) over 3 years reproducibly parallels with an increase of serum TSH (thyroid-stimulating hormone) above the normal limit. Previously, adverse effects of Genapol(R) insulin have been related to its intraperitoneal application, and thought to be restricted to anti-insulin-immunity; activating effects on thyroid auto-immunity have been repeatedly disputed. We suggest that Genapol(R) insulin should be replaced by other insulin preparations with a better safety record.

  1. Acute ST elevation myocardial infarction after intravenous immunoglobulin infusion in a young patient: a rare but probable adverse effect of immunoglobulin

    Directory of Open Access Journals (Sweden)

    Manish Ruhela

    2014-06-01

    Full Text Available Intravenous immunoglobulin (IVIG is used in the treatment of a variety of disorders, including autoimmune conditions. IVIG has been considered a safe medication, with minor and transient adverse effects. With the wider use of IVIG, the reported rate of adverse effects has been increased, some of them are potentially fatal cardiovascular reactions due to induction of hypercoagulable state. We report a 40-year-old female treated with IVIG for Guillain-Barre syndrome, who developed chest pain 1 hr following IVIG infusion. The symptoms were associated with ST elevation in anterior leads on electrocardiogram. This anterior wall myocardial infarction (MI is compatible with IVIG-induced hypercoagulability and considered as a probable adverse effect of this medication. To the best of our knowledge, this is probably the first case report where a young patient developed acute MI without any cardiac risk factors after IVIG infusion. [Int J Basic Clin Pharmacol 2014; 3(3.000: 569-571

  2. Safety and tolerability of an intravenously administered alpha1-proteinase inhibitor at an increased infusion rate: a novel, randomized, placebo-masked, infusion rate-controlled, crossover study in healthy adults

    Directory of Open Access Journals (Sweden)

    Ngo LY

    2014-06-01

    Full Text Available Leock Y Ngo,1 Adam Haeberle,1 Jacqueline Dyck-Jones,1 David Gelmont,1 Leman Yel11Baxter Healthcare Corporation, Westlake Village, CA, USAPurpose: Alpha1-proteinase inhibitor (A1PI is indicated for chronic augmentation therapy in adults with emphysema due to congenital deficiency of A1PI. An intravenous infusion rate of 0.04 mL/kg/minute is currently recommended for the A1PI product, Glassia®. This randomized, placebo-masked, rate-controlled, crossover study was designed to evaluate the safety and tolerability of A1PI administration at an increased infusion rate.Patients and methods: A total of 30 healthy male and female subjects aged 19–61 years were enrolled. Each subject received simultaneous intravenous infusions of A1PI (Glassia® and placebo (human albumin 2.5% administered through a single infusion site on two separate treatment periods. Subjects were randomized in a 1:1 ratio to receive either test treatment (A1PI 0.2 mL/kg/minute + placebo 0.04 mL/kg/minute, or reference treatment (A1PI 0.04 mL/kg/minute + placebo 0.2 mL/kg/minute on Day 1. On Day 15, subjects received the other treatment regimen in a crossover sequence.Results: A total of 36 adverse events (AEs, regardless of causality, were reported; all were non-serious and of mild intensity, with headaches and dizziness occurring most frequently (12 [33.3%] and three [8.3%] of 36 AEs, respectively. Only seven AEs in six subjects were assessed as related to study treatment: with two AEs reported in two subjects treated with the 0.2 mL/kg/minute rate compared with five AEs in four subjects treated with the 0.04 mL/kg/minute rate.Conclusions: This study demonstrated the safety and tolerability of an A1PI product at an increased infusion rate (0.2 mL/kg/minute resulting in a shorter infusion duration in healthy subjects.Keywords: A1PI, Glassia, administration rate, Alpha-1 antitrypsin, ATT

  3. Prevention of methionine and ammonia-induced coma by intravenous infusion of a branched chain amino acid solution to rats with liver injury.

    Directory of Open Access Journals (Sweden)

    Shiota,Tetsuya

    1984-10-01

    Full Text Available The prevention of hepatic encephalopathy by the intravenous infusion of a branched chain amino acid (BCAA-enriched solution was investigated in methionine and ammonium acetate-treated rats whose liver was already injured with carbon tetrachloride. A BCAA-enriched solution protected the rats from entering a coma. The brain BCAA contents became higher, and the brain methionine and tyrosine levels and the ratio of glutamine to glutamic acid in the brain diminished after administering the BCAA-enriched solution.

  4. High-dose insulin and intravenous lipid emulsion therapy for cardiogenic shock induced by intentional calcium-channel blocker and Beta-blocker overdose: a case series.

    Science.gov (United States)

    Doepker, Bruce; Healy, William; Cortez, Eric; Adkins, Eric J

    2014-04-01

    Recently, high-dose insulin (HDI) and intravenous lipid emulsion (ILE) have emerged as treatment options for severe toxicity from calcium-channel blocker (CCB) and beta blocker (BB). Our aim was to describe the use and effectiveness of HDI and ILE for the treatment of CCB and BB overdose. We describe 2 patients presenting to the emergency department after intentional ingestions of CCBs and BBs. A 35-year-old man presented in pulseless electrical activity after ingesting amlodopine, verapamil, and metoprolol. A 59-year-old man presented with cardiogenic shock (CS) after ingesting amlodopine, simvastatin, lisinopril, and metformin. Both patients were initially treated with glucagon, calcium, and vasopressors. Shortly after arrival, HDI (1 unit/kg × 1; 1 unit/kg/h infusion) and ILE 20% (1.5 mL/kg × 1; 0.25 mL/kg/min × 60 min) were initiated. This led to hemodynamic improvement and resolution of shock. At the time of hospital discharge, both patients had achieved full neurologic recovery. HDI effectively reverses CS induced by CCBs and BBs due to its inotropic effects, uptake of glucose into cardiac muscle, and peripheral vasodilatation. ILE is theorized to sequester agents dependent on lipid solubility from the plasma, preventing further toxicity. To our knowledge, these are the first two successful cases reported using the combination of HDI and ILE for reversing CS induced by intentional ingestions of CCBs and BBs. Copyright © 2014 Elsevier Inc. All rights reserved.

  5. Effects of glucose and amino acid infusion on glucose turnover in insulin-resistant obese and type II diabetic patients.

    Science.gov (United States)

    Tappy, L; Acheson, K; Normand, S; Pachiaudi, C; Jéquier, E; Riou, J P

    1994-04-01

    Glucose turnover was assessed from [6,6-2H]glucose and [U-13C]glucose dilution analysis in six lean nondiabetic subjects, six obese patients with normal glucose tolerance, and six obese patients with non-insulin-dependent diabetes mellitus (NIDDM) during sequential infusions of glucose (13.9 mumol/kg fat-free mass [FFM]/min) and glucose+amino acid (4.2 mg/kg FFM/min). Cori cycle activity was assessed from the difference between glucose turnover obtained from [6,6-2H]glucose and [U-13C]glucose. During infusion of glucose alone, total glucose turnover was increased by 70% in obese NIDDM patients. Amino acid infusion decreased glucose concentrations by 0.8, 0.5, and 1.8 mmol/L in controls, obese patients, and NIDDM patients, respectively. This decrease in glycemia occurred despite an increase in glucose turnover in lean and obese nondiabetic subjects, and was due to an increased metabolic clearance rate (MCR) of glucose. In NIDDM patients the MCR of glucose was unchanged, and the decrease in glycemia was explained by a diminution in hepatic glucose output. Glucose turnover obtained by [6.6-2H] dilution analysis exceeded significantly the values obtained by dilution analysis in obese subjects and obese NIDDM patients, but not in controls. This indicates an increased Cori cycle activity in these patients.

  6. Single-dose intravenous iron infusion versus red blood cell transfusion for the treatment of severe postpartum anaemia

    DEFF Research Database (Denmark)

    Holm, C; Thomsen, L L; Norgaard, A;

    2017-01-01

    BACKGROUND AND OBJECTIVES: There are no randomized trials comparing intravenous iron to RBC transfusion for the treatment of severe postpartum anaemia. The objectives of this study were to evaluate the feasibility of randomizing women with severe postpartum anaemia secondary to postpartum...... and a higher Hb in weeks 3-12. CONCLUSION: This pilot study shows that intravenous iron could be an attractive alternative to RBC transfusion in severe postpartum anaemia, and that a larger trial is needed and feasible....

  7. 评判性思维在静脉输液中应用的效果评价%Application effect of critical thinking in the intravenous infusion

    Institute of Scientific and Technical Information of China (English)

    谢春雷; 李春霞; 李爱文

    2013-01-01

    目的 探讨评判性思维在静脉输液中的应用效果.方法 选择2012年1~4月在神经外科工作的护士进行评判性思维能力的培养,运用评判性思维在静脉输液过程中进行分析、判断、制定与落实相应护理措施,观察实施评判性思维培训后患者的静脉输液穿刺成功率及患者对护理工作的满意度.结果 对护理人员进行静脉输液评判性思维的培训后,患者的静脉穿刺成功率及患者对护理工作的满意度较培训前明显提高.结论 对护士在静脉输液过程中实施评判性思维培训可有效提高护士的穿刺技能,减少输液肿胀及并发症的发生,提高临床护理质量及患者对护理工作的满意度.%Objective To explore the application effect of critical thinking applied in the intravenous infusion.Methods To give nurses who worked in the Neurosurgery Department from January to April 2012 training lessons of critical thinking so that they could analyze,judge,formulate and implement corresponding nursing measures during the intravenous infusion process through their critical thinking.Then the successful rate of venepuncture for patients and the patients' satisfaction degree with nursing before and after the critical thinking training lessons were observed.Results The successful rate of venepuncture for patients and the patients' satisfaction degree of nursing were apparently improved after the nurses received critical thinking training.The difference was of statistical significance.Conclusions After the implementation of critical thinking training during the intravenous infusion process for nurses,nurses puncture skills is enhanced,infusion swelling and complications are reduced,and the quality of clinical nursing care and patients' satisfaction degree of nursing is improved.

  8. Comparison of Intravenous Infusion of Tramadol Alone with Combination of Tramadol and Paracetamol for Postoperative Pain after Major Abdominal Surgery in Children.

    Science.gov (United States)

    Ali, Shayesta; Sofi, Khalid; Dar, Abdul Qayoom

    2017-01-01

    Pain is a common complaint after surgery and seems to be difficult to manage in children because of fear of complications of pain treatment or misconception that infants and small children do not feel pain at all or feel less pain. A survey reported that 40% of pediatric surgical patients experienced moderate or severe postoperative pain and that more than 75% had insufficient analgesia. Our study was carried to provide continuous infusion of intravenous (i.v.) tramadol alone using a dedicated infusion device Graseby 2100 syringe pump and compared it to a combination of i.v. tramadol infusion and per rectal paracetamol. A total of 124 children aged 1-8 years selected for the study were randomized into two groups using a table of random numbers. Power calculation had suggested a sample size of 62 in each group with a power of 80% and significance level of 5%. Group A comprising 62 children, received i.v. infusion of tramadol in a dose of 0.25 mg/kg/h for 24 h postoperatively. Group B comprising 62 children, received i.v. infusion of tramadol in a dose of 0.25 mg/kg/h for 24 h postoperatively in addition to per rectal suppository of paracetamol in a dose of 90 mg/kg in 24 h (30 mg/kg as first dose followed by 20 mg/kg every 6 hourly for the next 18 h). Postoperatively, patients were observed for 24 h. A statistically significant difference (P ≤ 0.001) in Face, Legs, Activity, Cry, Consolability pain scores was seen between two groups at 4, 6, and 8 h. Pain scores being less in Group B patients who had received infusion of tramadol and per rectal suppositories of paracetamol compared to Group A patients who received only infusion of tramadol. A statistically significant difference (P tramadol in a dose of 0.25 mg/kg/h in the first 24 h after surgery, in combination with a regular per rectal paracetamol in a daily dose of 90 mg/kg/day in four divided doses for children after major abdominal surgery. However, a close nursing supervision is essential to increase the

  9. Effect of Intravenous Infusion of G-CSF-Mobilized Peripheral Blood Mononuclear Cells on Upper Extremity Function in Cerebral Palsy Children.

    Science.gov (United States)

    Park, Kyeong Il; Lee, Young-Ho; Rah, Wee-Jin; Jo, Seung Hwi; Park, Si-Bog; Han, Seung Hoon; Koh, Hani; Suh, Jin Young; Um, Jang Soo; Choi, Eun Hye; Park, Un Jin; Kim, Mi Jung

    2017-02-01

    To investigate the effect of intravenous infusion of peripheral blood mononuclear cells (mPBMC) mobilized by granulocyte-colony stimulating factor (G-CSF) on upper extremity function in children with cerebral palsy (CP). Fifty-seven children with CP were enrolled. Ten patients were excluded due to follow-up loss. In total, 47 patients (30 males and 17 females) were analyzed. All patients' parents provided signed consent before the start of the study. After administration of G-CSF for 5 days, mPBMC was collected and cryopreserved. Patients were randomized into two groups 1 month later. Twenty-two patients were administered mPBMC and 25 patients received normal saline as placebo. Six months later, the two groups were switched, and administered mPBMC and placebo, respectively. Quality of Upper Extremity Skills Test (QUEST) and the Manual Ability Classification System (MACS) were used to evaluate upper motor function. All subdomain and total scores of QUEST were significantly improved after mPBMC and placebo infusion, without significant differences between mPBMC and placebo groups. A month after G-CSF, all subdomain and total scores of QUEST were improved. The level of MACS remained unchanged in both mPBMC and placebo groups. In this study, intravenously infused mPBMC showed no significant effect on upper extremity function in children with CP, as compared to placebo. The effect of mPBMC was likely masked by the effect of G-CSF, which was used in both groups and/or G-CSF itself might have other neurotrophic potentials in children with CP.

  10. The post-occipital spinal venous sinus of the Nile crocodile (Crocodylus niloticus: Its anatomy and use for blood sample collection and intravenous infusions

    Directory of Open Access Journals (Sweden)

    Jan G. Myburgh

    2014-02-01

    Full Text Available The post-occipital sinus of the spinal vein is often used for the collection of blood samples from crocodilians. Although this sampling method has been reported for several crocodilian species, the technique and associated anatomy has not been described in detail in any crocodilian, including the Nile crocodile (Crocodylus niloticus. The anatomy of the cranial neck region was investigated macroscopically, microscopically, radiographically and by means of computed tomography. Latex was injected into the spinal vein and spinal venous sinus of crocodiles to visualise the regional vasculature. The spinal vein ran within the vertebral canal, dorsal to and closely associated with the spinal cord and changed into a venous sinus cranially in the post-occipital region. For blood collection, the spinal venous sinus was accessed through the interarcuate space between the atlas and axis (C1 and C2 by inserting a needle angled just off the perpendicular in the midline through the craniodorsal cervical skin, just cranial to the cranial borders of the first cervical osteoderms. The most convenient method of blood collection was with a syringe and hypodermic needle. In addition, the suitability of the spinal venous sinus for intravenous injections and infusions in live crocodiles was evaluated. The internal diameter of the commercial human epidural catheters used during these investigations was relatively small, resulting in very slow infusion rates. Care should be taken not to puncture the spinal cord or to lacerate the blood vessel wall using this route for blood collection or intravenous infusions.

  11. Kinetics of intraperitoneally infused insulin in rats - Functional implications for the bioartificial pancreas

    NARCIS (Netherlands)

    de Vos, P; Vegter, D; de Haan, B.J; Strubbe, J.H.; Bruggink, J.E.; van Schilfgaarde, R

    Intraperitoneal transplantation of encapsulated islets can restore normoglycemia in diabetic recipients but not normal glucose tolerance nor normal insulin responses to a physiological stimulus. This study investigates whether the intraperitoneal implantation site as such contributes to the

  12. Kinetics of intraperitoneally infused insulin in rats - Functional implications for the bioartificial pancreas

    NARCIS (Netherlands)

    DeVos, P; Vegter, D; DeHaan, BJ; Strubbe, JH; Bruggink, JE; VanSchilfgaarde, R

    1996-01-01

    Intraperitoneal transplantation of encapsulated islets can restore normoglycemia in diabetic recipients but not normal glucose tolerance nor normal insulin responses to a physiological stimulus. This study investigates whether the intraperitoneal implantation site as such contributes to the interfer

  13. Insulin aspart pharmacokinetics

    DEFF Research Database (Denmark)

    Rasmussen, Christian Hove; Roge, Rikke Meldgaard; Ma, Zhulin

    2014-01-01

    Background: Insulin aspart (IAsp) is used by many diabetics as a meal-time insulin to control postprandial glucose levels. As is the case with many other insulin types, the pharmacokinetics (PK), and consequently the pharmacodynamics (PD), is associated with clinical variability, both between...... to investigate and quantify the properties of the subcutaneous depot. Data from Brange et al. (1990) are used to determine the effects of insulin chemistry in subcutis on the absorption rate. Intravenous (i.v.) bolus and infusion PK data for human insulin are used to understand and quantify the systemic...... distribution and elimination (Porksen et al., 1997; Sjostrand et al., 2002). PK and PD profiles for type 1 diabetics from Chen et al. (2005) are analyzed to demonstrate the effects of IAsp antibodies in terms of bound and unbound insulin. PK profiles from Thorisdottir et al. (2009) and Ma et al. (2012b...

  14. Use and Effectiveness of Continuous Subcutaneous Insulin Infusion (CSII) and Multiple Daily Insulin Injection Therapy (MIT) in Children, Adolescents and Young Adults with Type 1 Diabetes Mellitus.

    Science.gov (United States)

    Schiel, R; Burgard, D; Perenthaler, T; Stein, G; Kramer, G; Steveling, A

    2016-02-01

    Today continuous subcutaneous insulin infusion (CSII) is frequently used in children and adolescents with type 1 diabetes mellitus. The present cross-sectional trial aimed to document current practice, quality of diabetes control and incidence of acute complications in different age-groups under CSII vs. multiple daily insulin injection therapy (MIT). Moreover the survey analyzed socio-demographic backgrounds of the patients. A total of 901 patients (age 11.5±4.0, diabetes duration 4.0±3.6 years) was entered in the database. Clinical data, laboratory parameters and, using a standardized questionnaire, socio-demographic data were assessed. For age-related analyses patients were allocated to 4 groups: pre-school children (MIT. Patients with CSII vs. MIT had a longer diabetes duration, they used more frequently insulin analogues, performed more frequently blood-glucose self-tests and had a lower insulin dosage per kilogram body weight. In respect of HbA1c, the mean amplitude of blood-glucose excursions, but also of lipids, creatinine, microalbuminuria and blood pressure, there were no differences in neither age-group between patients with CSII and MIT. In patients with CSII and MIT, there was a tendency (pMIT there is an increase of HbA1c towards adolescence. It must also highlighted that CSII seems to be expansive and that CSII is more frequently used in patients with better educational levels and deriving from higher social classes. © Georg Thieme Verlag KG Stuttgart · New York.

  15. Incretin hormone and insulin responses to oral versus intravenous lipid administration in humans

    DEFF Research Database (Denmark)

    Lindgren, Ola; Carr, Richard D; Deacon, Carolyn F;

    2011-01-01

    Context: The incretin effect is responsible for the higher insulin response to oral glucose than to iv glucose at matching glucose levels. It is notknownwhetherthis effect is restricted to glucose only. Objective: The aim of the study was to examine whether insulin and incretin hormone responses ...

  16. Mesenchymal stem cells are short-lived and do not migrate beyond the lungs after intravenous infusion

    NARCIS (Netherlands)

    E. Eggenhofer (Elke); V. Benseler (Volker); H.K. Kroemer (Heyo); F. Popp (Felix); E.K. Geissler (Edward); H.J. Schlitt (Hans); C.C. Baan (Carla); M.H. Dahlke (Marc); M.J. Hoogduijn (Martin)

    2012-01-01

    textabstractMesenchymal stem cells (MSC) are under investigation as a therapy for a variety of disorders. Although animal models show long term regenerative and immunomodulatory effects of MSC, the fate of MSC after infusion remains to be elucidated. In the present study the localization and viabili

  17. Effects of continuous intravenous infusion of morphine and morphine-tramadol on the minimum alveolar concentration of sevoflurane and electroencephalographic entropy indices in dogs.

    Science.gov (United States)

    Mahidol, Chulabhorn; Niyom, Sirirat; Thitiyanaporn, Chaiyakorn; Suprasert, Apinun; Thengchaisri, Naris

    2015-03-01

    To compare the effects of continuous rate infusions (CRIs) of intravenous (IV) morphine and morphine-tramadol on the minimum alveolar concentration (MAC) of sevoflurane, and on electroencephalographic entropy indices in dogs. Prospective study. Eight young, healthy German shepherds, weighing 26.3 ± 3.1 kg (mean ± SD). Anaesthesia was induced and maintained with sevoflurane. A standard tail-clamp technique was used for MAC determination. Within one anaesthetic period, MAC was first determined during sevoflurane anaesthesia alone (MACB ); then during morphine infusion (MACM ), (loading dose 0.5 mg kg(-1) IM; CRI, 0.2 mg kg(-1 ) hour(-1)) then finally during morphine-tramadol infusion (tramadol loading dose 1.5 mg kg(-1) IV; CRI, 2.6 mg kg(-1)  hour(-1) ) (MACMT ). At each change, periods of 45 minutes were allowed for equilibration. Stated entropy (SE), response entropy (RE), and RE-SE differences were measured five minutes prior to and during tail clamping. The MACB was 2.1 ± 0.3vol%. The morphine and morphine-tramadol infusions reduced MAC to 1.6 ± 0.3vol% and 1.3 ± 0.3vol%, respectively. MAC was decreased below baseline more during morphine-tramadol than during morphine alone (39 ± 9% versus 25 ± 6%, respectively; p = 0.003). All SE and RE and most RE-SE differences were increased significantly (p tramadol CRI decreased sevoflurane MAC more than morphine CRI alone. Entropy indices changed during nociceptive responses in anaesthetized animals, suggesting that entropy measurements may be useful in determining anaesthetic depth in dogs. © 2014 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesia and Analgesia.

  18. Effects of intravenous ghrelin injection on plasma growth hormone, insulin and glucose concentrations in calves at weaning.

    Science.gov (United States)

    Fukumori, Rika; Mita, Takako; Sugino, Toshihisa; Hasegawa, Yoshihisa; Kojima, Masayasu; Kangawa, Kenji; Obitsu, Taketo; Taniguchi, Kohzo

    2013-04-01

    Ghrelin action, which stimulates growth hormone (GH) secretion, may alter during the weaning period in calves. Our objective was to compare the effects of intravenous ghrelin injection on plasma GH, insulin and glucose concentrations in calves around the weaning period. Four Holstein bull calves were fed whole milk and allowed free access to solid feeds, and weaned at 7 weeks of age. Measurements were performed at weeks 1, 2, 4, 6, 7, 9, 11 and 13, when calves were intravenously injected with ghrelin (1.0 μg/kg body weight (BW)) through a catheter, and jugular blood samples were obtained temporally relative to the injection time. Estimated digestible energy intake per metabolic BW transiently decreased at week 7 because of low solid intake immediately after weaning, and thereafter gradually increased. Plasma insulin and glucose concentrations were not affected by ghrelin injection at all ages. In contrast, plasma GH concentrations increased with ghrelin injection at all ages. The incremental area of GH at week 7 was greatest and significantly higher compared with weeks 2, 4, 6 and 9. This result suggests that nutrient insufficiency immediately after weaning enhances GH responsiveness to ghrelin.

  19. Young people with type 1 diabetes mellitus: Attitudes, perceptions, and experiences of diabetes management and continuous subcutaneous insulin infusion therapy.

    Science.gov (United States)

    Perry, Lin; James, Steven; Steinbeck, Katharine; Dunbabin, Janet; Lowe, Julia

    2017-06-01

    Continuous subcutaneous insulin infusion (CSII; insulin pump) use is increasing. However, there is little information about how this technology is used compared with other insulin delivery methods (ie, injections) by young people with type 1 diabetes mellitus in Australia. This study explored young people's attitudes, perceptions, and experiences with diabetes management comparing those using with those not using CSII, and proportions likely to transition to adult services requiring initiation and/or support for CSII use. A survey was undertaken of young people (aged 12 to 18 years) with type 1 diabetes mellitus and their parents/guardians living in Hunter New England, Australia, using a questionnaire designed to collect quantitative, descriptive, and demographic data. Most questions were based on previously developed and validated instruments. In total, 107 respondents returned partially or fully completed questionnaires. Respondents had positive attitudes and perceptions of their self-efficacy and diabetes management, but were moderately disturbed by their diabetes and reported experiencing suboptimal management outcomes. Patterns of associations were demonstrated between knowledge, attitudes, and experiences of diabetes modeled by regression analysis. There were no statistically significant differences in responses between users and nonusers of CSII. Over 40% indicated their intention to use the technology as adults. Opportunities for enhanced diabetes service support were clear, and CSII did not appear to be used to its full potential. Service redesign could enhance support for this young population using all preferred insulin delivery methods and should align to patients' goals and preferences to maximize service and patient gain. © 2017 John Wiley & Sons, Ltd.

  20. Modelling the Effect of Exercise on Insulin Pharmacokinetics in "Continuous Subcutaneous Insulin Infusion" Treated Type 1 Diabetes Patients

    DEFF Research Database (Denmark)

    Duun-Henriksen, Anne Katrine; Juhl, Rune; Schmidt, Signe

    transformation is used to ensure non-negative state values. A special focus is put on the structural identiflability of the base model, while the posterior identiflability is checked for all models from the conditional likelihood profiles. Results: The first model is disregarded due to the small number...... of observations during the exercise bout. From likelihood-ratio tests and information criteria, the third model is appointed as the best model to model the relationship between exercise and the insulin absorption. The posterior identiflability check showed that it was not possible to identify the variance...

  1. Kinetics and dose calculations of ampicillin and gentamicin given as continuous intravenous infusion during parenteral nutrition in 88 newborn infants

    DEFF Research Database (Denmark)

    Colding, H; Møller, S; Bentzon, M W

    1983-01-01

    Ampicillin and gentamicin were administered continuously intravenously to 88 newborn infants using individually calculated dosages. For infants with a mean value of plasma clearance of the antibiotics, it was calculated that the serum ampicillin and gentamicin concentrations would be between 35...

  2. Kinetics and dose calculations of ampicillin and gentamicin given as continuous intravenous infusion during parenteral nutrition in 88 newborn infants

    DEFF Research Database (Denmark)

    Colding, H; Møller, S; Bentzon, M W

    1983-01-01

    Ampicillin and gentamicin were administered continuously intravenously to 88 newborn infants using individually calculated dosages. For infants with a mean value of plasma clearance of the antibiotics, it was calculated that the serum ampicillin and gentamicin concentrations would be between 35-5...

  3. Pharmacokinetics, Safety, and Tolerability of Amygdalin and Paeoniflorin After Single and Multiple Intravenous Infusions of Huoxue-Tongluo Lyophilized Powder for Injection in Healthy Chinese Volunteers.

    Science.gov (United States)

    Li, Xiaobing; Shi, Fuguo; Zhang, Run; Sun, Chenglong; Gong, Chuting; Jian, Lingyan; Ding, Li

    2016-02-01

    Huoxue-Tongluo lyophilized powder for injection (HTLPI), a traditional Chinese medicine preparation, is a compound of Persicae semen and Paeoniae Radix Rubra that is used mainly for treating blood-stasis obstruction syndrome in the acute stage of cerebral ischemic stroke. Amygdalin (AD) and paeoniflorin (PF) are 2 typical bioactive components in HTLPI and were selected as indicators for this pharmacokinetic study of HTLPI. The objective of this study was to investigate the safety profile, tolerability, and pharmacokinetic properties of AD and PF after single and multiple intravenous infusions of HTLPI in healthy Chinese volunteers. Twenty-one healthy Chinese subjects were recruited for this open-label, single ascending-dose (3, 6, and 9 g) and multiple-dose (6 g, once daily) study. Safety profile was assessed by adverse events and physical examination throughout the study. Serial plasma and urine samples were analyzed by HPLC-MS/MS. Pharmacokinetic parameters of AD and PF were calculated using noncompartmental analysis. In the single-dose phase of the study, the mean maximum plasma concentration and the mean area under the plasma concentration-time curve of AD and PF increased proportionally with each dose escalation. In the multiple-dose phase, the steady state was achieved by day 4 after multiple-dose administration of 6 g HTLPI. Mean pharmacokinetic parameters achieved on day 1 were similar to those on day 7. No significant accumulation was observed after repeat doses of 6 g HTLPI. Approximately 79.6% of the administered AD and 48.4% of the administered PF were excreted unchanged in urine within 24 hours. No serious adverse events were observed during the entire study. The pharmacokinetic properties of AD and PF were linear after a single intravenous infusion of HTLPI in the dose range of 3-9 g. No systemic accumulation was observed with repeat doses of HTLPI. Sex had no significant effect on the pharmacokinetic properties of AD and PF. Intravenous infusion of

  4. Continuous Subcutaneous Insulin Infusion (CSII) Pumps for Type 1 and Type 2 Adult Diabetic Populations: An Evidence-Based Analysis.

    Science.gov (United States)

    2009-01-01

    In June 2008, the Medical Advisory Secretariat began work on the Diabetes Strategy Evidence Project, an evidence-based review of the literature surrounding strategies for successful management and treatment of diabetes. This project came about when the Health System Strategy Division at the Ministry of Health and Long-Term Care subsequently asked the secretariat to provide an evidentiary platform for the Ministry's newly released Diabetes Strategy.After an initial review of the strategy and consultation with experts, the secretariat identified five key areas in which evidence was needed. Evidence-based analyses have been prepared for each of these five areas: insulin pumps, behavioural interventions, bariatric surgery, home telemonitoring, and community based care. For each area, an economic analysis was completed where appropriate and is described in a separate report.To review these titles within the Diabetes Strategy Evidence series, please visit the Medical Advisory Secretariat Web site, http://www.health.gov.on.ca/english/providers/program/mas/mas_about.html,DIABETES STRATEGY EVIDENCE PLATFORM: Summary of Evidence-Based AnalysesContinuous Subcutaneous Insulin Infusion Pumps for Type 1 and Type 2 Adult Diabetics: An Evidence-Based AnalysisBehavioural Interventions for Type 2 Diabetes: An Evidence-Based AnalysisBARIATRIC SURGERY FOR PEOPLE WITH DIABETES AND MORBID OBESITY: An Evidence-Based SummaryCommunity-Based Care for the Management of Type 2 Diabetes: An Evidence-Based AnalysisHome Telemonitoring for Type 2 Diabetes: An Evidence-Based AnalysisApplication of the Ontario Diabetes Economic Model (ODEM) to Determine the Cost-effectiveness and Budget Impact of Selected Type 2 Diabetes Interventions in Ontario The objective of this analysis is to review the efficacy of continuous subcutaneous insulin infusion (CSII) pumps as compared to multiple daily injections (MDI) for the type 1 and type 2 adult diabetics. Insulin therapy is an integral component of the

  5. A cross-sectional international survey of continuous subcutaneous insulin infusion in 377 children and adolescents with type 1 diabetes mellitus from 10 countries

    NARCIS (Netherlands)

    Danne, T; Battelino, T; Kordonouri, O; Hanas, R; Klinkert, C; Ludvigsson, J; Barrio, R; Aebi, C; Gschwend, S; Mullis, PE; Schumacher, U; Zumsteg, U; Morandi, A; Rabbone, [No Value; Cherubini, [No Value; Toni, S; de Beaufort, C; Hindmarsh, P; Sumner, A; van Waarde, WM; van den Berg, N; Phillip, M

    2005-01-01

    Objective: To document current practices using continuous subcutaneous insulin infusion (CSII) by downloading electronically the 90-d pump data held within the pump memory and relating that to clinical data from children and adolescents in different pediatric diabetes centers from Europe and Israel.

  6. Effects of sitagliptin and metformin treatment on incretin hormone and insulin secretory responses to oral and "isoglycemic" intravenous glucose

    DEFF Research Database (Denmark)

    Vardarli, Irfan; Arndt, Elisabeth; Deacon, Carolyn F;

    2014-01-01

    Dipeptidyl peptidase-4 (DPP-4) inhibitors prevent degradation of incretin hormones (glucagon-like peptide 1 [GLP-1] and glucose-dependent insulinotropic polypeptide [GIP]), whereas metformin may increase GLP-1 levels. We examined, in a four-period crossover trial, the influence of metformin (2......,000 mg/day), sitagliptin (100 mg/day), or their combination, on GLP-1 responses and on the incretin effect in 20 patients with type 2 diabetes, comparing an oral glucose challenge (75 g, day 5) and an "isoglycemic" intravenous glucose infusion (day 6). Fasting total GLP-1 was significantly increased...... by metformin and not changed by sitagliptin. After oral glucose, metformin increased and sitagliptin significantly decreased (by 53%) total GLP-1. Fasting and postload intact GLP-1 increased with sitagliptin but not with metformin. After oral glucose, only sitagliptin, but not metformin, significantly...

  7. Effect of glucose-insulin-potassium infusion on mortality in critical care settings: a systematic review and meta-analysis.

    Science.gov (United States)

    Puskarich, Michael A; Runyon, Michael S; Trzeciak, Stephen; Kline, Jeffrey A; Jones, Alan E

    2009-07-01

    This study seeks to measure the treatment effect of glucose-insulin-potassium (GIK) infusion on mortality in critically ill patients. A systematic review of randomized controlled trials is conducted, comparing GIK treatment with standard care or placebo in critically ill adult patients. The primary outcome variable is mortality. Two authors independently extract data and assess study quality. The primary analysis is based on the random effects model to produce pooled odds ratios (ORs) with 95% confidence intervals (CIs). The search yields 1720 potential publications; 23 studies are included in the final analysis, providing a sample of 22,525 patients. The combined results demonstrate no heterogeneity (P=.57, I2=0%) and no effect on mortality (OR=1.02; 95% CI, 0.93-1.11) with GIK treatment. No experimental studies of shock or sepsis populations are identified. This meta-analysis finds that there is no mortality benefit to GIK infusion in critically ill patients; however, study populations are limited to acute myocardial infarction and cardiovascular surgery patients. No studies are identified using GIK in patients with septic shock or other forms of circulatory shock, providing an absence of evidence regarding the effect of GIK as a therapy in patients with shock.

  8. Designing the modern pump: engineering aspects of continuous subcutaneous insulin infusion software.

    Science.gov (United States)

    Welsh, John B; Vargas, Steven; Williams, Gary; Moberg, Sheldon

    2010-06-01

    Insulin delivery systems attracted the efforts of biological, mechanical, electrical, and software engineers well before they were commercially viable. The introduction of the first commercial insulin pump in 1983 represents an enduring milestone in the history of diabetes management. Since then, pumps have become much more than motorized syringes and have assumed a central role in diabetes management by housing data on insulin delivery and glucose readings, assisting in bolus estimation, and interfacing smoothly with humans and compatible devices. Ensuring the integrity of the embedded software that controls these devices is critical to patient safety and regulatory compliance. As pumps and related devices evolve, software engineers will face challenges and opportunities in designing pumps that are safe, reliable, and feature-rich. The pumps and related systems must also satisfy end users, healthcare providers, and regulatory authorities. In particular, pumps that are combined with glucose sensors and appropriate algorithms will provide the basis for increasingly safe and precise automated insulin delivery-essential steps to developing a fully closed-loop system.

  9. Effect of continuous subcutaneous insulin infusion on kidney function and size in IDDM patients

    DEFF Research Database (Denmark)

    Christensen, Cramer; Christiansen, J S; Schmitz, A;

    1987-01-01

    Glomerular filtration rate (GFR), renal plasma flow (RPF), kidney volume, and urinary albumin excretion rate were measured in 24 insulin-dependent diabetics, aged 29 +/- 7 years (mean +/- SD) with diabetes duration of 8 +/- 4 years who were randomly allocated to either continuous subcutaneous ins...

  10. The Effect of Intravenous Magnesium Sulfate Infusion on Sensory Spinal Block and Postoperative Pain Score in Abdominal Hysterectomy

    Directory of Open Access Journals (Sweden)

    Fatih Kahraman

    2014-01-01

    Full Text Available Aim. The aim of this study was to investigate the effect of i.v. infusion of magnesium sulphate during spinal anesthesia on duration of spinal block and postoperative pain. Methods. Forty ASA physical status I and status II, aged between 18 and 65, female patients undergoing abdominal hysterectomy under spinal anesthesia were enrolled in this study. Patients in the magnesium group (Group M, n = 20 received magnesium sulphate 65 mg kg−1 infusion in 250 mL 5% dextrose at 3.5 mL/min rate, and control group (Group C, n = 20 received at the same volume of saline during operation in a double-blind randomized manner. Duration of sensory and motor block, systolic, diastolic, and mean arterial blood pressures, heart rates, pain scores (VAS values, and side effects were recorded for each patient. Blood and CSF samples were taken for analysis of magnesium concentrations. Results. Regression of sensorial block was longer in Group M when compared with that in Group C (175 ± 39 versus 136 ± 32 min (P < 0.01. The VAS scores were lower in Group M than those in Group C at the 2 time points postoperatively (P < 0.01. Conclusion. 65 mg kg−1 of magnesium sulphate i.v. infusion under spinal anesthesia prolongs spinal sensorial block duration and decreases pain VAS scores without complication in patients undergoing abdominal hysterectomy.

  11. A web-based study of the relationship of duration of insulin pump infusion set use and fasting blood glucose level in adults with type 1 diabetes.

    Science.gov (United States)

    Sampson Perrin, Alysa J; Guzzetta, Russell C; Miller, Kellee M; Foster, Nicole C; Lee, Anna; Lee, Joyce M; Block, Jennifer M; Beck, Roy W

    2015-05-01

    To evaluate the impact of infusion set use duration on glycemic control, we conducted an Internet-based study using the T1D Exchange's online patient community, Glu ( myGlu.org ). For 14 days, 243 electronically consented adults with type 1 diabetes (T1D) entered online that day's fasting blood glucose (FBG) level, the prior day's total daily insulin (TDI) dose, and whether the infusion set was changed. Mean duration of infusion set use was 3.0 days. Mean FBG level was higher with each successive day of infusion set use, increasing from 126 mg/dL on Day 1 to 133 mg/dL on Day 3 to 147 mg/dL on Day 5 (P<0.001). TDI dose did not vary with increased duration of infusion set use. Internet-based data collection was used to rapidly conduct the study at low cost. The results indicate that FBG levels increase with each additional day of insulin pump infusion set use.

  12. 基层医院开展静脉输液化疗护理体会%Nursing Experience of Intravenous Infusion Chemotherapy Nursing in Basic Hospital

    Institute of Scientific and Technical Information of China (English)

    覃丽艳; 黄萍

    2015-01-01

    化疗是恶性肿瘤综合治疗中重要手段之一。本文根据近年来在我院开展静脉输液化疗工作实践,总结如何规避化疗过程中的安全隐患,树立患者治疗信念和依从性,在护理工作方面的经验体会。%Chemotherapy is one of the important means of comprehensive treatment of malignant tumor. In this paper, according to the recent development of intravenous infusion chemotherapy in our hospital work practice, summarized how to avoid the potential safety hazard during chemotherapy, set up the treatment of patients with faith and compliance, experience in the nursing work experience.

  13. Intravenous infusion of H2-saline suppresses oxidative stress and elevates antioxidant potential in Thoroughbred horses after racing exercise.

    Science.gov (United States)

    Yamazaki, Masahiko; Kusano, Kanichi; Ishibashi, Toru; Kiuchi, Masataka; Koyama, Katsuhiro

    2015-10-23

    Upon intensive, exhaustive exercise, exercise-induced reactive oxygen species may exceed the antioxidant defence threshold, consequently resulting in muscular damage or late-onset chronic inflammation. Recently, the therapeutic antioxidant and anti-inflammatory effects of molecular hydrogen (H2) for human rheumatoid arthritis have been demonstrated. However, it is also important to clarify the effects of administrating H2 in large animals other than humans, as H2 is thought to reach the target organ by passive diffusion upon delivery from the blood flow, indicating that the distance from the administration point to the target is critical. However, data on the effects of H2 on oxidative stress in real-life exhaustive exercise in large animals are currently lacking. We here investigated 13 Thoroughbred horses administered intravenous 2-L saline with or without 0.6-ppm H2 (placebo, N = 6; H2, N = 7) before participating in a high-intensity simulation race. Intravenous H2-saline significantly suppressed oxidative stress immediately, 3 h, and 24 h after the race, although the antioxidant capability was not affected throughout the study. The serum creatine kinase, lactate, and uric acid levels were increased in both groups. Taken together, these results indicate that intravenous H2-saline can significantly and specifically suppress oxidative stress induced after exhaustive racing in Thoroughbred horses.

  14. Normal neurologic and developmental outcome after an accidental intravenous infusion of expressed breast milk in a neonate.

    LENUS (Irish Health Repository)

    Ryan, C Anthony

    2012-02-03

    Here we describe a premature male infant who was accidentally given 10 mL of expressed breast milk intravenously over a 3.5-hour period. Having survived this event with supportive care, this boy was attending regular school with no obvious neurologic or learning difficulties at 6 years of age. In 1998, after a query on an e-mail discussion group for health care providers in neonatology (NICU-net), we were informed of 8 similar events that proved fatal in 3 infants. A root-cause analysis revealed that accidental intravenous administration of breast milk or formula can be avoided by the use of color-coded enteral-administration sets with Luer connections that are not compatible with intravenous cannulas. The addition of methylene blue to feeds, or bolus enteral feeds (instead of continuous gastric feedings), may also help prevent such errors. These cases show the value of gathering information about rare but important events through a neonatal network. In addition, they confirm that prevention of medical error should focus on faulty systems rather than faulty people.

  15. Role of the intravenous infusion team in management of infusion∥Li Lijuan, Yang%静脉输液专职护理团队在输液管理中的作用

    Institute of Scientific and Technical Information of China (English)

    李丽娟; 杨毅华; 赖文娟; 黄小红; 陶艳玲

    2013-01-01

    Objective To investigate the role of the intravenous infusion team in management of infusion and to provide emprirical evidence for infusion management. Methods An intravenous infusion team was established and served 36 800 intravenous infusion patients. The team analyzed factors which influenced the success rate of first puncture and factors contributing to patient satisfaction; the team received intensified training; an incentive system was set up for the team. Before the team was built, another 36 800 patient received routine intravenous infusion service. Results The success rates of first puncture, time to complete puncture procedure, patient waiting time and satisfaction before and after the establishment of intravenous infusion team had significant difference (P<0. 01 for all). Conclusion Establishment of an intravenous infusion team, design of scientific workflow and rational shift arrangement, conspire to improve the quality of infusion management and patient satisfaction.%目的 探讨建立静脉输液专职护理团队在输液管理中的作用,为输液管理提供实证依据.方法 对在输液室接受治疗的73 600 例患者,分别采用传统静脉输液管理(实施前36 800例),以及采取建立静脉输液专职护理团队的方法进行管理(实施后36 800例),其包括分析影响静脉穿刺成功率与满意度的因素、强化培训、建立激励机制等措施.结果 实施前后一次穿刺成功率、静脉穿刺时间、患者排队等候时间、输液满意度等比较,差异有统计学意义(均P<0.01).结论 结合医院情况建立静脉输液专职护理团队,设计科学的工作流程与合理排班是提升输液管理质量与护理服务满意度的有效途径.

  16. 正常速度输注万古霉素致红人综合征1例分析%Analysis of 1 Case of Red Man Syndrome after Intravenous Infusion of Vancomycin with Normal Velocity

    Institute of Scientific and Technical Information of China (English)

    叶红; 齐晓涟; 宿英英

    2011-01-01

    目的:提示临床重视正常速度输注万古霉素所致的不良反应.方法:报道我院1例正常速度输注万古霉素致红人综合征(RMS)的病例,并进行综合分析.结果与结论:国内未见有正常速度输注万古霉素致RMS的病例.临床应重视并减免正常速度输注万古霉素所致的RMS.预防RMS的措施主要是控制输注速度,必要时可预防性用药;RMS发生后,首先减慢或停止万古霉素输注,给予补液等对症支持治疗.%OBJECTIVE: To prompt clinical staff to pay attention to adverse drug reactions induced by intravenous infusion of vancomycin with normal velocity. METHODS: 1 case of red man syndrome (RMS) induced by intravenous infusion of vancomy-cin with normal velocity was reported in our hospital, and analyzed comprehensively. RESULTS & CONCLUSIONS: There was no case of RMS induced by intravenous infusion of vancomycin with normal velocity in China. Great importance should be attached to RMS induced by intravenous infusion of vancomycin with normal velocit. Main preventive measure is to control the infusion rate, if necessary, preventive medicine should be adopted; After RMS occurs, we firstly should slow down or stop the vancomycin infusion, then given supportive treatment, such as fluid infusion.

  17. Experiences of continuous subcutaneous insulin infusion in pregnant women with type 1 diabetes during delivery from four Italian centers: a retrospective observational study.

    Science.gov (United States)

    Fresa, Raffaella; Visalli, Natalia; Di Blasi, Vincenzo; Cavallaro, Vincenzo; Ansaldi, Egle; Trifoglio, Oria; Abbruzzese, Santina; Bongiovanni, Marzia; Agrusta, Mariano; Napoli, Angela

    2013-04-01

    An optimized metabolic control during delivery is mandatory to prevent maternal-neonatal complications. The primary aim of this study was to evaluate the efficacy and safety of continuous subcutaneous insulin infusion (CSII) during delivery in pregnant women with type 1 diabetes. The secondary aim was to assess the impact of real-time continuous glucose monitoring (RT-CGM) added to CSII versus CSII alone. This was a multicenter observational retrospective study. A standardized protocol, to use CSII throughout pregnancy and delivery, foresaw three different insulin basal rates according to blood glucose level: profile A, the last basal rate in use; profile B, preventive 50% reduction of the last basal rate in use; and profile C, 0.1-0.2 U/h for blood glucose level <70 mg/dL, activated just before anesthesia or at the beginning of active labor. An alternative intravenous protocol (IVP) was given in case of complications and relevant metabolic deterioration. Blood glucose in the target range (70-140 mg/dL) throughout delivery and percentage of activation of the IVP were primary outcomes. Sixty-five pregnant women with diabetes included in the study (56-86% cesarean section; 9-14% spontaneous/stimulated vaginal delivery). Mean blood glucose level was 102 ± 31 mg/dL at 0 min, 109 ± 42 mg/dL at 30 min, 120 ± 48 mg/dL at 60 min, and 99 ± 34 mg/dL at 24 h. Mean basal rate during delivery was 0.6 ± 0.4 U/h (profile B). Mean capillary blood glucose (CBG) level was lower in the RT-CGM group relative to the CSII-alone group: 80 ± 14 mg/dL versus 111 ± 32 mg/dL at 0 min (P<0.01), 79 ± 11 mg/dL versus 109 ± 42 mg/dL at 30 min (P<0.02), and 98 ± 20 mg/dL versus 125 ± 51 mg/dL at 60 min (difference not significant). Eleven newborns experienced transient neonatal hypoglycemia. None of the women switched to IVP. No major differences were observed according to delivery procedure. CSII is possible and safe in different types of delivery in selected and educated women. RT

  18. Development of A New Class of Wearable Intravenous Infusion Fixture Device%新型佩戴式静脉输液固定装置的研制

    Institute of Scientific and Technical Information of China (English)

    周维娜; 顾燕萍; 严嘉伟

    2016-01-01

    This paper describes the development process of a new wearable intravenous infusion ifxture device. The device consists of a wearable device and an infusion stand structure. It is characterized by ingenuity indesigning, low cost, easy fabrication, and user-friendliness. It can solve problems of impaired mobility during the infusion and increase patient’s comfort level. The clinical application of the results showed that the device can effectively improve patient’s mobility level and reduce the patient's restlessness caused by prolonged bed rest. The device also decreased the working load of nursing and attending and is of good clinical signiifcance.%本文阐述了一款新型佩戴式静脉输液固定装置的研制过程。该装置主要由佩戴装置及输液架等结构组成,具有设计新颖、成本低廉、制作简单、使用方便等特点,解决了患者在输液过程中行动不便的问题,提高了患者的舒适度。临床应用结果表明,该装置可有效改善患者活动的便利性,进而缓解了患者的烦躁情绪,同时也减轻了部分看(陪)护需求,具有较好的临床价值。

  19. Opioid-free total intravenous anesthesia with propofol, dexmedetomidine and lidocaine infusions for laparoscopic cholecystectomy: a prospective, randomized, double-blinded study

    Directory of Open Access Journals (Sweden)

    Mefkur Bakan

    2015-06-01

    Full Text Available BACKGROUND AND OBJECTIVES: Intraoperative use of opioids may be associated with postoperative hyperalgesia and increased analgesic consumption. Side effects due to perioperative use of opioids, such as postoperative nausea and vomiting may delay discharge. We hypothesized that total intravenous anesthesia consisting of lidocaine and dexmedetomidine as an opioid substitute may be an alternative technique for laparoscopic cholecystectomy and would be associated with lower fentanyl requirements in the postoperative period and less incidence of postoperative nausea and vomiting. METHODS: 80 Anesthesiologists I-II adults were scheduled for elective laparoscopic cholecystectomy. Patients were randomly allocated into two groups to have either opioid-free anesthesia with dexmedetomidine, lidocaine, and propofol infusions (Group DL or opioid-based anesthesia with remifentanil, and propofol infusions (Group RF. All patients received a standard multimodal analgesia regimen. A patient controlled analgesia device was set to deliver IV fentanyl for 6 h after surgery. The primary outcome variable was postoperative fentanyl consumption. RESULTS: Fentanyl consumption at postoperative 2nd hour was statistically significantly less in Group DL, compared with Group RF, which were 75 ± 59 µg and 120 ± 94 µg respectively, while it was comparable at postoperative 6th hour. During anesthesia, there were more hypotensive events in Group RF, while there were more hypertensive events in Group DL, which were both statistically significant. Despite higher recovery times, Group DL had significantly lower pain scores, rescue analgesic and ondansetron need. CONCLUSION: Opioid-free anesthesia with dexmedetomidine, lidocaine and propofol infusions may be an alternative technique for laparoscopic cholecystectomy especially in patients with high risk for postoperative nausea and vomiting.

  20. Opioid-free total intravenous anesthesia with propofol, dexmedetomidine and lidocaine infusions for laparoscopic cholecystectomy: a prospective, randomized, double-blinded study.

    Science.gov (United States)

    Bakan, Mefkur; Umutoglu, Tarik; Topuz, Ufuk; Uysal, Harun; Bayram, Mehmet; Kadioglu, Huseyin; Salihoglu, Ziya

    2015-01-01

    Intraoperative use of opioids may be associated with postoperative hyperalgesia and increased analgesic consumption. Side effects due to perioperative use of opioids, such as postoperative nausea and vomiting may delay discharge. We hypothesized that total intravenous anesthesia consisting of lidocaine and dexmedetomidine as an opioid substitute may be an alternative technique for laparoscopic cholecystectomy and would be associated with lower fentanyl requirements in the postoperative period and less incidence of postoperative nausea and vomiting. 80 Anesthesiologists I-II adults were scheduled for elective laparoscopic cholecystectomy. Patients were randomly allocated into two groups to have either opioid-free anesthesia with dexmedetomidine, lidocaine, and propofol infusions (Group DL) or opioid-based anesthesia with remifentanil, and propofol infusions (Group RF). All patients received a standard multimodal analgesia regimen. A patient controlled analgesia device was set to deliver IV fentanyl for 6h after surgery. The primary outcome variable was postoperative fentanyl consumption. Fentanyl consumption at postoperative 2nd hour was statistically significantly less in Group DL, compared with Group RF, which were 75 ± 59 μg and 120 ± 94 μg respectively, while it was comparable at postoperative 6th hour. During anesthesia, there were more hypotensive events in Group RF, while there were more hypertensive events in Group DL, which were both statistically significant. Despite higher recovery times, Group DL had significantly lower pain scores, rescue analgesic and ondansetron need. Opioid-free anesthesia with dexmedetomidine, lidocaine and propofol infusions may be an alternative technique for laparoscopic cholecystectomy especially in patients with high risk for postoperative nausea and vomiting. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  1. [Opioid-free total intravenous anesthesia with propofol, dexmedetomidine and lidocaine infusions for laparoscopic cholecystectomy: a prospective, randomized, double-blinded study].

    Science.gov (United States)

    Bakan, Mefkur; Umutoglu, Tarik; Topuz, Ufuk; Uysal, Harun; Bayram, Mehmet; Kadioglu, Huseyin; Salihoglu, Ziya

    2015-01-01

    Intraoperative use of opioids may be associated with postoperative hyperalgesia and increased analgesic consumption. Side effects due to perioperative use of opioids, such as postoperative nausea and vomiting may delay discharge. We hypothesized that total intravenous anesthesia consisting of lidocaine and dexmedetomidine as an opioid substitute may be an alternative technique for laparoscopic cholecystectomy and would be associated with lower fentanyl requirements in the postoperative period and less incidence of postoperative nausea and vomiting. 80 Anesthesiologists I-II adults were scheduled for elective laparoscopic cholecystectomy. Patients were randomly allocated into two groups to have either opioid-free anesthesia with dexmedetomidine, lidocaine, and propofol infusions (Group DL) or opioid-based anesthesia with remifentanil, and propofol infusions (Group RF). All patients received a standard multimodal analgesia regimen. A patient controlled analgesia device was set to deliver IV fentanyl for 6h after surgery. The primary outcome variable was postoperative fentanyl consumption. Fentanyl consumption at postoperative 2nd hour was statistically significantly less in Group DL, compared with Group RF, which were 75±59μg and 120±94μg respectively, while it was comparable at postoperative 6th hour. During anesthesia, there were more hypotensive events in Group RF, while there were more hypertensive events in Group DL, which were both statistically significant. Despite higher recovery times, Group DL had significantly lower pain scores, rescue analgesic and ondansetron need. Opioid-free anesthesia with dexmedetomidine, lidocaine and propofol infusions may be an alternative technique for laparoscopic cholecystectomy especially in patients with high risk for postoperative nausea and vomiting. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  2. Oligodeoxynucleotide CpG 7909 delivered as intravenous infusion demonstrates immunologic modulation in patients with previously treated non-Hodgkin lymphoma.

    Science.gov (United States)

    Link, Brian K; Ballas, Zuhair K; Weisdorf, Daniel; Wooldridge, James E; Bossler, Aaron D; Shannon, Mary; Rasmussen, Wendy L; Krieg, Arthur M; Weiner, George J

    2006-01-01

    Oligodeoxynucleotides containing CpG motifs (CpG ODN) can alter various immune cell subsets important in antibody therapy of malignancy. We undertook a phase I trial of CPG 7909 (also known as PF-3512676) in patients with previously treated lymphoma with the primary objective of evaluating safety across a range of doses, and secondary objectives of evaluating immunomodulatory effects and clinical effects. Twenty-three patients with previously treated non-Hodgkin lymphoma received up to 3 weekly 2-hour intravenous (IV) infusions of CPG ODN 7909 at dose levels 0.01 to 0.64 mg/kg. Evaluation of immunologic parameters and clinical endpoints occurred for 6 weeks. Infusion-related toxicity included grade 1 nausea, hypotension, and IV catheter discomfort. Serious adverse hematologic events observed more than once included anemia (2=Gr3, 2=Gr4), thrombocytopenia (4=Gr3), and neutropenia (2=Gr3), and were largely judged owing to progressive disease. Immunologic observations included: (1) The mean ratio of NK-cell concentrations compared with pretreatment at day 2 was 1.44 (95% CI=0.94-1.94) and at day 42 was 1.53 (95% CI=1.14-1.91); (2) NK activity generally increased in subjects; and (3) Antibody-dependent cellular cytotoxicity activity increased in select cohorts. No clinical responses were documented radiographically at day 42. Two subjects demonstrated late response. We conclude CpG 7909 can be safely given as a 2-hour IV infusion to patients with previously treated non-Hodgkin lymphoma at doses that have immunomodulatory effects.

  3. Efeitos da infusão contínua de propofol ou etomidato sobre variáveis intracranianas em cães Effects of propofol or etomidate intravenous infusion on intracranial variables in dogs

    Directory of Open Access Journals (Sweden)

    D.P. Paula

    2010-04-01

    Full Text Available Avaliaram-se os efeitos da infusão contínua de propofol ou de etomidato sobre as variáveis intracranianas em cães nomocapneicos. Foram utilizados 20 cães adultos distribuídos aleatoriamente em dois grupos: grupo propofol (GP e grupo etomidato (GE. Para o GP, os animais foram induzidos à anestesia com propofol (10mg/kg e, ato contínuo, iniciaram-se a infusão do fármaco (0,6mg/kg/min e a ventilação controlada. No GE, o etomidato foi usado para indução (5mg/kg e manutenção empregando-se a dose de 0,5mg/kg/min nos 10 minutos iniciais e, em seguida, de 0,2mg/kg/min. Após 30 minutos da implantação do cateter de fibra óptica do monitor de pressão intracraniana (PIC na superfície do córtex cerebral direito, realizaram-se as primeiras mensurações (M1 da PIC, da pressão de perfusão cerebral (PPC, da temperatura intracraniana (TIC, de temperatura corpórea (TC, da pressão arterial média (PAM e da frequência cardíaca (FC. As demais mensurações ocorreram em intervalos de 20 minutos (M2, M3 e M4. O propofol e o etomidato não ocasionaram alterações significativas nas variáveis estudadas com exceção da TC e TIC. Concluiu-se que a infusão contínua desses fármacos em cães mantém a perfusão cerebral e a autorregulação cerebral. Cães anestesiados com etomidato apresentam efeitos adversos intensos e redução gradativa da temperatura corpórea e intracraniana.The effects of total intravenous infusion of propofol or etomidate on intracranial variables in normocapneic dogs were evaluated. Twenty adult mongrel dogs were randomly allotted to: propofol group (GP or etomidate group (GE. In GP animals, the propofol was used for induction (10mg/kg, followed by immediate continuous infusion of the drug (0.6mg/kg/min and controlled ventilation. In GE dogs, the etomidate was used for induction (5mg/kg, followed by a continuous rate infusion (CRI at 0.5mg/kg/min during the first ten minutes and, right after, it was changed to 0

  4. Dual effect of insulin on plasma volume and transcapillary albumin transport

    DEFF Research Database (Denmark)

    Hilsted, J; Christensen, N J

    1992-01-01

    During the past decade it has been demonstrated that insulin, apart from its effects on metabolism and ion fluxes, has acute effects on the cardiovascular system and capillary permeability. Intravenous infusion of insulin in doses which increase plasma insulin to physiological levels, induced vas...... in a normal transfer of macromolecules from the blood to the extracellular space after food intake. This process may be greatly disturbed in insulin-dependent diabetic patients....

  5. THE FEATURES OF BYOCINETICS OF PLUTONIUM AND OTHERS HEPATO-OSTEOTROPIC RADIONUCLIDES AFTER INTRAVENOUS INFUSION OF SODIUM ETYLENDYAMINTETRAACETAT

    Directory of Open Access Journals (Sweden)

    V. S. Repin

    2013-01-01

    Full Text Available In experimental work with experimental animals it is shown that creation of artificial deficiency of calcium in the blood of rats at the 2-hours infusion of sodium salt EDTA stimulates activation of resorption processes in a skeleton and promotes increase an urine temp excretion of plutonium-239, americium-241 and ittrium-91 whereas the temp of calcium-45 excretion with urine decreases and becomes below the level which was before EDTA intake. Activation of resorption processes begins after12 hours from the moment of EDTA intake and proceeds within 3 days and more. The effect can find practical application in the estimation of radionuclides content in a skeleton by method of indirect dosimetry using the value of excretion with urine velocity.

  6. Comparison of the analgesic effects of intravenous magnesium sulfate infusion versus intrathecal fentanyl in patients with severe pre-eclampsia undergoing caesarean section

    Directory of Open Access Journals (Sweden)

    Ahmed Said Elgebaly

    2011-01-01

    Full Text Available Background : A double-blinded, prospective, randomized, controlled study was designed to determine the analgesic efficacy and tolerability of intravenous magnesium sulfate versus intrathecal fentanyl, in patients with severe pre-eclampsia, scheduled for caesarean section, under spinal anaesthesia. Materials and Methods : One hundred and five patients were randomly allocated to one of the three groups; the control group B received spinal anaesthesia with 10 mg of 0.5% heavy bupivacaine, the test group FB received spinal anaesthesia with 10 mg of 0.5% heavy bupivacaine plus 25 ΅g of preservative-free fentanyl and the test group MB received spinal anaesthesia with 10 mg of 0.5% heavy bupivacaine along with intravenous magnesium sulfate (6 gm iv as a loading dose over 20-30 minutes, followed by infusion of magnesium sulfate 2 gm per hour for 24 hours. Results : The time required for the first postoperative analgesic requirement was significantly more in groups FB and MB, as compared to the control group. (Group FB: 6.85 + 1.7 hours, group MB: 7.05 + 1.95 hours and Group B: 3.75 + 0.75 hours. This difference, however, was not significant between group FB and group MB. The frequency of postoperative analgesic requirement was significantly less in the FB and MB groups, as compared to the control group. (Control group: 3.9 + 0.5, group FB 2.3 + 0.25 and group MB: 2.5 + 0.4. Perioperative sedation was significantly higher in group FB as compared to group B and group MB. Nine patients in group FB had postoperative nausea and vomiting, whereas, none of the patients in the control group or group MB experienced this. This difference too was statistically significant. Conclusion : Intravenous magnesium sulfate and intrathecal fentanyl in the doses mentioned, increased the duration of postoperative analgesia in severely pre-eclamptic patients undergoing caesarean section under spinal anaesthesia; however, patients who received intravenous magnesium sulfate

  7. 探讨患儿监护人参与查对在儿科静脉输液中的应用%Application of Child’s Guardian Infusion Checklist in Pediatric Intravenous Infusion Therapy

    Institute of Scientific and Technical Information of China (English)

    张英; 荣德明; 谢功群

    2014-01-01

    Objective To investigate the effective management method of pediatric transfusion safety. Methods 5086 patients undergoing intravenous treatment of children were used as a test group, use the method of Child’s guardian in transfusion verification of single sign on. A control group of 4800 cases by routine check, only performed by nurses in fluids infusion executing single sign on. Comparison of two groups of parents satisfaction, nursing defects, nursing complaint occurred, and were analyzed by test. Results The test group parents satisfaction, nursing defects, nursing complaints was significantly better than the control group(P<0. 01). Conclusion In pediatric intravenous infusion in the treatment of child’s guardian in transfusion verification im-plementation of single sign on, the family satisfaction is got rised, defect of nursing, nursing complaints are significantly reduced.%目的:探讨确保小儿输液安全的有效管理方法。方法将5086例接受静脉输液治疗的患儿作为试验组,采用常规查对基础上患儿监护人在输液核查单上签字方法。对照组4800例患儿采用常规查对,仅由执行护士在输液执行单上签字方法。比较两组患儿家长满意度,护理缺陷、护理投诉的发生情况,并进行检验。结果试验组患儿家长满意度、护理缺陷及护理投诉发生情况明显优于对照组,差异有统计学意义( P<0.05)。结论儿科静脉输液治疗中实施患儿监护人在输液核查单上签字,患儿家属满意度提高,因输液导致的护理缺陷、护理投诉明显减少。

  8. Intravenous infusion of ketamine-propofol can be an alternative to intravenous infusion of fentanyl-propofol for deep sedation and analgesia in paediatric patients undergoing emergency short surgical procedures

    Directory of Open Access Journals (Sweden)

    Samit Kumar Khutia

    2012-01-01

    Full Text Available Background: Paediatric patients often present with different painful conditions that require immediate surgical interventions. Despite a plethora of articles on the ketamine-propofol combination, comprehensive evidence regarding the suitable sedoanalgesia regime is lacking due to heterogeneity in study designs. Methods: This prospective, randomized, double-blind, active-controlled trial was conducted in 100 children, of age 3-14 years, American Society of Anesthesiologist physical status IE-IIE, posted for emergency short surgical procedures. Patients were randomly allocated to receive either 2 mL of normal saline (pre-induction plus calculated volume of drug from the 11 mL of ketamine-propofol solution for induction (group PK, n=50 or fentanyl 1.5 μg/kg diluted to 2 mL with normal saline (pre-induction plus calculated volume of drug from the 11 mL of propofol solution for induction (group PF, n=50. In both the groups, the initial bolus propofol 1 mg/kg i.v. (assuming the syringes contained only propofol, for simplicity was followed by adjusted infusion to achieve a Ramsay Sedation Scale score of six. Mean arterial pressure (MAP was the primary outcome measurement. Results: Data from 48 patients in group PK and 44 patients in group PF were available for analysis. Hypotension was found in seven patients (14.6% in group PK compared with 17 (38.6% patients in group PF (P=0.009. Intraoperative MAP was significantly lower in group PF than group PK when compared with baseline. Conclusion: The combination of low-dose ketamine and propofol is more effective and a safer sedoanalgesia regimen than the propofol-fentanyl combination in paediatric emergency short surgical procedures in terms of haemodynamic stability and lesser incidence of apnoea.

  9. [Current status of continuous subcutaneous insulin infusion and continuous glucose monitoring systems in the Community of Madrid].

    Science.gov (United States)

    Arranz Martín, Alfonso; Calle Pascual, Alfonso; Del Cañizo Gómez, Francisco Javier; González Albarrán, Olga; Lisbona Gil, Arturo; Botella Serrano, Marta; Pallardo Sánchez, Luis Felipe

    2015-04-01

    To analyze the available information about continuous subcutaneous insulin infusion (CSII) and continuous glucose monitoring (CGM) systems in the public health care system of the Community of Madrid. A survey consisting of 31 items was sent to the 28 endocrinology department of the Madrid public hospitals. Items focused on CSII and CGM and included patients' registrations, as well as data regarding healthcare, administrative, and logistic aspects. Responses from a total of 20 hospitals where these procedures are used were received from March 2013 to May 2014. Data about pediatric patients were obtained from adult endocrinology departments, except for two hospitals which directly reported the information. A total of 1256 CSII pumps were recorded in the Madrid region, of which 1089 were used by adults, and the remaining 167 by pediatric patients. During 2013, 151 new CSII systems were implanted (12% of the total), while 14 pumps were withdrawn. Availability of human resources (medical assistance) and the number of staff practitioners experienced in management of these systems widely varied between hospitals. Eighty-five percent of hospitals used retrospective CGM systems, and 40% routinely placed them before starting an insulin pump. Thirteen hospitals (65%) used long-term, real-time CGM systems in selected cases (a total of 67 patients). Use of these technologies in diabetes is unequal between public health care hospitals in Madrid, and is still significantly lower as compared to other countries with similar incomes. However, there appears to be a trend to an increase in their use. Copyright © 2014 SEEN. Published by Elsevier España, S.L.U. All rights reserved.

  10. ACUTE RENAL EFFECTS OF SOMATOSTATIN ANALOG, OCTREOTIDE, IN INSULIN-DEPENDENT DIABETIC-PATIENTS - ANTAGONISM BY LOW-DOSE GLUCAGON

    NARCIS (Netherlands)

    STEGEMAN, CA; DULLAART, RPF; MEIJER, S; MARBACH, P; SLUITER, WJ

    1993-01-01

    Thirty patients affected by insulin-dependent diabetes mellitus, without overt diabetic nephropathy, were randomly allocated to receive either octreotide (20 mug bolus followed by 10 mug.h-1) or vehicle intravenously over 2 hr. A similar infusion of octreotide with concomitant glucagon infusion (2 t

  11. Intravenous paracetamol infusion: Superior pain management and earlier discharge from hospital in patients undergoing palliative head-neck cancer surgery

    Directory of Open Access Journals (Sweden)

    Saikat Majumdar

    2014-01-01

    Full Text Available Background: Paracetamol; a cyclooxygenase inhibitor; acts through the central nervous system as well as serotoninergic system as a nonopioid analgesic. A prospective, double-blinded, and randomized-controlled study was carried out to compare the efficacy of preoperative 1g intravenous (iv paracetamol with placebo in providing postoperative analgesia in head-neck cancer surgery. Materials and Methods: From 2008 February to 2009 December, 80 patients for palliative head-neck cancer surgery were randomly divided into (F and (P Group receiving ivplacebo and iv paracetamol, respectively, 5 min before induction. Everybody received fentanyl before induction and IM diclofenac for pain relief at8 hourly for 24 h after surgery. Visual analogue scale (VAS and amount of fentanyl were measured for postoperative pain assessment (24 h. Results and Statistical analysis: The mean VAS score in 1 st , 2 nd postoperative hour, and fentanyl requirement was less and the need for rescue analgesic was delayed in ivparacetamol group which were all statistically significant. Paracetamol group had a shorter surgical intensive care unit (SICU and hospital stay which was also statistically significant. Conclusion: The study demonstrates the effectiveness of ivparacetamol as preemptive analgesic in the postoperative pain control after head-neck cancer surgery and earlier discharge from hospital.

  12. The effect of intravenous lidocaine infusion on postoperative pain management%静脉输注利多卡因在术后镇痛中的应用

    Institute of Scientific and Technical Information of China (English)

    孙艳霞; 李天佐

    2013-01-01

    背景 术后疼痛依然是麻醉医师所面临的挑战之一.作为术后镇痛的一线药物,阿片类药物常伴有一些副作用也会影响患者术后的恢复.任何可以减少阿片类药物的用量,并增强术后镇痛效果的多模式术后镇痛方案均推荐用于术后镇痛.研究发现静脉输注利多卡因可以增强术后镇痛效果,降低术后阿片类药物的用量,促进术后胃肠功能的恢复. 目的 现就静脉输注利多卡因对术后镇痛的影响作一综述. 内容 从镇痛机制、药代动力学特点、给药策略以及对不同手术术后镇痛效果的影响等方面分别进行探讨. 趋向 静脉输注利多卡因可以增强腹部术后镇痛效果,减少阿片类药物的用量,但其对其他手术术后镇痛效果的影响及最佳镇痛方案函待进一步研究.%Background Postoperative pain remains one of the challenges faced by anesthesiologists.However,as the mainstay for postoperative pain control,opioid analgesics are associated with undesirable side effects which can lead to delayed postoperative recovery.Multimodal approaches and adjunct therapies are therefore recommended to postoperative pain management by reducing opioid consumption and opioid-related side effects.Studies have shown that perioperative intravenous lidocaine infusion is a useful adjunct for postoperative pain management.It could provide significant pain relief,reduce opioid consumption and promote postoperative recovery of gastrointestinal function.Objective The aim of this review was to discuss analgesic effects of intravenous lidocaine on postoperative pain management.Content The issue was discussed through the following aspects:analgesic mechanism,pharmacokinetics,infusion strategy and clinical effects.Trend Intravenous lidocaine may be a useful adjunct for postoperative pain management,and enhance pain relief after abdominal surgery,reduce the amount of opiates.But its analgesic effect on other surgeries and the

  13. Responses of plasma glucose metabolism to exogenous insulin infusion in sheep-fed forage herb plantain and exposed to heat.

    Science.gov (United States)

    Al-Mamun, M; Shibuya, K; Kajita, M; Tamura, Y; Sano, H

    2017-01-16

    The use of herbal plants as traditional medicines has a century long history. Plantain (Plantago lanceolata L.) is a perennial herb containing bioactive components with free radical scavenging activities. An isotope dilution technique using [U-13C]glucose was conducted to determine the effect of plantain on the responses of plasma glucose metabolism to exogenous insulin infusion in sheep. Six crossbred sheep (three wethers and three ewes; mean initial BW=40±2 kg) were fed either a mixed hay of orchardgrass (Dactylis glomerata) and reed canarygrass (Phalaris arundinacea) (MH-diet) or mixed hay and fresh plantain (1 : 1 ratio, dry matter basis, PL-diet) and exposed to a thermoneutral (TN, 20°C; 70% relative humidity (RH)) environment or a heat exposure (HE, 30°C; 70% RH) for 5 days using a crossover design for two 23-day periods. The isotope dilution was conducted on days 18 and 23 of the experimental period during TN and HE, respectively. Plasma concentration of α-tocopherol was greater (Pinfusion.

  14. Continuous Subcutaneous Insulin Infusion in Children: A Pilot Study Validating a Protocol to Avoid Hypoglycemia at Initiation

    Directory of Open Access Journals (Sweden)

    Patricia Olivier

    2017-04-01

    Full Text Available BackgroundThe occurrence of hypoglycemia and hyperglycemia during the first days after transition to continuous subcutaneous insulin infusion (CSII in patients with type 1 diabetes has not been systematically studied in children. The aim of this prospective study was to demonstrate that the protocol applied in our diabetes clinic is safe at CSII initiation in children.MethodsWe assessed 22 pediatric patients with type 1 diabetes, using continuous glucose monitoring (CGM before and after CSII initiation (±3 days.ResultsAfter CSII initiation, there was no difference in the rates of hypoglycemic events expressed as relative rates (RRs per person-reading (RR = 0.85, p = 0.52, 95% CI 0.52–1.39, as well as in the number of prolonged hypoglycemic events (>1 h per day (RR = 1.12, p = 0.56, 95% CI 0.75–1.68. We observed only a trend toward prolonged episodes of hyperglycemia after pump initiation (RR = 1.52, p = 0.06, 95% CI 0.97–2.35.ConclusionOur study is the first to assess, through CGM and in a prospective way, the impact of a CSII initiation protocol on glycemic values. Our protocol provides a safe model to avoid hypoglycemia at CSII initiation in children.Clinical Trial Registrationwww.ClinicalTrials.gov, identifier NCT01840358.

  15. Phase I trial of systemic intravenous infusion of interleukin-13-Pseudomonas exotoxin in patients with metastatic adrenocortical carcinoma.

    Science.gov (United States)

    Liu-Chittenden, Yi; Jain, Meenu; Kumar, Parag; Patel, Dhaval; Aufforth, Rachel; Neychev, Vladimir; Sadowski, Samira; Gara, Sudheer K; Joshi, Bharat H; Cottle-Delisle, Candice; Merkel, Roxanne; Yang, Lily; Miettinen, Markku; Puri, Raj K; Kebebew, Electron

    2015-07-01

    Adrenocortical carcinoma (ACC) is a rare but lethal malignancy without effective current therapy for metastatic disease. IL-13-PE is a recombinant cytotoxin consisting of human interleukin-13 (IL-13) and a truncated form of Pseudomonas exotoxin A (PE). The main objectives of this Phase I dose-escalation trial were to assess the maximum-tolerated dose (MTD), safety, and pharmacokinetics (PK) of IL-13-PE in patients with metastatic ACC. Eligible patients had confirmed IL-13 receptor alpha 2 (IL-13Rα2) expressions in their tumors. IL-13-PE at dose of 1-2 μg/kg was administered intravenously (IV) on day 1, 3, and 5 in a 4-week cycle. Six patients received 1 μg/kg and two patients received 2 μg/kg of IL-13-PE. Dose-limiting toxicity was observed at 2 μg/kg, at which patients exhibited thrombocytopenia and renal insufficiency without requiring dialysis. PK analysis demonstrated that at MTD, the mean maximum serum concentration (Cmax ) of IL-13-PE was 21.0 ng/mL, and the terminal half-life of IL-13-PE was 30-39 min. Two (25%) of the eight patients had baseline neutralizing antibodies against PE. Three (75%) of the remaining four tested patients developed neutralizing antibodies against IL-13-PE within 14-28 days of initial treatment. Of the five patients treated at MTD and assessed for response, one patient had stable disease for 5.5 months before disease progression; the others progressed within 1-2 months. In conclusion, systemic IV administration of IL-13-PE is safe at 1 μg/kg. All tested patients developed high levels of neutralizing antibodies during IL-13-PE treatment. Use of strategies for immunodepletion before IL-13-PE treatment should be considered in future trials.

  16. Clip to Hold Children Scalp Intravenous Infusion%夹抱式幼儿头皮静脉输液体位的探讨

    Institute of Scientific and Technical Information of China (English)

    刘松春

    2014-01-01

    Objective To compare the infant scalp infusion by holding type method and traditional supine success rate of puncture, children crying, pul ing, cooperation. Methods 200 cases of 2012~2013 years children below 2 years old, were randomly divided into experimental group (holding type) and control group (conventional supine) scalp intravenous infusion. Observation of the children's success rate of puncture, crying and cope with the situation, and using statistical method scientific summary. Results The experimental group scalp puncture success rate increased, decreased, pull of crying with obvious decrease. Conclusion Holding type infant scalp infusion posture children more easily accept, against the success rate increased significantly, while the light degree of puncture, reduces the workload of the nurse and psychological pressure, is worthy of clinical application.%目的:比较幼儿头皮输液时采取夹抱式法与传统仰卧式的穿刺成功率、幼儿哭闹程度、抓扯、配合情况。方法选择2012~2013年200例<2岁幼儿,随机分成实验组(夹抱式)和对照组(传统仰卧式)进行头皮静脉输液。观察患儿的穿刺成功率、哭闹程度和配合情况,并采用科学的统计法归纳总结。结果实验组头皮穿刺成功率明显升高、哭闹程度降低、扯脱配合情况明显降低。结论夹抱式幼儿头皮输液体位幼儿比较容易接受,反抗程度轻、穿刺成功率明显升高,同时减轻了护士的工作负担和心理压力,值得临床推广应用。

  17. Biochemical and clinical evaluation of the efficiency of intracervical extraamniotic prostaglandin F2 alpha and intravenous oxytocin infusion to induce labour at term.

    Science.gov (United States)

    Kaminski, K; Rechberger, T; Oleszczuk, J; Jakowicki, J; Oleszczuk, J

    1994-08-01

    A prospective randomized study of 296 patients was undertaken to evaluate the efficiency of 15 mg prostaglandin F2 alpha (PGF2 alpha) suspended in tylose gel and applied intracervically for labour induction. The control group was treated with standard oxytocin intravenous infusion. Results indicated that local PGF2 alpha was superior to oxytocin therapy in shortening the duration of labour (6.3 +/- 2.3 versus 8.1 +/- 2.6 hours, p < 0.05). Only 19% of the patients treated with PGF2 alpha required oxytocin augmentation during labour. Our data suggest that PGF2 alpha treatment is associated with few maternal side-effects, few failed inductions, a low operative delivery rate and favourable neonatal outcome. To investigate the influence of PGF2 alpha for labour promotion we have measured interstitial collagenase and elastase activity in the lower uterine segment after both methods of labour induction. The total collagenase activity was 22 times higher in tissue samples obtained from patients in active spontaneous and oxytocin-induced labour, compared with women not in labour (at term) (p < 0.001). The total interstitial elastase activity was 2-fold higher in women in active labour than in patients at term (p < 0.03). A significantly higher collagenase and elastase activity was observed in uterine specimens obtained from patients treated with PGF2 alpha compared to oxytocin, and this indicates that cervical collagen may be digested more quickly in the presence of exogenous prostaglandin F2 alpha.

  18. Intravenous Infusion of Dexmedetomidine Combined Isoflurane Inhalation Reduces Oxidative Stress and Potentiates Hypoxia Pulmonary Vasoconstriction during One-Lung Ventilation in Patients

    Directory of Open Access Journals (Sweden)

    Rui Xia

    2015-01-01

    Full Text Available Inhalation anesthetic isoflurane inhibits hypoxia pulmonary vasoconstriction (HPV, while dexmedetomidine (Dex could reduce the dose of isoflurane inhalation and potentiate HPV, but the mechanism is unclear. Inhibition of reactive oxygen species (ROS production can favor HPV during one-lung ventilation (OLV. Similarly, nitric oxide (NO, an important endothelium-derived vasodilator in lung circulation, can decrease the regional pulmonary vascular resistance of ventilated lung and reduce intrapulmonary shunting. We hypothesized that Dex may augment HPV and improve oxygenation during OLV through inhibiting oxidative stress and increasing NO release. Patients undergoing OLV during elective thoracic surgery were randomly allocated to either isoflurane + saline (NISO, n=24 or isoflurane + dexmedetomidine (DISO, n=25 group. Anesthesia was maintained with intravenous remifentanil and inhalational isoflurane (1.0–2.0%, with concomitant infusion of dexmedetomidine 0.7 μgkg−1h−1 in DISO and saline 0.25 mL kg−1h−1 in NISO group. Hemodynamic variables or depth of anesthesia did not significantly differ between groups. Administration of Dex significantly reduced Qs/Qt and increased PaO2 after OLV, accompanied with reduced lipid peroxidation product malondialdehyde and higher levels of SOD activity as well as serum NO (all P<0.05 DISO versus NISO. In conclusion, reducing oxidative stress and increasing NO release during OLV may represent a mechanism whereby Dex potentiates HPV.

  19. Study on Steady-State Kinetics for Multiple Intravenous Infusion%周期性静滴给药的稳态动力学研究

    Institute of Scientific and Technical Information of China (English)

    丁勇

    2000-01-01

    The kinetic model for multiple intravenous infusion is a piecewise continuous function. Steady-State characteristics of this model are studied for drugs obeying one-compartment open model. Relationships of blood concentration between single dosing and multiple dosing are derived in this paper, which shows the parameters of Steady-State kinetic model can be predicted by the parameters from single dosing model. Based on these studies, dosage regimens are discussed for clinical application.%对线性一室模型的药物,周期性静滴给药的动力学模型为一分段连续函数,本文对其动态动力学特征进行了研究,得到了稳态浓度的$c-t$方程以及一次给药和多次给药动力学参数之间的关系,为预测稳态浓度提供了依据.在此基础上对给药方案的拟定进行了讨论.

  20. Improved Postprandial Glycemic Control with Faster-Acting Insulin Aspart in Patients with Type 1 Diabetes Using Continuous Subcutaneous Insulin Infusion.

    Science.gov (United States)

    Bode, Bruce W; Johnson, Joseph A; Hyveled, Liselotte; Tamer, Søren C; Demissie, Marek

    2017-01-01

    Faster aspart is insulin aspart (IAsp) in a new formulation, which in continuous subcutaneous insulin infusion (CSII) in subjects with type 1 diabetes has shown a faster onset and offset of glucose-lowering effect than IAsp. This double-blind, randomized, crossover active-controlled trial compared 2-h postprandial plasma glucose (PPG) response, following 2 weeks of CSII with faster aspart or IAsp. Primary endpoint: mean change in PPG 2 h after a standardized meal test (ΔPGav,0-2h). Subjects (n = 43) had masked continuous glucose monitoring (CGM) throughout. Faster aspart provided a statistically significantly greater glucose-lowering effect following the meal versus IAsp: ΔPGav,0-2h: 3.03 mmol/L versus 4.02 mmol/L (54.68 mg/dL vs. 72.52 mg/dL); estimated treatment difference (ETD) [95% CI]: -0.99 mmol/L [-1.95; -0.03] (-17.84 mg/dL [-35.21; -0.46]; P = 0.044). One hour postmeal, PG levels were -1.64 mmol/L (-29.47 mg/dL) lower with faster aspart versus IAsp (P = 0.006). Interstitial glucose (IG) profiles supported these findings; the largest differences were observed at breakfast: 9.08 versus 9.56 mmol/L (163.57 vs. 172.19 mg/dL; ETD [95% CI]: -0.48 mmol/L [-0.97; 0.01]; -8.62 mg/dL [-17.49; 0.24]; P = 0.057). Duration of low IG levels (≤3.9 mmol/L [70 mg/dL] per 24 h) was statistically significantly shorter for faster aspart versus IAsp (2.03 h vs. 2.45 h; ETD [95% CI]: -0.42 [-0.72; -0.11]; P = 0.008). No unexpected safety findings were observed. CSII delivery of faster aspart had a greater glucose-lowering effect than IAsp after a meal test. CGM results recorded throughout all meals supported this finding, with less time spent with low IG levels.

  1. The effects of preoperative oral pregabalin and perioperative intravenous lidocaine infusion on postoperative morphine requirement in patients undergoing laparatomy/Les effets de la prégabaline préopératoire par voie orale et de la perfusion intraveineuse de lidocaïne périopératoire sur les besoins postopératoires en morphine des patients qui subissent une laparotomie

    National Research Council Canada - National Science Library

    Senniye Ulgen Zengin; Ayten Saracoglu; Zeynep Eti; Tumay Umuroglu; Fevzi Yilmaz Gogus

    2015-01-01

      To evaluate and compare the effects of preoperative oral pregabalin and perioperative intravenous lidocaine infusion on postoperative morphine requirement, adverse effects, patients' satisfaction...

  2. Clinical observation and nursing of phlebitis caused by intravenous infusion fusidatesodium in 20 patients%20例静脉输注夫西地酸钠患者静脉炎的观察与护理

    Institute of Scientific and Technical Information of China (English)

    沈世银

    2012-01-01

    Objective To discuss the reason and nursing intervention of phlebitis caused by intravenous infusion fusidate sodium in 20 patients. Methods To retrospectively analysis the clinical data of 20 patients with phlebitis caused by intravenous infusion fusidate sodium and summarize the cause as well as nursing intervention of phlebitis. Results The causes of phlebitis caused by intravenous infusion fusidate sodium was mainly due to nurses, fusidate sodium and patients. Nursing interventions were to promote overall quality, enhance patient care and dietary care as well. The phlebitis of 20 patients disappeared after symptomatic treatment. Conclusion Promoting overall nursing quality and strengthening the overall quality of nursing could effectively prevent phlebitis caused by intravenous infusion fusidate sodium.%目的 探讨静脉输注夫西地酸钠患者静脉炎发生的原因及护理对策.方法 回顾性分析20例静脉输注夫西地酸钠发生静脉炎患者的临床资料,总结静脉炎发生的原因和护理对策.结果 20例静脉输注夫西地酸钠后,静脉炎发生的原因主要是护理人员原因、夫西地酸钠本身原因和患者自身原因,护理干预措施包括提升护理人员综合素质、加强护理和患者饮食护理等.20例患者经对症处理后炎症均消失.结论 提升护理人员综合素质和加强输液期间护理,可以有效防治静脉输注夫西地酸钠静脉炎.

  3. Type B insulin resistance syndrome induced by systemic lupus erythematosus and successfully treated with intravenous immunoglobulin: case report and systematic review.

    Science.gov (United States)

    Zhang, Sigong; Wang, Guochun; Wang, Jinping

    2013-02-01

    Type B insulin resistance syndrome is characterized by the formation of autoantibodies against insulin receptors, which can cause severe hyperglycemia and insulin resistance. Systemic lupus erythematosus is the most common underlying diseases of the syndrome. This report details our study of a case involving a Chinese female with type B insulin resistance syndrome as well as systemic lupus erythematosus who completely recovered after undergoing immunosuppressive therapy, specifically pulse therapy utilizing intravenous immunoglobulin. We also conducted search in MEDLINE and Chinese BioMedicine database to identify relevant literatures published in the past 46 years. From our searches, six case reports in Chinese, 15 case reports, and a 28-year perspective article in English met our criteria; a total of 67 cases were included in our report. The mean age of subjects at presentation for groups A, B, and C were 42.95, 44.10, and 41.68 years, respectively, yielding no significant difference between these groups. African Americans were the most susceptible group to type B insulin resistance syndrome, followed by Asians representing 20.90 % of all cases. Comparisons between the three main racial groups surveyed indicated that the mean age of subjects at presentation were very contiguous for African Americans and Asians, and mean age of white people was remarkably higher than either of the first two groups. The syndrome appeared most common among Asian males, and white males were relatively less likely to suffer from type B insulin resistance syndrome. Hypoglycemia was most commonly observed in white people than in other racial groups. Hypoalbuminemia, elevated serum immunoglobulin G, and elevated sedimentation rates were more common in African Americans; Asian cases were more likely to show low serum C3 or C4 and nephritis. Two cases received intravenous immunoglobulin therapy, which has a remarkably rapid effect on insulin resistance.

  4. Serum lipase activity and concentration during intravenous infusions of GLP-1 and PYY3-36 and after ad libitum meal ingestion in overweight men

    DEFF Research Database (Denmark)

    Schmidt, Julie Berg; Sjödin, Anders Mikael; Stevner, Lene Susanne

    2016-01-01

    the infusion and after intake of an ad libitum meal for measurement of serum lipase. Serum lipase levels measured by enzyme-linked immunosorbent assay (ELISA) following mono-infusions of GLP-1 and PYY3-36 were comparable to serum lipase levels following placebo (P = 0.054 and P = 0.873, respectively......To examine the effect on serum lipase activity and protein concentration of intravenous infusions of glucagon-like peptide-1 (GLP-1) and peptide YY (PYY3-36) and of an ad libitum meal in healthy overweight men. Twenty-five healthy, male subjects participated in this randomized, double......-blinded, placebo-controlled 4-arm crossover study (Body Mass Index (BMI): 29 ± 3 kg/m(2), age: 33 ± 9 years). On separate days, the subjects received a 150-min intravenous infusion of either (1) 0.8 pmol/kg/min PYY3-36, (2) 1.0 pmol/kg/min GLP-1, (3) 1 + 2, or (4) placebo. Samples were collected throughout...

  5. Bioequivalence and Population Pharmacokinetic Modeling of Two Forms of Antibiotic, Cefuroxime Lysine and Cefuroxime Sodium, after Intravenous Infusion in Beagle Dogs

    Directory of Open Access Journals (Sweden)

    Longshan Zhao

    2012-01-01

    Full Text Available To investigate the bioequivalence and the population pharmacokinetics of cefuroxime lysine and cefuroxime sodium in healthy beagle dogs. A randomized 2-period crossover design in 18 healthy beagle dogs after receiving 20, 40, and 80 mg/kg of cefuroxime lysine or cefuroxime sodium was conducted. A 3-compartment open model was used as the basic model for the population pharmacokinetic study. Both of the antibiotics exhibited dose-proportional pharmacokinetics over the dose range of 20–80 mg/kg. The mean relative bioavailability of cefuroxime lysine versus cefuroxime sodium was 1.05 (range, 0.71 to 1.42, with a significant difference between males and females. The estimates of population pharmacokinetic of CL, V1, Q2, V2, Q3, V3 were 3.74 mL/h, 1.70 mL, 29.5 mL/min, 3.58 mL, 0.31 mL/min, and 158 mL for cefuroxime lysine and 4.10 mL/h, 1.00 mL, 38.5 mL/min, 4.19 mL, 0.06 mL/min, and 13.6 mL for cefuroxime sodium, respectively. The inter-individual variability was determined to be less than 29.1%. A linear pharmacokinetic was revealed for cefuroxime lysine and cefuroxime sodium in dogs after intravenous infusion, and the bioequivalence of these forms of the antibiotic was observed with the significant gender-related differences in mean relative bioavailability of cefuroxime lysine versus cefuroxime sodium.

  6. Pharmacogenetic determinants of outcomes on triplet hepatic artery infusion and intravenous cetuximab for liver metastases from colorectal cancer (European trial OPTILIV, NCT00852228).

    Science.gov (United States)

    Lévi, Francis; Karaboué, Abdoulaye; Saffroy, Raphaël; Desterke, Christophe; Boige, Valerie; Smith, Denis; Hebbar, Mohamed; Innominato, Pasquale; Taieb, Julien; Carvalho, Carlos; Guimbaud, Rosine; Focan, Christian; Bouchahda, Mohamed; Adam, René; Ducreux, Michel; Milano, Gérard; Lemoine, Antoinette

    2017-08-17

    The hepatic artery infusion (HAI) of irinotecan, oxaliplatin and 5-fluorouracil with intravenous cetuximab achieved outstanding efficacy in previously treated patients with initially unresectable liver metastases from colorectal cancer. This planned study aimed at the identification of pharmacogenetic predictors of outcomes. Circulating mononuclear cells were analysed for 207 single-nucleotide polymorphisms (SNPs) from 34 pharmacology genes. Single-nucleotide polymorphisms passing stringent Hardy-Weinberg equilibrium test were tested for their association with outcomes in 52 patients (male/female, 36/16; WHO PS, 0-1). VKORC1 SNPs (rs9923231 and rs9934438) were associated with early and objective responses, and survival. For rs9923231, T/T achieved more early responses than C/T (50% vs 5%, P=0.029) and greatest 4-year survival (46% vs 0%, P=0.006). N-acetyltransferase-2 (rs1041983 and rs1801280) were associated with up to seven-fold more macroscopically complete hepatectomies. Progression-free survival was largest in ABCB1 rs1045642 T/T (P=0.026) and rs2032582 T/T (P=0.035). Associations were found between toxicities and gene variants (P<0.05), including neutropenia with ABCB1 (rs1045642) and SLC0B3 (rs4149117 and rs7311358); and diarrhoea with CYP2C9 (rs1057910), CYP2C19 (rs3758581), UGT1A6 (rs4124874) and SLC22A1 (rs72552763). VKORC1, NAT2 and ABCB1 variants predicted for HAI efficacy. Pharmacogenetics could guide the personalisation of liver-targeted medico-surgical therapies.British Journal of Cancer advance online publication, 17 August 2017; doi:10.1038/bjc.2017.278 www.bjcancer.com.

  7. Enhancing the [13C]bicarbonate signal in cardiac hyperpolarized [1‐13C]pyruvate MRS studies by infusion of glucose, insulin and potassium

    DEFF Research Database (Denmark)

    Lauritzen, Mette Hauge; Laustsen, Christoffer; Butt, Sadia Asghar

    2013-01-01

    the myocardial glucose oxidation in the citric acid cycle, reflected as an increase in the [13C]bicarbonate signal in cardiac hyperpolarized [1‐13C]pyruvate MRS measurements in fasted rats. Two groups of rats were infused with two different doses of GIK and investigated by MRS after injection of hyperpolarized...... rats. The increased [13C]bicarbonate signal indicates an increased flux of pyruvate through the pyruvate dehydrogenase enzyme complex and an increase in myocardial glucose oxidation through the citric acid cycle. Copyright © 2013 John Wiley & Sons, Ltd....... fasting, the myocardial glucose oxidation is low and the fatty acid oxidation (β‐oxidation) is high, which complicates the interpretation of pyruvate metabolism with the technique. The aim of this study was to investigate whether the infusion of glucose, insulin and potassium (GIK) could increase...

  8. Effect of 4 years subcutaneous insulin infusion treatment on albuminuria, kidney function and HbA1c compared with multiple daily injections

    DEFF Research Database (Denmark)

    Vestergaard Rosenlund, Signe; Hansen, T W; Andersen, Steen

    2015-01-01

    , diabetes duration, estimated GFR, UACR, mean arterial pressure, HbA1c , cholesterol, renin-angiotensin-aldosterone system inhibition, anti-hypertensive treatment and smoking (P ...AIM: The effect of insulin pump [continuous subcutaneous insulin infusion (CSII)] treatment on diabetes complications in a modern clinical setting is largely unknown. We investigated the effect of 4 years CSII treatment on HbA1c, albuminuria and kidney function compared with multiple daily...... on diabetes duration, gender, HbA1c and normo-, micro- or macroalbuminuria at baseline. Urinary albumin/creatinine ratio (UACR) was measured yearly and annual change assessed from linear regression. RESULTS: CSII- vs. MDI-treated patients were comparable at baseline. After 4 years, HbA1c was 62 ± 11 vs. 68...

  9. Regulation of insulin-stimulated glucose uptake in rat white adipose tissue upon chronic central leptin infusion: effects on adiposity.

    Science.gov (United States)

    Bonzón-Kulichenko, Elena; Fernández-Agulló, Teresa; Moltó, Eduardo; Serrano, Rosario; Fernández, Alejandro; Ros, Manuel; Carrascosa, José M; Arribas, Carmen; Martínez, Carmen; Andrés, Antonio; Gallardo, Nilda

    2011-04-01

    Leptin enhances the glucose utilization in most insulin target tissues and paradoxically decreases it in white adipose tissue (WAT), but knowledge of the mechanisms underlying the inhibitory effect of central leptin on the insulin-dependent glucose uptake in WAT is limited. After 7 d intracerebroventricular leptin treatment (0.2 μg/d) of rats, the overall insulin sensitivity and the responsiveness of WAT after acute in vivo insulin administration were analyzed. We also performed unilateral WAT denervation to clarify the role of the autonomic nervous system in leptin effects on the insulin-stimulated [(3)H]-2-deoxyglucose transport in WAT. Central leptin improved the overall insulin sensitivity but decreased the in vivo insulin action in WAT, including insulin receptor autophosphorylation, insulin receptor substrate-1 tyrosine-phosphorylation, and Akt activation. In this tissue, insulin receptor substrate-1 and glucose transporter 4 mRNA and protein levels were down-regulated after central leptin treatment. Additionally, a remarkable up-regulation of resistin, together with an augmented expression of suppressor of cytokine signaling 3 in WAT, was also observed in leptin-treated rats. As a result, the insulin-stimulated glucose transporter 4 insertion at the plasma membrane and the glucose uptake in WAT were impaired in leptin-treated rats. Finally, denervation of WAT abolished the inhibitory effect of central leptin on glucose transport and decreased suppressor of cytokine signaling 3 and resistin levels in this tissue, suggesting that resistin, in an autocrine/paracrine manner, might be a mediator of central leptin antagonism of insulin action in WAT. We conclude that central leptin, inhibiting the insulin-stimulated glucose uptake in WAT, may regulate glucose availability for triacylglyceride formation and accumulation in this tissue, thereby contributing to the control of adiposity.

  10. Role of capsaicin-sensitive peripheral sensory neurons in anorexic responses to intravenous infusions of cholecystokinin, peptide YY-(3-36), and glucagon-like peptide-1 in rats.

    Science.gov (United States)

    Reidelberger, Roger; Haver, Alvin; Anders, Krista; Apenteng, Bettye

    2014-10-15

    Cholecystokinin (CCK)-induced suppression of feeding is mediated by vagal sensory neurons that are destroyed by the neurotoxin capsaicin (CAP). Here we determined whether CAP-sensitive neurons mediate anorexic responses to intravenous infusions of gut hormones peptide YY-(3-36) [PYY-(3-36)] and glucagon-like peptide-1 (GLP-1). Rats received three intraperitoneal injections of CAP or vehicle (VEH) in 24 h. After recovery, non-food-deprived rats received at dark onset a 3-h intravenous infusion of CCK-8 (5, 17 pmol·kg⁻¹·min⁻¹), PYY-(3-36) (5, 17, 50 pmol·kg⁻¹·min⁻¹), or GLP-1 (17, 50 pmol·kg⁻¹·min⁻¹). CCK-8 was much less effective in reducing food intake in CAP vs. VEH rats. CCK-8 at 5 and 17 pmol·kg⁻¹·min⁻¹ reduced food intake during the 3-h infusion period by 39 and 71% in VEH rats and 7 and 18% in CAP rats. In contrast, PYY-(3-36) and GLP-1 were similarly effective in reducing food intake in VEH and CAP rats. PYY-(3-36) at 5, 17, and 50 pmol·kg⁻¹·min⁻¹ reduced food intake during the 3-h infusion period by 15, 33, and 70% in VEH rats and 13, 30, and 33% in CAP rats. GLP-1 at 17 and 50 pmol·kg⁻¹·min⁻¹ reduced food intake during the 3-h infusion period by 48 and 60% in VEH rats and 30 and 52% in CAP rats. These results suggest that anorexic responses to PYY-(3-36) and GLP-1 are not primarily mediated by the CAP-sensitive peripheral sensory neurons (presumably vagal) that mediate CCK-8-induced anorexia.

  11. Insulin pump-associated adverse events are common, but not associated with glycemic control, socio-economic status, or pump/infusion set type.

    Science.gov (United States)

    Ross, P; Gray, A R; Milburn, J; Kumarasamy, I M; Wu, F; Farrand, S; Armishaw, J; Wiltshire, E; Rayns, J; Tomlinson, P; Wheeler, B J

    2016-12-01

    While there have been many outcome-focussed studies examining insulin pump therapy, only a few have looked at potential adverse events (AEs), with none examining the relationship between AEs and pump/infusion set type, ethnicity or socio-economic status. In addition, current data on the incidence and characteristics of pump-associated AEs are confined to one paediatric centre. We aimed to describe the incidence, characteristics and potential predictors of insulin pump-associated AEs in New Zealand adults and children with T1DM. We approached adults and families of children with T1DM on insulin pumps in four main New Zealand centres. Participants completed a questionnaire examining pump-related issues they had experienced in the preceding 12 months. Response rate was 64 % with 174 of 270 eligible people participating in the study. 84 % of subjects reported one or more AEs, with an overall AE incidence of 3.42 per person/year (95 % CI 3.14, 3.73). An event serious enough to require a hospital presentation occurred in 9.8 %, all but one reporting high ketones or diabetic ketoacidosis (DKA). Set/site problems were the AE most commonly reported (by 53 % of respondents), followed by cutaneous complications (43 %) and pump malfunction (38 %). Few predictors of AEs (of any type) were found; however, a negative binomial regression model found that a longer duration of pumping (p = 0.018) and age Insulin pump-associated AEs are very common. However, few variables are predictive of them with no relationships seen with glycaemic control, socio-economic status, pump manufacturer or infusion set type. Based on these findings, AEs should be anticipated in both adults and children, with anticipatory patient education and training recommended for their successful and safe use.

  12. Cardiorespiratory and antinociceptive effects of two different doses of lidocaine administered to horses during a constant intravenous infusion of xylazine and ketamine

    Science.gov (United States)

    2013-01-01

    Background This study investigated the antinociceptive effects of a constant rate infusion (CRI) of lidocaine during xylazine and ketamine anesthesia in horses and aimed to correlate these effects with cardiorespiratory variables, bispectral index (BIS) and plasma lidocaine concentrations. Six adult crossbred mares weighing 320–400 kg were anesthetized on three different occasions. Sedation was performed with xylazine (0.75 mg/kg IV) and anesthetic induction with guaifenesin (75 mg/kg IV) and ketamine (2 mg/kg IV). Anesthesia was maintained with 37.5 μg/kg/min of xylazine and 87.5 μg/kg/min of ketamine both administered intravenously for 75 min. The three treatments consisted of: lidocaine (loading dose: 5 mg/kg, CRI: 100 μg/kg/min; THL); lidocaine (loading dose: 2.5 mg/kg; CRI: 50 μg/kg/min: TLL); and saline (TS); all given 15 min after induction and maintained for 1 h. Antinociception was measured by response to electrical stimulation and bispectral index (BIS) was recorded during anesthesia. Parametric and non-parametric data were compared using ANOVA followed by Student-Newman-Keuls and Friedman tests, respectively. Results Plasma lidocaine concentrations peaked at the end of lidocaine loading dose and was greater in THL (9.61 ± 2.75 μg/mL) vs TLL (4.50 ± 3.34 μg/mL). Electrical noxious stimulation caused purposeful movement in all horses from TS, but no response in THL. The BIS was decreased in THL only and was less when compared to the other treatments throughout anesthesia. Blood pressure, PaO2 and PaCO2 increased and heart rate (HR), respiratory rate (RR), pH, total plasma protein and temperature decreased during anesthesia in all treatments. PaCO2 and HR were greater and RR and pH less in THL compared to TLL and TS at 30 min during anesthesia. All recoveries were considered excellent. Time to standing was longer after THL (60 ± 20 min) than following TLL and TS (32 ± 17 and 30 ± 15 min, respectively

  13. Pharmacokinetics of ginkgolides A, B and K after single and multiple intravenous infusions and their interactions with midazolam in healthy Chinese male subjects.

    Science.gov (United States)

    Shao, Feng; Zhang, Hongwen; Xie, Lijun; Chen, Juan; Zhou, Sufeng; Zhang, Jinsong; Lv, Jinru; Hao, Weiwen; Ma, Yunsu; Liu, Yun; Ou, Ning; Xiao, Wei

    2017-05-01

    Ginkgo terpene lactones meglumine injection (GMI) is a novel preparation of traditional Chinese medicine that contains ginkgolides A, B and K (GA, GB, GK, respectively) as its primary components. In this study we evaluated the safety, tolerability and pharmacokinetics of these three ginkgolides after single and multiple intravenous infusions of GMI. We also investigated the effect of GMI on cytochrome P450 3A4 (CYP3A4) in healthy Chinese volunteers. In this open-label, placebo-controlled study 15 subjects were randomly assigned to receive GMI or matched placebo (4:1 ratio). All subjects first received midazolam (MDZ) on day 1, followed by a 6-day washout. On Day 8, the subjects were started on once-daily dosing of either GMI or placebo for 14 days. Lastly, on Day 22 the subjects were given second dose of MDZ + GMI or MDZ + placebo. Plasma concentrations of ginkgolides, MDZ and its metabolite 1-hydroxy midazolam were quantified. The steady-state conditions of GA, GB and GK were achieved after 6 days of daily dosing. Following a single dose of GMI (Day 8) the area under the concentration-timecurve from zero to 24 h after administration (AUC0-24h) of GA, GB and GK (arithmetic ± standard deviation) was 4.10 ± 1.06, 4.61 ± 1.31 and 0.127 ± 0.102 h μg/mL, respectively; the corresponding values following multiple doses of GMI (Day 19) were 3.94 ± 1.16, 5.00 ± 1.55 and 0.118 ± 0.096 h μg/mL, respectively. The mean accumulation ratios were 0.95, 1.08 and 0.89 for GA, GB and GK, respectively. Additionally, the geometric mean [peak concentration (Cmax) and AUC0-24h] ratios of MDZ and 1-hydroxy midazolam were all within the specified acceptance ranges in the MDZ + placebo treatment and MDZ + GMI treatment. Our results show that GMI was well tolerated during the entire study. There was no systemic accumulation and no significant effects on the pharmacokinetics of MDZ in healthy Chinese male subjects after repeated dosing of GMI.

  14. Design and performance evaluation of the "iTIVA" algorithm for manual infusion of intravenous anesthetics based on effect-site target

    NARCIS (Netherlands)

    D.E. Ramírez (David Eduardo); J.A. Calvache (Jose Andrés)

    2016-01-01

    textabstractIntroduction: Remifentanil and propofol infusion using TCI pumps has proven to be beneficial for the practice of anesthesia but the availability of these systems is limited. Objective: Designing a pharmacokinetic model-based algorithm for calculating manual infusion regimens to achieve p

  15. Design and performance evaluation of the "iTIVA" algorithm for manual infusion of intravenous anesthetics based on effect-site target

    NARCIS (Netherlands)

    D.E. Ramírez (David Eduardo); J.A. Calvache (Jose Andrés)

    2016-01-01

    textabstractIntroduction: Remifentanil and propofol infusion using TCI pumps has proven to be beneficial for the practice of anesthesia but the availability of these systems is limited. Objective: Designing a pharmacokinetic model-based algorithm for calculating manual infusion regimens to achieve p

  16. Synthesis and intravenous infusion into the rat of glyceryl bisacetoacetate, 1-acetoacetamido-2, 3-propane diol, and partially reduced glucosyl pentaacetoacetate.

    Science.gov (United States)

    Birkhahn, R H; Clemens, R J; Hubbs, J C

    1997-07-01

    The efficacy of parenteral nutrition could be improved by finding a more effective energy source. Esters of short-chain fatty acids have exhibited some promise as alternatives to glucose. The present study reports on two new esters and one amide, each containing acetoacetate as the organic acid. The three compounds: glyceryl bisacetoacetate, N-2',3'-dihydroxypropyl-3-oxo-butanamide (1-acetoacetamido-2,3-propane diol), and partially reduced glucosyl pentaacetoacetate, were synthesized and then continuously infused into rats for 7 d. The infusion rate provided 50% of the rats' estimated metabolic energy requirements, and rats were fed with a reduced-energy oral diet that provided the remaining 50% of energy plus adequate protein. Rat groups for each compound were: (1) experimental-compound-infused and ad libitum-fed, (2) isoenergetic glucose-infused and pairfed, and (3) saline infused and pair-fed. Body-weight changes, N losses and N retention were measured daily. All rats died from partially reduced glucosyl pentaacetoacetate infusion at 100% and 50% of the intended rate. Rats infused with 1-acetoacetamido-2,3-propane diol failed to gain weight and to increase the plasma ketone-body concentration. Glyceryl bisacetoacetate produced hyperketonaemia, and weight gain and N variables that were similar to those for glucose-infused rats. It was concluded that only glyceryl bisacetoacetate would make a satisfactory parenteral nutrient.

  17. Dodecanedioic acid infusion induces a sparing effect on whole-body glucose uptake, mainly in non-insulin-dependent diabetes mellitus.

    Science.gov (United States)

    Mingrone, G; De Gaetano, A; Greco, A V; Capristo, E; Benedetti, G; Castagneto, M; Gasbarrini, G

    1997-11-01

    Even-numbered dicarboxylic acids (DA) have been proposed as an alternative fuel substrate in parenteral nutrition. In particular, dodecanedioic acid (C12) shows a rapid plasma clearance from tissues, a very low urinary excretion compared with other DA and a high oxidation rate. The aim of the present study was to investigate the effect of C12 infusion on insulin-stimulated glucose uptake in patients with non-insulin-dependent diabetes mellitus (NIDDM) compared with healthy volunteers. A primed-constant infusion of C12 (0.39 mmol/min) was administered over 240 min, and at 120 min a 2 h euglycaemic hyperinsulinaemic clamp was performed. Blood specimens were sampled every 30 min and fractioned urines were collected over 24 h. The levels of C12 were measured by HPLC. Indirect calorimetry was performed continuously during the entire session. Body composition was assessed in all subjects studied to obtain fat-free mass (FFM) values. Whole-body glucose uptake decreased significantly during C12 infusion in both groups, although this effect was much more evident (P < 0.01) in NIDDM patients (52.4 (SD 15.8) % decrease compared with saline) than in controls (25.9 (SD 12.1) % decrease). The M value (mumol/kgFFM per min) was reduced by C12 to lower levels in NIDDM patients than in normal controls (12.6 (SD 3.9) v. 25.9 (SD 4.5), P < 0.01). Urinary excretion of C12 over 24 h was significantly lower in NIDDM patients than in controls (4.26 (SD 0.30) mmol v. 5.43 (SD 0.48), P < 0.01), corresponding to less than 3% of the administered dose. The infusion of C12 decreased non-protein RQ significantly in both groups of patients. In conclusion, this study shows, for the first time, that C12 significantly reduces glucose uptake in both normal controls and NIDDM patients, although this sparing effect on glucose uptake is much more pronounced in diabetic patients. These data suggest that C12 decreases glucose uptake and oxidation, mainly through a mechanism of substrate competition. Thus

  18. Plasma adiponectin is modestly decreased during 24-hour insulin infusion but not after inhibition of lipolysis by Acipimox

    NARCIS (Netherlands)

    Dullaart, RPF; Riemens, SC; Meinardi, [No Value; Wolffenbuttel, BHR; Sluiter, WJ

    2005-01-01

    Objective. Plasma adiponectin is associated with insulin resistance and atherosclerosis. Adiponectin expression in adipose tissue is up-regulated by peroxisome proliferator-activated receptor (PPAR)-gamma agonist treatment and its plasma level may be affected by insulin. We tested the hypothesis

  19. Plasma adiponectin is modestly decreased during 24-hour insulin infusion but not after inhibition of lipolysis by Acipimox

    NARCIS (Netherlands)

    Dullaart, RPF; Riemens, SC; Meinardi, [No Value; Wolffenbuttel, BHR; Sluiter, WJ

    2005-01-01

    Objective. Plasma adiponectin is associated with insulin resistance and atherosclerosis. Adiponectin expression in adipose tissue is up-regulated by peroxisome proliferator-activated receptor (PPAR)-gamma agonist treatment and its plasma level may be affected by insulin. We tested the hypothesis tha

  20. 儿科门急诊患儿静脉输液疼痛相关因素的研究%Related factors research of intravenous infusion-related pain access in out-patient and emergency departments of pediatrics

    Institute of Scientific and Technical Information of China (English)

    杜瑞成

    2011-01-01

    目的:通过研究儿科门急诊患儿静脉输液疼痛相关因素,分析影响静脉输液时患儿疼痛的原因以及改进工作的最佳方法,提高患儿及家长的满意度.方法:通过应用疼痛量表Wong-Baker面部表情评估法和改良面部表情评分法评估327例儿科门急诊患儿静脉输液疼痛程度,收集与儿科门急诊患儿静脉输液疼痛相关的因素并详细记录,运用统计学的方法分析其对疼痛结果的影响程度.结果:Logistic回归分析显示:转移患儿注意力和血管清晰度为静脉输液相关疼痛的保护因素;家长陪伴人数>2人是其危险因素.强制固定患儿、近期重复输液对静脉输液相关疼痛没有统计学意义上的影响.结论:采取有效的安抚和诱导患儿转移注意力,提高操作技能,限制家长陪伴人数使患儿配合护士操作,能减轻患儿疼痛,保证静脉输液成功实施.%Objective : Through the related factors research of intravenous infusion - related pain access in out - patient and emergency departments of pediatrics, to search the main cause of intravenous infusion - related pain and the best method of improving the work in order to heighten the contentment rate of the sick children and parents. Methods : Apply the modified Wong - Baker faces scale and the modified faces , legs , activity , cry and console ahility scale , dato collections list to completely record every related factor about intravenous infusion and the influence degree to the result, adopt statistics means to get a conclusion. Results:A total of 327 patients were included in the study. By multivariate logistic regression analysis, to transfer the children' s attention and blood vessel appearance degree were found as protected ( or beneficial ) factors of intravenous infusion - related pain, more than 2 people of households accompanying was risk factor. Whether mandatory fixed children and recent repeated infusion have no statistics meanings influence

  1. Insulin-dependent and insulin-independent effects after surgical alterations of the pancreas.

    Science.gov (United States)

    Krusch, D A; Brown, K B; Cornett, G; Freedlender, A E; Kaiser, D L; Hanks, J B

    1989-07-01

    Anatomic alterations of the pancreas result in physiologic alterations that have not been completely analyzed. Insulin plays a major role in carbohydrate metabolism; nevertheless, as much as 50% of a hyperglycemic load may be metabolized independent of insulin. We analyzed the effects of surgical alterations of the pancreas on postoperative glucose metabolism, including insulin-independent effects. Mongrel female dogs underwent one of three procedures: proximal partial pancreatectomy (PPx), PPx plus diversion of pancreatic venous effluent to the systemic circulation (SC), or PPx plus segmental pancreatic autotransplantation (PAT). Intravenous glucose tolerance tests, with or without a background infusion of somatostatin (SST; 400 ng/kg/min) were performed on all animals preoperatively and postoperatively. SST completely suppressed secretion of assayable peripheral insulin. The rate of glucose disposal during SST suppression approximates the rate of insulin-independent glucose disposal (IIGD). Although there was a significant decrease in the rate of glucose disposal during SST infusion when compared with the rate without SST, no differences in IIGD were found between postoperative groups. IIGD was calculated at 50% to 55% for control, PPx, and SC groups and at 67% for PAT. Peripheral sensitivity to an exogenous insulin infusion (euglycemic clamp) was unchanged by any of the procedures. We conclude that surgical alteration of the pancreas, including pancreas transplantation, results in altered glucose handling in the face of "normal" peripheral levels of insulin. Changes in IIGD and analysis of peripheral sensitivity to insulin do not explain these alterations completely.

  2. Effect of catecholamines and insulin on plasma volume and intravascular mass of albumin in man

    DEFF Research Database (Denmark)

    Hilsted, J; Christensen, N J; Larsen, S

    1989-01-01

    1. The effect of intravenous catecholamine infusions and of intravenous insulin on plasma volume and intravascular mass of albumin was investigated in healthy males. 2. Physiological doses of adrenaline (0.5 microgram/min and 3 microgram/min) increased peripheral venous packed cell volume...... significantly; intravenous noradrenaline at 0.5 microgram/min had no effect on packed cell volume, whereas packed cell volume increased significantly at 3 micrograms of noradrenaline/min. No significant change in packed cell volume was found during saline infusion. 3. During adrenaline infusion at 6 micrograms...... in packed cell volume, plasma volume, intravascular mass of albumin and transcapillary escape rate of albumin during hypoglycaemia may be explained by the combined actions of adrenaline and insulin....

  3. Microvascular Recruitment in Insulin Resistance

    DEFF Research Database (Denmark)

    Sjøberg, Kim Anker

    In this PhD work a new method for measuring microvascular recruitment was developed and evaluated, using continues real-time imaging of contrast enhanced ultrasound. Gas-filled microbubbles were infused intravenously and by taking advantage of the echogenic properties of the microbubbles the reso......In this PhD work a new method for measuring microvascular recruitment was developed and evaluated, using continues real-time imaging of contrast enhanced ultrasound. Gas-filled microbubbles were infused intravenously and by taking advantage of the echogenic properties of the microbubbles...... hormone glucagon-like-peptide-1 (GLP-1) in the microcirculation. Glucagon-like-peptide-1 analogs are drugs used for treatments of insulin resistance and type 2 diabetes but the vascular effects of GLP-1 in vivo are elusive. Here it was shown that GLP-1 rapidly increased the microvascular recruitment...

  4. Preliminary evaluation of intravenous infusion and intrapancreatic injection of human umbilical cord blood-derived mesenchymal stem cells for the treatment of diabetic mice

    OpenAIRE

    Ngoc Kim Phan; Thuy Thanh Duong; Truc Le-Buu Pham; Loan Thi-Tung Dang; Anh Nguyen-Tu Bui; Vuong Minh Pham; Nhat Chau Truong; and Phuc Van Pham

    2014-01-01

    Type 1 diabetes mellitus is characterized by the destruction of pancreatic islet beta cells, which leads to insulin insufficiency, hyperglycemia, and reduced metabolic glucose level. Insulin replacement is the current standard therapy for type 1 diabetes mellitus but has several limitations. Pancreatic islet transplantation can result in the production of exogenous insulin, but its use is limited by immune-rejection and donor availability. Recent studies have shown that mesenchymal stem cells...

  5. Direct effects of TNF-α on local fuel metabolism and cytokine levels in the placebo controlled bilaterally infused human leg; increased insulin sensitivity, increased net protein breakdown and increased IL-6 release

    DEFF Research Database (Denmark)

    Bach, Ermina; Nielsen, Bent Roni Ranghøj; Vendelbo, Mikkel H;

    2013-01-01

    Tumor necrosis factor-α (TNF-α) has widespread metabolic actions. Systemic TNF-α administration, however, generates a complex hormonal and metabolic response. Our study was designed to test whether regional, placebo-controlled TNF-α infusion directly affects insulin resistance and protein breakdo...... interest and may concurrently act to provide adequate tissue fuel supply and contribute to the occurrence of systemic hypoglycemia. This distinct metabolic feature places TNF-α among the rare insulin mimetics of human origin....

  6. Exenatide augments first- and second-phase insulin secretion in response to intravenous glucose in subjects with type 2 diabetes

    DEFF Research Database (Denmark)

    Fehse, Frauke; Trautmann, Michael; Holst, Jens Juul;

    2005-01-01

    CONTEXT: First-phase insulin secretion (within 10 min after a sudden rise in plasma glucose) is reduced in type 2 diabetes mellitus (DM2). The incretin mimetic exenatide has glucoregulatory activities in DM2, including glucose-dependent enhancement of insulin secretion. OBJECTIVE: The objective o...

  7. Clinical outcomes with extended or continuous versus short-term intravenous infusion of carbapenems and piperacillin/tazobactam: a systematic review and meta-analysis.

    Science.gov (United States)

    Falagas, Matthew E; Tansarli, Giannoula S; Ikawa, Kazuro; Vardakas, Konstantinos Z

    2013-01-01

    We sought to study whether the better pharmacokinetic and pharmacodynamic (PK/PD) properties of carbapenems and piperacillin/tazobactam, when the duration of infusion is longer, were associated with lower mortality. PubMed and Scopus were searched for studies reporting on patients treated with extended (≥3 hours) or continuous (24 hours) versus short-term duration (20-60 minutes) infusions of carbapenems or piperacillin/tazobactam. Fourteen studies were included (1229 patients). Mortality was lower among patients receiving extended or continuous infusion of carbapenems or piperacillin/tazobactam compared to those receiving short-term (risk ratio [RR], 0.59; 95% confidence interval [CI], .41-.83). Patients with pneumonia who received extended or continuous infusion had lower mortality than those receiving short-term infusion (RR, 0.50; 95% CI, 0.26-0.96). Data for other specific infections were not available. The available evidence from mainly nonrandomized studies suggests that extended or continuous infusion of carbapenems or piperacillin/tazobactam was associated with lower mortality. Well-designed randomized controlled trials are warranted to confirm these findings before such approaches become widely used.

  8. Acute in vivo regulation of 11beta-hydroxysteroid dehydrogenase type 1 activity by insulin and intralipid infusions in humans.

    Science.gov (United States)

    Wake, Deborah J; Homer, Natalie Z M; Andrew, Ruth; Walker, Brian R

    2006-11-01

    Extraadrenal regeneration of cortisol by 11beta-hydroxysteroid dehydrogenase type 1 (11HSD1) is increased after a mixed meal. It is unknown which tissue is responsible and whether this reflects the complex transcriptional control of 11HSD1 or posttranscriptional control exerted by supply of reduced nicotinamide adenine dinucleotide phosphate from hexose-6-phosphate dehydrogenase. The objective of this study was to test whether hyperinsulinemia and/or increased serum free fatty acids increase whole-body and intraadipose 11HSD1, and whether adipose 11HSD1 switches from dehydrogenase to reductase activity. In nine healthy men, we measured whole-body cortisol regeneration (by iv infusion of 9,11,12,12-[2H]4 -cortisol) and intra-adipose interconversion of cortisol and cortisone (by sc microdialysis infusion of [3H]4 -cortisol and [3H]2 -cortisone in separate cannulae) during: 1) a hyperinsulinemic euglycemic clamp; 2) iv lipid infusion (Intralipid 20% fat emulsion); and 3) saline infusion, each for 3.5 h. Hyperinsulinemia increased rate of appearance of 9,12,12-[2H]3 -cortisol (19.3 +/- 0.8 vs. 16.7 +/- 1.1 nmol/min with saline, P adipose, the predominant reaction was reductase conversion of cortisone to cortisol (after 3.5 h of saline infusion, reaching 11.0 +/- 2.7% per hour reductase vs. 5.2 +/- 1.3 dehydrogenase, P effects on whole-body deuterated cortisol metabolism, but increased both dehydrogenase and reductase (reaching 16.7 +/- 1.8, P adipose. Hyperinsulinemia and increased free fatty acids induce acute increases in 11HSD1 activity in adipose tissue that are not attributable to a switch from dehydrogenase to reductase. Hyperinsulinemia also increases systemic cortisol regeneration. These effects may enhance intracellular cortisol concentrations after a meal.

  9. Adipose Tissue Promotes a Serum Cytokine Profile Related to Lower Insulin Sensitivity after Chronic Central Leptin Infusion

    Science.gov (United States)

    Burgos-Ramos, Emma; Canelles, Sandra; Perianes-Cachero, Arancha; Arilla-Ferreiro, Eduardo; Argente, Jesús; Barrios, Vicente

    2012-01-01

    Obesity is an inflammatory state characterized by an augment in circulating inflammatory factors. Leptin may modulate the synthesis of these factors by white adipose tissue decreasing insulin sensitivity. We have examined the effect of chronic central administration of leptin on circulating levels of cytokines and the possible relationship with cytokine expression and protein content as well as with leptin and insulin signaling in subcutaneous and visceral adipose tissues. In addition, we analyzed the possible correlation between circulating levels of cytokines and peripheral insulin resistance. We studied 18 male Wistar rats divided into controls (C), those treated icv for 14 days with a daily dose of 12 μg of leptin (L) and a pair-fed group (PF) that received the same food amount consumed by the leptin group. Serum leptin and insulin were measured by ELISA, mRNA levels of interferon-γ (IFN-γ), interleukin-2 (IL-2), IL-4, IL-6, IL-10 and tumor necrosis factor-α (TNF-α) by real time PCR and serum and adipose tissue levels of these cytokines by multiplexed bead immunoassay. Serum leptin, IL-2, IL-4, IFN-γ and HOMA-IR were increased in L and TNF-α was decreased in PF and L. Serum leptin and IL-2 levels correlate positively with HOMA-IR index and negatively with serum glucose levels during an ip insulin tolerance test. In L, an increase in mRNA levels of IL-2 was found in both adipose depots and IFN-γ only in visceral tissue. Activation of leptin signaling was increased and insulin signaling decreased in subcutaneous fat of L. In conclusion, leptin mediates the production of inflammatory cytokines by adipose tissue independent of its effects on food intake, decreasing insulin sensitivity. PMID:23056516

  10. Adipose tissue promotes a serum cytokine profile related to lower insulin sensitivity after chronic central leptin infusion.

    Science.gov (United States)

    Burgos-Ramos, Emma; Canelles, Sandra; Perianes-Cachero, Arancha; Arilla-Ferreiro, Eduardo; Argente, Jesús; Barrios, Vicente

    2012-01-01

    Obesity is an inflammatory state characterized by an augment in circulating inflammatory factors. Leptin may modulate the synthesis of these factors by white adipose tissue decreasing insulin sensitivity. We have examined the effect of chronic central administration of leptin on circulating levels of cytokines and the possible relationship with cytokine expression and protein content as well as with leptin and insulin signaling in subcutaneous and visceral adipose tissues. In addition, we analyzed the possible correlation between circulating levels of cytokines and peripheral insulin resistance. We studied 18 male Wistar rats divided into controls (C), those treated icv for 14 days with a daily dose of 12 μg of leptin (L) and a pair-fed group (PF) that received the same food amount consumed by the leptin group. Serum leptin and insulin were measured by ELISA, mRNA levels of interferon-γ (IFN-γ), interleukin-2 (IL-2), IL-4, IL-6, IL-10 and tumor necrosis factor-α (TNF-α) by real time PCR and serum and adipose tissue levels of these cytokines by multiplexed bead immunoassay. Serum leptin, IL-2, IL-4, IFN-γ and HOMA-IR were increased in L and TNF-α was decreased in PF and L. Serum leptin and IL-2 levels correlate positively with HOMA-IR index and negatively with serum glucose levels during an ip insulin tolerance test. In L, an increase in mRNA levels of IL-2 was found in both adipose depots and IFN-γ only in visceral tissue. Activation of leptin signaling was increased and insulin signaling decreased in subcutaneous fat of L. In conclusion, leptin mediates the production of inflammatory cytokines by adipose tissue independent of its effects on food intake, decreasing insulin sensitivity.

  11. Intravenous Glucose Acutely Stimulates Intestinal Lipoprotein Secretion in Healthy Humans.

    Science.gov (United States)

    Xiao, Changting; Dash, Satya; Morgantini, Cecilia; Lewis, Gary F

    2016-07-01

    Increased production of intestinal triglyceride-rich lipoproteins (TRLs) contributes to dyslipidemia and increased risk of atherosclerotic cardiovascular disease in insulin resistance and type 2 diabetes. We have previously demonstrated that enteral glucose enhances lipid-stimulated intestinal lipoprotein particle secretion. Here, we assessed whether glucose delivered systemically by intravenous infusion also enhances intestinal lipoprotein particle secretion in humans. On 2 occasions, 4 to 6 weeks apart and in random order, 10 healthy men received a constant 15-hour intravenous infusion of either 20% glucose to induce hyperglycemia or normal saline as control. Production of TRL-apolipoprotein B48 (apoB48, primary outcomes) and apoB100 (secondary outcomes) was assessed during hourly liquid-mixed macronutrient formula ingestion with stable isotope enrichment and multicompartmental modeling, under pancreatic clamp conditions to limit perturbations in pancreatic hormones (insulin and glucagon) and growth hormone. Compared with saline infusion, glucose infusion induced both hyperglycemia and hyperinsulinemia, increased plasma triglyceride levels, and increased TRL-apoB48 concentration and production rate (Plipoprotein production. Hyperglycemia may contribute to intestinal lipoprotein overproduction in type 2 diabetes. URL: http://www.clinicaltrials.gov. Unique identifier: NCT02607839. © 2016 American Heart Association, Inc.

  12. 静脉用胺碘酮致急性严重肝损害七例分析%Clinical analysis of seven cases of acute severe hepatic injury induced by intravenous infusion with amiodarone

    Institute of Scientific and Technical Information of China (English)

    衣桂燕; 张彩云; 张萱; 彦青

    2013-01-01

    目的 探讨短时(12 h内)静脉滴注胺碘酮致急性严重肝功能损害的临床特点.方法 收集我院2000年1月至2011年12月12 h内静脉用胺碘酮患者908例的临床表现进行回顾性分析.结果 908例患者中发生急性严重肝损害者7例,发生率为0.8%,病毒性肝炎指标均未见异常.静脉使用胺碘酮时间为1.0~10.0 h,平均使用时间(6±4)h;胺碘酮使用总剂量为210± 1150 mg,平均(733±312)mg.静脉使用胺碘酮前有5例患者肝功能正常,2例轻度升高,ALT为15 ~ 78 U/L,平均(39±21) U/L,AST为22~ 65 U/L,平均(37±15)U/L.用胺碘酮后次日ALT为820~ 4845 U/L,平均(2604±1295) U/L,AST为758~3962U/L,平均(2069±1091) U/L.肝功能恢复时间为7~15 d,平均(10±3)d.肝功能恢复后继续随访至少3个月,未再出现肝损害.结论 短时静脉滴注胺碘酮可导致急性严重肝损害,其发生较早,及时停用胺碘酮后可较快恢复.在静脉用胺碘酮过程中应监测肝功能,尽量避免或及时治疗肝损害.%Objective To analyze the clinical feature and possible mechanism of acute severe hepatic injury induced by intravenous infusion with amiodarone within 12 hours.Methods The clinical diagnoses,medication and characteristics of hepatic injury induced by intravenous infusion with amiodarone within 12 hours were analyzed in 908 cases from 2000 to 2011.Results There were 7 cases of acute severe hepatic injury in 908 cases of intravenous infusion with amiodarone(the rate of 0.8%).The average time of intravenous infusion with amiodarone was (6 ± 4) h.The average accumulated dosage of amiodarone was (733 ± 312) mg,ranging from 210 mg to 1150 mg.The peak of alanine aminotransferase(ALT) was (2604 ± 1295) U/L,ranging from 820 U/L to 4845 U/L,and the aspartate aminotransferase (AST) was (2069 ± 1091) U/L,ranging from 758 U/L to 3962 U/L.The liver enzyme levels returned to baseline values within (10 ± 3)d after hepatoprotection therapy,ranging from 7 d to

  13. Effects of different free fatty acids on insulin resistance in rats

    Institute of Scientific and Technical Information of China (English)

    Ping Han; Yong-Yan Zhang; Yan Lu; Bing He; Wei Zhang; Fei Xia

    2008-01-01

    BACKGROUND:Much evidence demonstrates that elevated free fatty acids (FFAs) are associated with insulin resistance. However, it is not clear whether different FFAs can cause different degrees of peripheral insulin resistance. This study aimed to investigate the effects of short-term elevation of FFAs on hepatic and peripheral insulin action, and determine whether FFAs with different degrees of saturation have differential effects on hepatic insulin resistance. METHODS:Intralipid+heparin (IH, polyunsaturated fatty acids), oleate (OLE), lard oil+heparin (LOH), and saline (SAL) were separately infused intravenously for 7 hours in normal Wistar rats. During the last 2 hours of the fat/saline infusion, a hyperinsulinemic-euglycemic clamping was performed with [6-3H] glucose tracer. Plasma glucose was measured using the glucose oxygenase method. Plasma insulin and C-peptide were determined by radioimmunoassays. Plasma FFAs were measured using a colorimetric method. RESULTS:Compared with infusion of SAL, plasma FFA levels were signiifcantly elevated by infusions of IH, OLE, and LOH (P CONCLUSIONS:Short-term elevation of FFAs can induce hepatic and peripheral insulin resistance. Polyunsaturated fatty acids induced less hepatic insulin resistance than monounsaturated or saturated fatty acids. However, IH, OLE, and LOH infusions induced similar peripheral insulin resistance.

  14. To investigate the impact facots of dose of drug in intravenous infusion for decision-making%浅析静脉用药过程中影响药物剂量的护理因素及对策

    Institute of Scientific and Technical Information of China (English)

    卢桂华

    2012-01-01

    Objective To investigate the impact facots of dose of drug in intravenous infusion for decision-making. Methods 80 cases used of piperacillin tazobactam were randomly divided into control and experimental groups, using double-blind study, collection residual liquid of the original bottles and infusion tube, calculating drug dose, with daily infusion process in the control group, while strict intervention infusion process in experimental group. Average of drug residues between two groups with t-test. Results In control group, piperacillin tazobactam sodium content of the residual liquid average was(0. 9256 ± 0. 1189) g; experimental group ( 0. 2654 ± 0. 0398 ) g, P = 0. 000, the difference was statistically significant. Conclusion In intravenous drug preparation and the infusion process, strict rules of the nurses to reduce the residual liquid of drug.%目的 探讨静脉治疗过程中影响药物剂量的护理因素及对策.方法 80例输注哌拉西林钠他唑巴坦钠患者随机分为对照组和实验组,并采用双盲研究,收集原药瓶和输液器中的残留液计算残留药物剂量,对照组为护士日常输液流程,实验组为研究人员严格干预下输液流程.两组残留药物平均数进行t检验.结果 对照组残余药液平均含量为(0.9256±0.1189)g;实验组为(0.2654±0.0398)g(P=0.000),差异有统计学意义.结论 静脉药物配制及输液过程中,护理人员严格操作规程,可减少药液的残留.

  15. Intravenous lipid and heparin infusion-induced elevation in free fatty acids and triglycerides modifies circulating androgen levels in women: a randomized, controlled trial.

    Science.gov (United States)

    Mai, K; Bobbert, T; Reinecke, F; Andres, J; Maser-Gluth, C; Wudy, S A; Möhlig, M; Weickert, M O; Hartmann, M F; Schulte, H M; Diederich, S; Pfeiffer, A F H; Spranger, J

    2008-10-01

    The polycystic ovarian syndrome (PCOS) is characterized by hyperandrogenism and associated with obesity and impaired glucose metabolism. Despite the high prevalence of PCOS and the considerable clinical impact, the precise interplay between metabolism and hyperandrogenemia is not entirely clear. The objective of the study was to analyze the effects of iv lipid and heparin infusion on circulating androgen levels in healthy women. This was a randomized, controlled, crossover trial. The study was conducted at an endocrinology center. Patients included 12 healthy young women during the early follicular phase of two subsequent cycles. After an overnight fast, a 20% lipid/heparin or a saline/heparin infusion was administered in random order for 330 min. A detailed characterization of androgen metabolism was performed. Elevations in free fatty acids and triglycerides, induced by lipid/heparin infusion, elevates the levels of androstenedione, dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulfate (DHEAS), testosterone, 5alpha-dihydrotestosterone, estrone, and 17beta-estradiol. Urinary excretion of DHEA, DHEAS, 5-androstene-3beta,17beta-diol, and the sum of urinary excreted DHEA and its 16-hydroxylated downstream metabolites, 16alpha-hydroxy-DHEA and 5-androstene-3beta,16alpha,17beta-triol, were reduced. The mechanism of iv lipid and heparin infusion-induced elevation of circulating androgens described here might contribute to the development of hyperandrogenism in women with PCOS and suggests that lowering of hyperlipidemia might be a potential therapeutic target in patients with PCOS to treat hyperandrogenemia.

  16. Assessment of use of specific features of subcutaneous insulin infusion systems and their relationship to metabolic control in patients with type 1 diabetes.

    Science.gov (United States)

    Quirós, Carmen; Patrascioiu, Ioana; Giménez, Marga; Vinagre, Irene; Vidal, Mercè; Jansà, Margarita; Conget, Ignacio

    2014-01-01

    Patients with type 1 diabetes (T1DM) treated with continuous subcutaneous insulin infusion (CSII) have available several specific features of these devices. The aim of this study was to evaluate the relationship between real use of them and the degree of glycemic control in patients using this therapy. Forty-four T1DM patients on CSII therapy with or without real-time continuous glucose monitoring (CGM) were included. Data from 14 consecutive days were retrospectively collected using the therapy management software CareLink Personal/Pro(®) and HbA1c measurement performed at that period. The relationship between the frequency of usie of specific features of insulin pumps (non-sensor augmented or sensor-augmented) and glycemic control was analyzed. Mean HbA1c in the group was 7.5 ± .8%. Mean daily number of boluses administered was 5.1 ± 1.8, with 75.4% of them being bolus wizards (BW). Daily number of boluses was significantly greater in patients with HbA1c 7.5% (5.3 ± 1.6 vs. 4.3 ± 1.6, P=.056). There was a trend to greater use of BW in patients with better control (82.8 ± 21.4% vs. 69.9 ± 29.1%, P=.106). HbA1c was lower in patients using CGM (n=8) as compared to those not using sensor-augmented pumps (7.6 ± .8 vs 7.1 ± .7, P=.067), but the difference was not statistically significant. More frequent use of BW appears to be associated to better metabolic control in patients with T1DM using pump therapy. In standard clinical practice, augmentation of insulin pump with CGM may be associated to improved glycemic control. Copyright © 2013 SEEN. Published by Elsevier Espana. All rights reserved.

  17. Budget impact of continuous subcutaneous insulin infusion therapy in patients with type 1 diabetes who experience severe recurrent hypoglycemic episodes in Spain.

    Science.gov (United States)

    Giménez, Marga; Elías, Isabel; Álvarez, María; Quirós, Carmen; Conget, Ignacio

    Hypoglycemia is one of the most common complications to achieve a good metabolic control, and has been listed by several scientific associations as a common indication to start treatment with continuous subcutaneous insulin infusion (CSII). Use of CSII is still residual in Spain as compared to neighbouring countries, and cost of acquisition cost is one of the main reasons. This study estimates the budget impact of treatment with CSII, as compared to multiple daily insulin injections, of patients with type 1 diabetes mellitus who experience recurrent severe hypoglycemia episodes from the National Healthcare System perspective. Budget impact was based on a retrospective, observational study evaluating the efficacy of CSII in patients with type 1 diabetes mellitus conducted at Hospital Clínic i Universitari in Barcelona, where one of the main indications for switching to CSII were recurrent severe hypoglycemia episodes. The mean number of annual episodes was 1.33 in the two years prior to CSII start and 0.08 in the last two years of follow up (p=0.003). Costs of treatment and major hypoglycemic events over a four-year period were considered. Costs were taken from different Spanish data sources and expressed in € of 2016. Treatment with CSII increased costs by €9,509 per patient as compared to multiple daily insulin injections (€11,902-€2,393). Cost associated to severe hypoglycemic events decreased by €19,330 per patient treated with CSIII (€1,371-€20,701). Results suggest mean total savings of €9,821 per patient during the four-year study period. The higher costs associated to CSII therapy may be totally offset by the severe hypoglycemic events prevented. Copyright © 2017 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.

  18. Safety and efficacy of subcutaneous and continuous intravenous infusion of rIL-2 in patients with metastatic renal cell carcinoma

    DEFF Research Database (Denmark)

    Geertsen, P.F.; Gore, M.E.; Negrier, S.

    2004-01-01

    A retrospective analysis was conducted on data from four open-label, nonrandomised, phase II trials of recombinant interleukin-2 (rIL-2) in patients with metastatic renal cell carcinoma to compare the safety and efficacy of administration by subcutaneous (s.c.) and continuous intravenous (c.i.v.)...

  19. Ghrelin enhances glucose-induced insulin secretion in scheduled meal-fed sheep.

    Science.gov (United States)

    Takahashi, H; Kurose, Y; Kobayashi, S; Sugino, T; Kojima, M; Kangawa, K; Hasegawa, Y; Terashima, Y

    2006-04-01

    The purpose of this study was to investigate the effects of physiologic levels of ghrelin on insulin secretion and insulin sensitivity (glucose disposal) in scheduled fed-sheep, using the hyperglycemic clamp and hyperinsulinemic euglycemic clamp respectively. Twelve castrated Suffolk rams (69.8 +/- 0.6 kg) were conditioned to be fed alfalfa hay cubes (2% of body weight) once a day. Three hours after the feeding, synthetic ovine ghrelin was intravenously administered to the animals at a rate of 0.025 and 0.05 mug/kg body weight (BW) per min for 3 h. Concomitantly, the hyperglycemic clamp or the hyperinsulinemic euglycemic clamp was carried out. In the hyperglycemic clamp, a target glucose concentration was clamped at 100 mg/100 ml above the initial level. In the hyperinsulinemic euglycemic clamp, insulin was intravenously administered to the animals for 3 h at a rate of 2 mU/kg BW per min. Basal glucose concentrations (44+/- 1 mg/dl) were maintained by variably infusing 100 mg/dl glucose solution. In both clamps, plasma ghrelin concentrations were dose-dependently elevated and maintained at a constant level within the physiologic range. Ghrelin infusions induced a significant (ANOVA; P ghrelin-infused animals. In the hyperinsulinemic euglycemic clamp, glucose infusion rate, an index of insulin sensitivity, was not affected by ghrelin infusion. In conclusion, the present study has demonstrated for the first time that ghrelin enhances glucose-induced insulin secretion in the ruminant animal.

  20. Infusion of glucose and lipids at physiological rates causes acute endoplasmic reticulum stress in rat liver.

    Science.gov (United States)

    Boden, Guenther; Song, Weiwei; Duan, Xunbao; Cheung, Peter; Kresge, Karen; Barrero, Carlos; Merali, Salim

    2011-07-01

    Endoplasmic reticulum (ER) stress has recently been implicated as a cause for obesity-related insulin resistance; however, what causes ER stress in obesity has remained uncertain. Here, we have tested the hypothesis that macronutrients can cause acute (ER) stress in rat liver. Examined were the effects of intravenously infused glucose and/or lipids on proximal ER stress sensor activation (PERK, eIF2-α, ATF4, Xbox protein 1 (XBP1s)), unfolded protein response (UPR) proteins (GRP78, calnexin, calreticulin, protein disulphide isomerase (PDI), stress kinases (JNK, p38 MAPK) and insulin signaling (insulin/receptor substrate (IRS) 1/2 associated phosphoinositol-3-kinase (PI3K)) in rat liver. Glucose and/or lipid infusions, ranging from 23.8 to 69.5 kJ/4 h (equivalent to between ~17% and ~50% of normal daily energy intake), activated the proximal ER stress sensor PERK and ATF6 increased the protein abundance of calnexin, calreticulin and PDI and increased two GRP78 isoforms. Glucose and glucose plus lipid infusions induced comparable degrees of ER stress, but only infusions containing lipid activated stress kinases (JNK and p38 MAPK) and inhibited insulin signaling (PI3K). In summary, physiologic amounts of both glucose and lipids acutely increased ER stress in livers 12-h fasted rats and dependent on the presence of fat, caused insulin resistance. We conclude that this type of acute ER stress is likely to occur during normal daily nutrient intake.

  1. Aprotinin induced lipohypertrophy and glomerulonephritis in an insulin dependent diabetic.

    Science.gov (United States)

    Dandona, P; Mier, A; Boag, F; Chappell, M; Beckett, A G

    1985-07-01

    In an insulin dependent diabetic who was hyperglycaemic and ketotic despite 3,000 u of insulin injected subcutaneously in 2 divided doses daily, 50 u of intravenous insulin infused over 24 hr restored normal glucose homeostasis. A combination of insulin (800 u) and aprotinin (10,000 u) given twice daily also produced adequate glucose homeostasis for a period of 12 months. The patient then developed local hypertrophy of subcutaneous tissue at the injection site and her diabetic control deteriorated. Non-selective proteinuria followed and she developed nephrotic syndrome. Renal biopsy revealed a membraneous glomerulonephritis with subepithelial immune complexes, appearances consistent with a drug-induced glomerulonephritis. Withdrawal of aprotinin led to a gradual remission of nephrotic syndrome and proteinuria over several months. During this period, her diabetes was well controlled with continuous subcutaneous infusion of insulin at a dose of 500 u/24 hr. This case report demonstrates: the effective use of aprotinin for prolonged periods in insulin dependent diabetics with abnormal absorption of subcutaneously injected insulin; aprotinin induced lipohypertrophy which was not observed when insulin was injected alone; aprotinin-associated glomerulonephritis and nephrotic syndrome; the effective use of CSII--at higher insulin doses--in such patients with subcutaneous malabsorption of insulin.

  2. Bomba de infusão de insulina em diabetes melito tipo 1 Insulin pump therapy in type 1 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Raphael Del Roio Liberatore Jr.

    2006-08-01

    Full Text Available OBJETIVO: Rever a experiência com a utilização da bomba de infusão de insulina em crianças e adolescentes, a fim de orientar o pediatra quanto às suas indicações e complicações. FONTE DOS DADOS : Foi realizada revisão sistemática de artigos publicados em literatura que abordassem a utilização da bomba de infusão de insulina, suas indicações, complicações e resposta ao tratamento. Dessa forma, todos os artigos publicados entre 1995 e 2005 foram resgatados através do levantamento em banco de dados MEDLINE e LILACS. As palavras-chave utilizadas foram: insulin pumps, type 1 diabetes mellitus e diabetes mellitus. Foram separados os artigos que, além disso, versassem sobre o assunto na faixa etária descrita SÍNTESE DOS DADOS: O uso da bomba de infusão de insulina em pacientes com diabetes melito tipo 1 não é uma necessidade para todos os pacientes, visto que, com tratamentos intensivos, os resultados conseguidos são muito parecidos, em termos de hemoglobina glicada e de controle de complicações a médio e longo prazo. No entanto, a bomba permite um maior conforto ao paciente, no sentido de que ele não precisa ficar tão restrito a horários rígidos de refeição e pode levar uma vida com melhor qualidade. Um primeiro requisito para quem pretenda usar a bomba é adaptar-se a aparelhos conectados ao corpo e a ter uma rotina de monitorização glicêmica rigorosa, pois, sem isso, as vantagens da bomba serão anuladas. As complicações, com os avanços tecnológicos de que dispomos atualmente, são muito infreqüentes. O custo, no entanto, é maior que nos tratamentos convencionais. CONCLUSÃO: Com a evolução das bombas de infusão e dos monitores de glicemia, incluindo sistemas de monitorização contínua, abre-se caminho para as "bombas inteligentes", e estaremos com um verdadeiro "pâncreas artificial", que pode mesmo ser implantado no paciente, permitindo uma vida com todas as regalias de uma pessoa não diab

  3. Intravenous iron isomaltoside 1000 administered by high single-dose infusions or standard medical care for the treatment of fatigue in women after postpartum haemorrhage

    DEFF Research Database (Denmark)

    Holm, Charlotte; Thomsen, Lars Lykke; Norgaard, Astrid

    2015-01-01

    BACKGROUND: Postpartum haemorrhage can lead to iron deficiency with and without anaemia, the clinical consequences of which include physical fatigue. Although oral iron is the standard treatment, it is often associated with gastrointestinal side effects and poor compliance. To date, no published...... randomised controlled studies have compared the clinical efficacy and safety of standard medical care with intravenous administration of iron supplementation after postpartum haemorrhage.The primary objective of this study is to compare the efficacy of an intravenous high single-dose of iron isomaltoside...... 1000 with standard medical care on physical fatigue in women with postpartum haemorrhage. METHODS/DESIGN: In a single centre, open-labelled, randomised trial, women with postpartum haemorrhage exceeding 700 mL will be allocated to either a single dose of 1,200 mg of iron isomaltoside 1000 or standard...

  4. Qualitative Research of the Compliance of Hand Hygiene for Nurses in Intravenous Infusion Process%静脉输液护士手卫生依从性的质性研究

    Institute of Scientific and Technical Information of China (English)

    毕娜; 王建荣; 蔡永琴

    2013-01-01

    Objective To analyze the influencing factors of hand hygiene compliance for nurses performing intravenous infusion by qualitative research, so as to provide evidence for making health management decisions. Methods By convenience sampling method, totally 10 registered female nurses were enrolled into this research from three hospitals in Beijing. With good qualification of performing intravenous infusion, all of the nurses can complete the "Six Steps of Hand Washing" accurately and all worked in clinical front-line care. Date were collected by face-to-face semi-structure interviews and subjects were formed by continuous comparing and classifying. Results The influencing factors of hand hygiene compliance for nurses implementing intravenous infusion included three major themes and eight sub-themes. Subjective factors included conformity, self-protection, and fluky mind. The factors of hand-washing facilities and materials included comfort, convenience and accessibility; The factors of job include the time factor and action items. Conclusion Reforming hand hygiene training content, improving the status of hand hygiene facilities and hand hygiene monitoring methods can improve the hand hygiene compliance for nurses in intravenous infusion process.%目的 深入探讨影响静脉输液护士手卫生依从性的原因,为卫生管理决策提供依据.方法 采用目的抽样法选取北京市3所三级甲等医院的注册护士10名,均为女性,目前从事临床一线护理工作,具备静脉输液操作资质,现场考核均能准确完成手卫生"六步洗手法".通过半结构式深度访谈法收集资料,采用持续比较的方式对资料进行比较、归类,形成主题.结果 静脉输液护士手卫生依从性的影响因素包括3个一级主题、8个次主题.护士主观因素包括从众心理、自我保护和侥幸心理;洗手设施和物品因素包括舒适度、便捷性和可及性;工作因素包括时间因素和情境因素.结论 改

  5. Effects of acute exposure to increased plasma branched-chain amino acid concentrations on insulin-mediated plasma glucose turnover in healthy young subjects.

    Directory of Open Access Journals (Sweden)

    Sarah Everman

    Full Text Available Plasma branched-chain amino acids (BCAA are inversely related to insulin sensitivity of glucose metabolism in humans. However, currently, it is not known whether there is a cause-and-effect relationship between increased plasma BCAA concentrations and decreased insulin sensitivity.To determine the effects of acute exposure to increased plasma BCAA concentrations on insulin-mediated plasma glucose turnover in humans.Ten healthy subjects were randomly assigned to an experiment where insulin was infused at 40 mU/m2/min (40U during the second half of a 6-hour intravenous infusion of a BCAA mixture (i.e., BCAA; N = 5 to stimulate plasma glucose turnover or under the same conditions without BCAA infusion (Control; N = 5. In a separate experiment, seven healthy subjects were randomly assigned to receive insulin infusion at 80 mU/m2/min (80U in association with the above BCAA infusion (N = 4 or under the same conditions without BCAA infusion (N = 3. Plasma glucose turnover was measured prior to and during insulin infusion.Insulin infusion completely suppressed the endogenous glucose production (EGP across all groups. The percent suppression of EGP was not different between Control and BCAA in either the 40U or 80U experiments (P > 0.05. Insulin infusion stimulated whole-body glucose disposal rate (GDR across all groups. However, the increase (% in GDR was not different [median (1st quartile - 3rd quartile] between Control and BCAA in either the 40U ([199 (167-278 vs. 186 (94-308] or 80 U ([491 (414-548 vs. 478 (409-857] experiments (P > 0.05. Likewise, insulin stimulated the glucose metabolic clearance in all experiments (P 0.05.Short-term exposure of young healthy subjects to increased plasma BCAA concentrations does not alter the insulin sensitivity of glucose metabolism.

  6. A QUASI EXPERIMENTAL STUDY TO EVALUATE EFFECTIVENESS OF GLYCERIN MAGNESIUM SULPHATE DRESSING ON PHLEBITIS AMONG PATIENTS UNDERGOING PERIPHERAL INTRAVENOUS INFUSION IN SELECTED HOSPITAL,VADODARA

    Directory of Open Access Journals (Sweden)

    Ravindra HN, Patel Krupa D

    2015-07-01

    Full Text Available Introduction: Intravenous therapy is indicated for many reasons. A significant number of patients admitted into hospital receive some forms of intravenous therapy through peripheral venous cannula, which is a common procedure carried out in hospital to allow rapid and accurate administration of medication. However, the intravenous cannulation can have undesirable effects, the most of which is phlebitis, which is due to mechanical, chemical or infectious cause. Method: In this study quasi-experimental research approach was used. Non probability purposive sampling technique was used to select the sample from the selected hospital. The research design adopted for the study was pre-test, post-test control group design. In the present study a sample of 60 hospitalised patients and who met the inclusion criteria was selected from the target population. In this study the instruments used are baseline Performa, structured interview schedule to assess the subjective symptoms and observation scale to observe the objective symptoms. Result: In experimental group post test mean score 1.10, SD was 0.71 respectively. In control group post test mean score 2.53, SD was 0.78 respectively. The obtained value 7.454 statistically was significant at 0.001 levels. So research hypothesis was accepted. So there was significant difference between post intervention phlebitis among the experimental group and control group. Discussion: In the research study findings revealed that Glycerin Magnesium sulphate dressing is highly effective in decrease phlebitis level to the patients.

  7. Area under the curve predictions of dalbavancin, a new lipoglycopeptide agent, using the end of intravenous infusion concentration data point by regression analyses such as linear, log-linear and power models.

    Science.gov (United States)

    Bhamidipati, Ravi Kanth; Syed, Muzeeb; Mullangi, Ramesh; Srinivas, Nuggehally

    2017-03-14

    1. Dalbavancin, a lipoglycopeptide, is approved for treating gram-positive bacterial infections. Area under plasma concentration versus time curve (AUCinf) of dalbavancin is a key parameter and AUCinf/MIC ratio is a critical pharmacodynamic marker. 2. Using end of intravenous infusion concentration (i.e. Cmax) Cmax versus AUCinf relationship for dalbavancin was established by regression analyses (i.e. linear, log-log, log-linear and power models) using 21 pairs of subject data. 3. The predictions of the AUCinf were performed using published Cmax data by application of regression equations. The quotient of observed/predicted values rendered fold difference. The mean absolute error (MAE)/root mean square error (RMSE) and correlation coefficient (r) were used in the assessment. 4. MAE and RMSE values for the various models were comparable. The Cmax versus AUCinf exhibited excellent correlation (r > 0.9488). The internal data evaluation showed narrow confinement (0.84-1.14-fold difference) with a RMSE regression models, a single time point strategy of using Cmax (i.e. end of 30-min infusion) is amenable as a prospective tool for predicting AUCinf of dalbavancin in patients.

  8. Optimization of health-care organization and perceived improvement of patient comfort by switching from intra-venous BU four-times-daily infusions to a once-daily administration scheme in adult hematopoietic stem cell recipients.

    Science.gov (United States)

    Xhaard, A; Rzepecki, P; Valcarcel, D; Santarone, S; Fürst, S; Serrano, D; De Angelis, G; Krüger, W; Scheid, C

    2014-04-01

    Previous studies have shown an equivalent pharmacokinetic profile between four-times-daily (4QD) and once-daily (QD) administration of intra-venous (IV) BU, without increased toxicity. We assess the impact of a switch in IV BU from a 4QD to a QD schedule, in terms of health-care organization, staff working conditions, quality of care dispensed and perceived patient comfort. Clinicians, nurses and pharmacists from nine allogeneic transplantation units in five European countries were interviewed face to face. Overall perception of QD versus 4QD BU was very positive. Both administration schemes were evaluated to be equally efficaciousZ. QD BU was perceived to be safer and more convenient. Clinicians and nurses perceived that patient comfort was improved, due to fewer complications associated with repeated infusions, and avoiding night infusions associated with stress, anxiety and decreased quality of sleep. Switching from 4QD to QD BU had a significant impact on health-care organization, with a better integration in the overall management and usual timelines in the pharmacies and transplantation units. Time spent to prepare and administer BU was significantly reduced, leading to potential financial savings that merit further assessment and would be of particular interest in the current economic climate.

  9. Biodistribution of boron after intravenous 4-dihydroxyborylphenylalanine-fructose (BPA-F) infusion in meningioma and schwannoma patients: A feasibility study for boron neutron capture therapy.

    Science.gov (United States)

    Kulvik, Martti; Kallio, Merja; Laakso, Juha; Vähätalo, Jyrki; Hermans, Raine; Järviluoma, Eija; Paetau, Anders; Rasilainen, Merja; Ruokonen, Inkeri; Seppälä, Matti; Jääskeläinen, Juha

    2015-12-01

    We studied the uptake of boron after 100 mg/kg BPA infusion in three meningioma and five schwannoma patients as a pre-BNCT feasibility study. With average tumour-to-whole blood boron concentrations of 2.5, we discuss why BNCT could, and probably should, be developed to treat severe forms of the studied tumours. However, analysing 72 tumour and 250 blood samples yielded another finding: the plasma-to-whole blood boron concentrations varied with time, suggesting that the assumed constant boron ratio of 1:1 between normal brain tissue and whole blood deserves re-assessment.

  10. Endothelial Cell Toxicity of Vancomycin Infusion Combined with Other Antibiotics

    OpenAIRE

    Drouet, Maryline; Chai, Feng; Barthélémy, Christine; Lebuffe, Gilles; Debaene, Bertrand; Décaudin, Bertrand; Odou, Pascal

    2015-01-01

    French guidelines recommend central intravenous (i.v.) infusion for high concentrations of vancomycin, but peripheral intravenous (p.i.v.) infusion is often preferred in intensive care units. Vancomycin infusion has been implicated in cases of phlebitis, with endothelial toxicity depending on the drug concentration and the duration of the infusion. Vancomycin is frequently infused in combination with other i.v. antibiotics through the same administrative Y site, but the local toxicity of such...

  11. Co-infusion of autologous adipose tissue derived insulin-secreting mesenchymal stem cells and bone marrow derived hematopoietic stem cells: Viable therapy for type III.C. a diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Umang G Thakkar

    2014-12-01

    Full Text Available Transition from acute pancreatitis to insulin-dependent diabetes mellitus (IDDM is a rare manifestation of primary hyperparathyroidism caused by parathyroid adenoma because of impaired glucose tolerance and suppresses insulin secretion. We report the case of a 26-year-old male with pancreatic diabetes caused by parathyroid adenoma induced chronic pancreatitis. He had serum C-peptide 0.12 ng/ml, glutamic acid decarboxylase antibody 5.0 IU/ml, and glycosylated hemoglobin (HbA1C 8.9%, and required 72 IU/day of biphasic-isophane insulin injection for uncontrolled hyperglycemia. We treated him with his own adipose tissue derived insulin-secreting mesenchymal stem-cells (IS-ADMSC along with his bone marrow derived hematopoietic stem cells (BM-HSC. Autologous IS-ADMSC + BM-HSC were infused into subcutaneous tissue, portal and thymic circulation without any conditioning. Over a follow-up of 27 months, the patient is maintaining fasting and postprandial blood sugar levels of 132 and 165 mg/dl, respectively, with HbA1C 6.8% and requiring 36 IU/day of biphasic-isophane insulin. Co-infusion of IS-ADMSC + BM-HSC offers a safe and viable therapy for type III.C.a Diabetes Mellitus.

  12. Intravenous infusion alarm device level signal detection principle%静脉输液报警装置中液位信号的检测原理

    Institute of Scientific and Technical Information of China (English)

    李文静

    2013-01-01

    To reduce the labor intensity of nurses,the burden on the families of patients,to ensure the safety of the infusion,the level detection method using optical,capacitive,ultrasonic,mechanical,images,design an infusion monitoring alarm device changes by monitoring physical quantities.Monitoring liquid level information in real time,then the relevant signal sent to the follow-up alarm circuit,in order to achieve the automatic alarm.Experiments show that the design can be an effective solution liquid level monitoring,alarm display functions.%为减轻护士的劳动强度、患者家属负担、保证输液安全,文中通过采用光电式、电容式、超声、力学、图像等液位检测方法,设计了一种输液监视报警装置.通过监视物理量的变化,以实时监控液位信息,再将相关信号传送到后续报警电路,从而实现自动报警.实验证明,该设计可以有效实现对药液液位的监测、报警、显示等功能.

  13. Application Effect of Nursing Risk Management Measures in Pediatric Scalp Intravenous Infusion%护理风险管理措施在儿童头皮静脉输液中的应用效果分析

    Institute of Scientific and Technical Information of China (English)

    孙连红

    2016-01-01

    目的:探讨护理风险管理措施在儿童头皮静脉输液中的应用效果。方法选择2015年4月~2016年4月我院收治的头皮静脉输液患儿304例,将其平均分为研究组与对照组,各152例。对照组采取常规输液护理干预,研究组在此基础上应用护理风险管理干预。结果研究组反复穿刺率、液体渗出率及针头脱落率分别为3.29%、1.97%、1.97%,均低于对照组的9.87%、7.89%、8.55%(P<0.05)。结论护理风险管理措施在儿童头皮静脉输液中具有显著的应用效果,适于推广。%Objective To study the nursing risk management measures in pediatric scalp intravenous infusion in application effect. Methods 304 cases of scalp intravenous infusion were selected from April 2015 to April 2016 in our hospital, they average were divided into the research group and the control group (n=152). The control group was given regular transfusion nursing intervention, the research group on the basis of the application was given nursing risk management intervention. Results The repeated puncture rate, liquid leakage rate and needle loss rate of the research group were 3.29%, 1.97% and 1.97% respectively, were lower than the control group(9.87%, 7.89%, 8.55%) (P<0.05). Conclusion Nursing risk management measures in the children's scalp intravenous fluids has obvious application effect, suitable for promotion.

  14. Effects of recombinant human insulin-like growth factor I on glomerular dynamics in the rat.

    OpenAIRE

    Hirschberg, R; Kopple, J D; Blantz, R C; Tucker, B J

    1991-01-01

    This study was undertaken to investigate the mechanisms by which an infusion of recombinant human insulin-like growth factor I (rhIGF-I) increases GFR and renal plasma flow (RPF) in rats. Glomerular micropuncture studies were carried out in 14 nonstarved Munich Wistar rats and in 12 rats deprived of food for 60-72 h. Animals were given an intravenous injection and infusion of either rhIGF-I or vehicle. In both nonstarved and starved animals, the IGF-I injection and infusion increased the seru...

  15. Therapy of Acupressure Pointer before Intravenous Infusion in Cephalic Vein Applied Nursing Research%穴位指针疗法在头静脉输液前应用的护理研究

    Institute of Scientific and Technical Information of China (English)

    蒋应玲; 刘倩; 冯珏; 肖艳平; 郭庆; 乔艾春; 邓玲华

    2013-01-01

    Objective To investigate the cephalic vein puncture on hand in three acupressure pointer therapy intervention on the comfortable degree of infusion nursing. Methods In 2010 March to 2012 March in hospitalized patients with standard 160 patients according to the time of admission, were randomLy divided into experimental group and control group, 80 cases in each group. The control group in the"new"basis of nursing science"for the standard, using conventional intravenous infusion method. In experimental group received puncture side hand in three acupressure pointer therapy after routine intravenous infusion, observe two groups of patients in the cephalic vein puncture disposable puncture success rate, pain response and transfusion puncture nursing satisfaction were compared. Results The patients in the experimental group received acupuncture needle therapy, cephalic vein puncture success rate of puncture, disposable transfusion puncture pain reaction and nursing satisfaction compared with the control group had statistical significance (P<0.05). Conclusion The cephalic vein puncture on hand in three acupressure pointer therapy intervention, can significantly reduce the puncture pain, so that patients can cooperate smoothly infusion operation, improve the success rate of puncture and intravenous transfusion of patients satisfaction.%  目的探讨头静脉穿刺前行手三里穴位指针疗法干预对输液护理舒适度的影响.方法将2010年3月至2012年3月住院患者中符合标准的160例患者按照入院时间,随机分成实验组和对照组,每组80例.对照组以《新编护理学基础》为标准,采用常规静脉输液法.实验组在接受穿刺侧手三里穴位指针疗法后按常规静脉输液法,观察两组患者在头静脉穿刺的一次性穿刺成功率、疼痛反应及输液穿刺满意度等进行比较.结果实验组患者在接受穴位指针疗法后,头静脉穿刺的一次性穿刺成功率、疼痛反应及

  16. A multicentre randomized controlled trial of an empowerment-inspired intervention for adolescents starting continuous subcutaneous insulin infusion--a study protocol.

    Science.gov (United States)

    Brorsson, Anna Lena; Leksell, Janeth; Viklund, Gunnel; Lindholm Olinder, Anna

    2013-12-20

    Continuous subcutaneous insulin infusion (CSII) treatment among children with type 1 diabetes is increasing in Sweden. However, studies evaluating glycaemic control in children using CSII show inconsistent results. The distribution of responsibility for diabetes self-management between children and parents is often unclear and needs clarification. There is much published support for continued parental involvement and shared diabetes management during adolescence. Guided Self-Determination (GSD) is an empowerment-based, person-centred, reflection and problem solving method intended to guide the patient to become self-sufficient and develop life skills for managing difficulties in diabetes self-management. This method has been adapted for adolescents and parents as Guided Self-Determination-Young (GSD-Y). This study aims to evaluate the effect of an intervention with GSD-Y in groups of adolescents starting on insulin pumps and their parents on diabetes-related family conflicts, perceived health and quality of life (QoL), and metabolic control. Here, we describe the protocol and plans for study enrollment. This study is designed as a randomized, controlled, prospective, multicentre study. Eighty patients between 12-18 years of age who are planning to start CSII will be included. All adolescents and their parents will receive standard insulin pump training. The education intervention will be conducted when CSII is to be started and at four appointments in the first 4 months after starting CSII. The primary outcome is haemoglobin A1c levels. Secondary outcomes are perceived health and QoL, frequency of blood glucose self-monitoring and bolus doses, and usage of carbohydrate counting. The following instruments will be used: Disabkids, 'Check your health', the Diabetes Family Conflict Scale and the Swedish Diabetes Empowerment Scale. Outcomes will be evaluated within and between groups by comparing data at baseline, and at 6 and 12 months after starting treatment. In this

  17. Inhibition of thromboxane synthesis attenuates insulin hypertension in rats.

    Science.gov (United States)

    Keen, H L; Brands, M W; Smith, M J; Shek, E W; Hall, J E

    1997-10-01

    Chronic insulin infusion in rats increases mean arterial pressure (MAP) and reduces glomerular filtration rate (GFR), but the mechanisms for these actions are not known. This study tested whether thromboxane synthesis inhibition (TSI) would attenuate the renal and blood pressure responses to sustained hyperinsulinemia. Male Sprague-Dawley rats were instrumented with arterial and venous catheters, and MAP was measured 24 h/day. After 4 days of baseline measurements, endogenous synthesis of thromboxane was suppressed in 7 rats by infusing the thromboxane synthetase inhibitor, U63557A, intravenously (30 microg/kg/min) for the remainder of the experiment; 7 other rats received vehicle. Baseline MAP was not significantly different between vehicle and TSI rats (96 +/- 1 v 99 +/- 1 mm Hg). After 3 days of U63557A or vehicle, a 5-day control period was started, followed by a 7-day infusion of insulin (1.5 mU/kg/min, intravenously). Glucose (22 mg/kg/min, intravenously) was infused along with insulin to prevent hypoglycemia. In the control period, MAP was not different between vehicle and TSI rats (99 +/- 2 v 100 +/- 1 mm Hg), but MAP increased throughout the 7-day infusion period only in the vehicle rats with an average increase in blood pressure of 7 +/- 2 mm Hg. In the control period, GFR was lower in vehicle rats compared with TSI rats (2.5 +/- 0.1 v 3.1 +/- 0.2 mL/min, P = .06), and the decrease to 81% +/- 4% and 91% +/- 6% of control, respectively, during insulin was significant only in the vehicle rats. All variables returned toward control during a 6-day recovery period. These results suggest that full expression of hypertension and renal vasoconstriction during hyperinsulinemia in rats is dependent on a normal ability to synthesize thromboxane.

  18. Epidemiological characterization of diabetic patients on therapy with continuous subcutaneous insulin infusion and continuous glucose monitoring in real time.

    Science.gov (United States)

    Aristizábal, Natalia; Ramírez, Alex; Hincapié-García, Jaime; Laiton, Estefany; Aristizábal, Carolina; Cuesta, Diana; Monsalve, Claudia; Hincapié, Gloria; Zapata, Eliana; Abad, Verónica; Delgado, Maria-Rocio; Torres, José-Luis; Palacio, Andrés; Botero, José

    2015-11-01

    To describe baseline characteristics of diabetic patients who were started on insulin pump and real time continuous glucose monitor (CSII-rtCGM) in a specialized center in Medellin, Colombia. All patients with diabetes with complete data who were started on CSII-rtCGM between February 2010 and May 2014 were included. This is a descriptive analysis of the sociodemographic and clinical characteristics. 141 of 174 patients attending the clinic were included. 90,1% had type 1diabetes (T1D). The average age of T1D patients at the beginning of therapy was 31,4 years (SD 14,1). 75.8% of patients had normal weight (BMI30). The median duration of T1D was 13 years (P25-P75=10.7-22.0). 14,2% of the patients were admitted at least once in the year preceding the start of CSII-rtCGM because of diabetes related complications. Mean A1c was 8.6%±1.46%. The main reasons for starting CSII-rtCGM were: poor glycemic control (50.2%); frequent hypoglycemia, nocturnal hypoglycemia, hypoglycemia related to exercise, asymptomatic hypoglycemia (30.2%); severe hypoglycemia (16.44%) and dawn phenomena (3.1%). Baseline characteristics of patients included in this study who were started on CSII-rtCGM are similar to those reported in the literature. The Clinic starts CSII-rtCGM mainly in T1D patients with poor glycemic control, frequent or severe hypoglycemia despite being on basal/bolus therapy. Copyright © 2015 SEEN. Published by Elsevier España, S.L.U. All rights reserved.

  19. Application and effect of ISO9001 quality certification in quality management of intravenous infusion%ISO9001质量认证在静脉输液质量管理中的应用及效果

    Institute of Scientific and Technical Information of China (English)

    蒋梅; 易东

    2013-01-01

    目的 探讨ISO9001质量管理在静脉输液患者中的应用及效果.方法 选择2010年9月~2012年10月在重庆市红十字会医院(江北区人民医院)住院治疗的200例静脉输液患者为研究对象,根据有无实施ISO9001质量管理分为A组和B组,A组患者仅给予常规管理,而B组患者则接受ISO9001质量管理模式指导下的干预措施,比较两组患者静脉输液不良事件发生率、基础护理合格率和患者对护理服务的满意度.结果 B组患者不良事件发生率明显低于A组,差异均有统计学意义(均P < 0.05);B组患者的护理质量和患者对护理服务的满意度均明显高于A组,差异均有统计学意义(均P < 0.05).结论 ISO9001质量管理能减少静脉输液不良事件的发生,有效提高静脉输液护理质量和患者对静脉输液护理服务的满意度,值得推广应用.%Objective To investigate the application and effect of ISO9001 quality certification in patients with intravenous infusion. Methods 200 patients treated with intravenous infusion in red cross hospital in Chongqing City (People's Hospital of Jiangbei District) from September 2010 to October 2012 were collected. Then the patients were divided into group A and group B according to providing ISO9001 quality management or not. Patients in group A were given routine management, patients in group B were given specific intervention measures under the theory of ISO9001 quality management. The incidence of adverse events, basic nursing qualified rate and patients' satisfaction for the nursing service were evaluated. Results The incidence of adverse events in group B was all lower than that in group A (all P < 0.05); but the basic nursing qualified rate and the patients' satisfaction for nursing service in group B were all higher than those in group A (all P < 0.05). Conclusion ISO9001 quality management can obviously reduce the adverse events of intravenous infusion in patients, and improve the basic nursing

  20. Practice of teachers' care about nursing students during intravenous infusion training%静脉输液实训中教师对护生关怀的实践

    Institute of Scientific and Technical Information of China (English)

    李晓环; 卢建文; 张新宇

    2011-01-01

    Objective To observe the impact of teachers' care about nursing students during intravenous infusion training,and to probe into the feasibility of integrating caring education into teaching. Methods Nursing students of four classes from a junior college were randomly divided into an observation group (n=56) and a control group (n = 60). For students in the control group, teachers routinely demonstrated the intravenous infusion procedure. For students in the observation group, teachers practiced caring behaviors to them besides the demonstration of the routine procedure: teachers conducted investigation to comprehend students' cognition about the training, they respected students' choice, embraced their psychological reaction, helped students adjust their anxiety, and provided emotional support. Results The proportion of students who voluntarily acted as puncture recipients, the rate of successful first puncture, and proportion of students who embarked on the journey of a second puncture after a failure in the observation group were significantly higher than those in the control group (P<0. 05 for all). Students in the observation group more actively employed humanistic caring during the training, and their emotional reaction about the procedure were better than the control group. Conclusion The practice of teachers integrating caring into intravenous infusion training helps students better comprehend the caring theory. Teachers should practice caring behaviors as much as possible so as to provide students with more opportunities of feeling the unreserved support and giving concern of humanity.%目的 观察教师在静脉输液实训中给护生实施关怀的效果,探讨在教学中渗透关怀教育的可行性.方法 在实训前将4个班的高职护生分成两组,对照组(60人)行常规操作指导,观察组(56人)在常规操作讲解基础上实施关怀,包括了解护生对实训的认知,尊重护生选择,接纳心理反应,调

  1. 静脉输注活血药物后预防穿刺点出血的研究%The investigation of preventing point-pricking bleeding after intravenous infusing hemorheologic agent

    Institute of Scientific and Technical Information of China (English)

    崔伯艳; 田帅

    2008-01-01

    目的 探讨静脉输注活血药物后预防穿刺点出血的有效方法.方法 将60例静脉输注活血药物的患者随机分为2组(各30例),按压时间分别为3,5 min;再选择按压5 min的患者100例随机分为3组,未制动组32例,制动5 min组34例,制动10 min组34例,观察穿刺点出血、皮下淤血的发生率.结果 按压5 min后穿刺点出血率明显低于按压3 min(P<0.01);手臂制动5 min组与10 min组穿刺点出血率明显低于未制动组(P<0.01);手臂制动5 min组与10 min组穿刺点出血率无统计学意义(P>0.05).结论 静脉输注活血药物后增加穿刺点按压时间至5 min,穿刺手臂制动5 min能有效预防穿刺点出血、皮下淤血的发生.%Objective To approach the effective methods of preventing point-pricking bleeding after the intravenous infusing hemorheologic agent. Methods 60 patients who had been given intravenous infused hemorheologic agent were divided into two groups at random, with 30 patients in each group. The pressing times were 3 and 5 minutes, respectively. Then, another 100 patients who had been pressed for 5 minutes were divided into 3 groups at random, 32 patients in the group with no braking, 34 patients in the group with braking for 5 minutes and 34 patients in the group with braking for 10 minutes. The incidence rates of point-pricking bleeding and blood clotting subcutaneously had been recorded. Results The incidence rate of point-pricking bleeding in the group with pressing for 5 minutes was significantly lower than that in the group with pressing for 3 minutes (P<0.001), and those in the group with arm braking for 5 minutes and 10 minutes had no difference (P>0.05). Conelusious The incidence rates of point-pricking bleeding and blood clotting subcutaneously can be effectively prevented by pressing for 5 minutes and arm braking for 5 minutes when the hemorheologic agent be intravenously infused.

  2. Treatment of sulfonylurea and insulin overdose.

    Science.gov (United States)

    Klein-Schwartz, Wendy; Stassinos, Gina L; Isbister, Geoffrey K

    2016-03-01

    The most common toxicity associated with sulfonylureas and insulin is hypoglycaemia. The article reviews existing evidence to better guide hypoglycaemia management. Sulfonylureas and insulin have narrow therapeutic indices. Small doses can cause hypoglycaemia, which may be delayed and persistent. All children and adults with intentional overdoses need to be referred for medical assessment and treatment. Unintentional supratherapeutic ingestions can be initially managed at home but if symptomatic or if there is persistent hypoglycaemia require medical referral. Patients often require intensive care and prolonged observation periods. Blood glucose concentrations should be assessed frequently. Asymptomatic children with unintentional sulfonylurea ingestions should be observed for 12 h, except if this would lead to discharge at night when they should be kept until the morning. Prophylactic intravenous dextrose is not recommended. The goal of therapy is to restore and maintain euglycaemia for the duration of the drug's toxic effect. Enteral feeding is recommended in patients who are alert and able to tolerate oral intake. Once insulin or sulfonylurea-induced hypoglycaemia has developed, it should be initially treated with an intravenous dextrose bolus. Following this the mainstay of therapy for insulin-induced hypoglycaemia is intravenous dextrose infusion to maintain the blood glucose concentration between 5.5 and 11 mmol l(-1) . After sulfonylurea-induced hypoglycaemia is initially corrected with intravenous dextrose, the main treatment is octreotide which is administered to prevent insulin secretion and maintain euglycaemia. The observation period varies depending on drug, product formulation and dose. A general guideline is to observe for 12 h after discontinuation of intravenous dextrose and, if applicable, octreotide.

  3. Impact of repeated intravenous bone marrow mesenchymal stem cells infusion on myocardial collagen network remodeling in a rat model of doxorubicin-induced dilated cardiomyopathy.

    Science.gov (United States)

    Yu, Qin; Li, Qianxiao; Na, Rongmei; Li, Xiaofei; Liu, Baiting; Meng, Lili; Liutong, Hanyu; Fang, Weiyi; Zhu, Ning; Zheng, Xiaoqun

    2014-02-01

    Bone marrow mesenchymal stem cells (MSCs) transplantation improved cardiac function and reduced myocardial fibrosis in both ischemic and non-ischemic cardiomyopathies. We evaluated the effects of repeated peripheral vein injection of MSCs on collagen network remodeling and myocardial TGF-β1, AT1, CYP11B2 (aldosterone synthase) gene expressions in a rat model of doxorubicin (DOX)-induced dilated cardiomyopathy (DCM). Thirty-eight out of 53 SD rats survived at 10 weeks post-DOX injection (2.5 mg/kg/week for 6 weeks, i.p.) were divided into DCM blank (without treatment, n = 12), DCM placebo (intravenous tail injection of 0.5 mL serum-free culture medium every other day for ten times, n = 13), and DCM plus MSCs group (intravenous tail injection of 5 × 10(6) MSCs dissolved in 0.5 mL serum-free culture medium every other day for 10 times, n = 13). Ten untreated rats served as normal controls. At 20 weeks after DOX injection, echocardiography, myocardial collagen content, myocardial expressions of types I and III collagen, TGF-β1, AT1, and CYP11B2 were compared among groups. At 20 weeks post-DOX injection, 8 rats (67%) survived in DCM blank group, 9 rats (69%) survived in DCM placebo group while 13 rats (100 %) survived in DCM plus MSCs group. Left ventricular end-diastolic diameter was significantly higher and ejection fraction was significantly lower in DCM blank and DCM placebo groups compared to normal control rats, which were significantly improved in DCM plus MSCs group (all p collagen volume fraction, types I and III collagen, myocardial mRNA expressions of TGF-β1, AT1, CYP11B2, and collagen I/III ratio were all significantly lower in DCM plus MSCs group compared to DCM blank and DCM placebo groups (all p collagen network remodeling possibly through downregulating renin-angiotensin-aldosterone system in DOX-induced DCM rats.

  4. Plasma and interstitial fluid pharmacokinetics of enrofloxacin, its metabolite ciprofloxacin, and marbofloxacin after oral administration and a constant rate intravenous infusion in dogs.

    Science.gov (United States)

    Bidgood, T L; Papich, M G

    2005-08-01

    Enrofloxacin and marbofloxacin were administered to six healthy dogs in separate crossover experiments as a single oral dose (5 mg/kg) and as a constant rate IV infusion (1.24 and 0.12 mg/h.kg, respectively) following a loading dose (4.47 and 2 mg/kg, respectively) to achieve a steady-state concentration of approximately 1 microg/mL for 8 h. Interstitial fluid (ISF) was collected with an in vivo ultrafiltration device at the same time period as plasma to measure protein unbound drug concentrations at the tissue site and assess the dynamics of drug distribution. Plasma and ISF were analyzed for enrofloxacin, its active metabolite ciprofloxacin, and for marbofloxacin by high performance liquid chromatography (HPLC). Lipophilicity and protein binding of enrofloxacin were higher than for marbofloxacin and ciprofloxacin. Compared to enrofloxacin, marbofloxacin had a longer half-life, higher Cmax, and larger AUC(0-infinity) in plasma and ISF after oral administration. Establishing steady state allowed an assessment of the dynamics of drug concentrations between plasma and ISF. The ISF and plasma-unbound concentrations were similar during the steady-state period despite differences in lipophilicity and pharmacokinetic parameters of the drugs.

  5. Application of Foot Type Plaster Mold in Children with Intravenous Infusion of Foot Fixed%足型石膏模在小儿静脉输液足部固定中的应用

    Institute of Scientific and Technical Information of China (English)

    郑芳; 叶祎烜; 林少芳

    2014-01-01

    目的:改良小儿足部静脉输液的固定方法,提高患儿舒适度,减少液体渗漏、多次穿刺,使输液治疗顺利完成。方法将需要在足背部进行静脉输液的1~4岁患儿100例,随机分成两组,实验组和对照组,各50例。实验组患儿在足背部进行静脉穿刺成功后运用足型石膏模进行足部固定,完成静脉输液治疗;对照组患儿则运用传统的直硬板进行足部固定,两组患儿进行效果观察比较。结果实验组患儿进行足部静脉输液时,液体渗漏、自行拔针、重复穿刺等不良情况明显少于对照组。结论运用足型石膏模进行小儿足背部的输液固定,能增加患儿舒适度,强化固定效果,避免重复多次的静脉穿刺,减少患儿痛苦,提高患儿家属的满意度,降低护士工作量。%Objective This study by the improvement of fixed mode of foot venous transfusion to children, to improve their comfort level, reduce accidents of leakage of liquid, repeated the number of puncture, to make the infusion therapy complete. Method Make 1-4 years old children with 100 who need for intravenous infusion on the dorsum of foot randomly divided into two groups, experimental group and control group, 50 cases in each. The experimental group with the vein punctures success on the dorsum of foot by foot after the plaster mold foot fixed, complete the intravenous infusion therapy. Patients in the control group used traditional straight board foot fixed. Observe and compare the results of these two groups. Result Liquid leakage, pulling needles, repeated puncture and other adverse conditions of the experimental group for foot venous transfusion were significantly less than the control group. Conclusion The infusion of pediatric foot back fixed by foot plaster mold, can increase the comfort level, strengthen the fixed effect, avoid repeated puncture times, reduce the pain of patients, improve the patients' satisfaction

  6. Continuous Intravenous Infusion of Sodium Fusidate Sodium and Calcium Gluconate are Incompatibility%静脉连续输注夫西地酸钠与葡萄糖酸钙存在配伍禁忌

    Institute of Scientific and Technical Information of China (English)

    叶富云

    2014-01-01

    随着我国医药科学的发展,不断出现一些新的药物,原来的药物配伍禁忌表已经不能满足新药的查询要求。夫西地酸钠是临床常用的抗菌药物,主要治疗葡萄球菌引起的各种感染,葡萄糖酸钙注射液为常用的钙补充剂,临床上有将这两种药物在同一患者身上序贯输入的情况。我科于2013年9月收治1例急性上呼吸道感染并患急性荨麻疹的患儿,在遵医嘱静脉输液时我们发现夫西地酸钠与葡萄糖酸钙之间存在配伍禁忌,不能依次序贯输注。%With the development of medical science in China, some of the emerging of new drugs, the original drug incompatibility table has been unable to meet the requirements of new query. Sodium fusidate is the clinical commonly used antibiotics, causing the main treatment of staphylococcal infection, Calcium gluconate injection calcium supplements commonly used, there wil be the two drugs in the same patient is clinical on sequential input. Division in 2013.9 treated 1 cases of acute upper respiratory tract infection and acute urticaria in children, in the prescribed intravenous infusion we find there is incompatibility between fusidic acid sodium and calcium gluconate, cannot turn the sequential infusion.

  7. Safety and pharmacokinetics of 120 mg/kg versus 60 mg/kg weekly intravenous infusions of alpha-1 proteinase inhibitor in alpha-1 antitrypsin deficiency: a multicenter, randomized, double-blind, crossover study (SPARK).

    Science.gov (United States)

    Campos, Michael A; Kueppers, Friedrich; Stocks, James M; Strange, Charlie; Chen, Junliang; Griffin, Rhonda; Wang-Smith, Laurene; Brantly, Mark L

    2013-12-01

    Augmentation therapy with the approved dose of 60 mg/kg weekly intravenous (IV) alpha-1 proteinase inhibitor (alpha1-PI), achieves a trough serum level of 11 μM in individuals with alpha-1 antitrypsin deficiency (AATD), yet this is still below the level observed in healthy individuals. This study assessed the safety and pharmacokinetic profile of weekly infusions of a 120 mg/kg dose of alpha1-PI in 30 adults with AATD. Subjects with symptomatic, genetically determined (genotypes PI*ZZ, PI*Z(null), PI*(null)(null) or PI*(Z)Mmalton) AATD were randomly assigned to weekly infusions of 60 or 120 mg/kg alpha1-PI (Prolastin-C®) for 8 weeks before crossing over to the alternate dose for 8 weeks. Adverse events (AEs) (including exacerbations), vital signs, pulmonary function tests, and laboratory assessments were recorded. Pharmacokinetic measurements included AUC0-7days, Cmax, trough, tmax, and t1/2, based on serum alpha1-PI concentrations. In total for both treatments, 112 AEs were reported, with exacerbation of COPD being the most frequent, consistent with the subjects' diagnoses. Mean steady-state serum alpha1-PI concentrations following 120 mg/kg weekly IV alpha1-PI were higher than with the 60 mg/kg dose and mean trough concentrations were 27.7 versus 17.3 μM, respectively. Dose proportionality was demonstrated for AUC0-7days and Cmax, with low inter-subject variability. The 120 mg/kg alpha1-PI weekly dose was considered to be safe and well tolerated, and provided more favorable physiologic alpha1-PI serum levels than the currently recommended 60 mg/kg dose. The effect of this dosing regimen on slowing and/or preventing emphysema progression in subjects with AATD warrants further investigation.

  8. Flow determination of an intravenous fluid delivery system for large animals / Fluxo de escoamento de um sistema de infusão intravenosa de soluções eletrolíticas para grandes animais

    Directory of Open Access Journals (Sweden)

    Antonio Cesa de Oliveira Dearo

    2009-12-01

    Full Text Available Intravenous (IV administration of fluids is largely practiced in veterinary medicine. For this purpose, a sterile IV set and a large fluid container are required to assure a safe and efficient infusion. Once the IV set has been developed, fluid flow determinations must be established in order to assure the amount of fluid to be delivered to a given animal in a given time. The purpose of this study was to determine the flow of water through an IV set designed specifically for large animals with the flow clamp in a full open position. The flow rate achieved was 7,32 l/h.Em medicina veterinária a administração intravenosa de fluidos é amplamente utilizada. Essa prática necessita de um sistema que, constituído basicamente por um recipiente contendo a solução a ser administrada e um equipo que transfere a solução do recipiente ao paciente, garanta uma administração segura e estéril. Uma vez desenvolvido o sistema, taxas de escoamento devem ser determinadas a fim de se assegurar as quantidades de fluidos a serem administradas por unidade de tempo em situações clínicas reais. O presente trabalho objetivou a determinação do fluxo de escoamento de água em um sistema de infusão intravenosa idealizado para grandes animais com o regulador de fluxo totalmente aberto. A taxa de escoamento obtida foi igual a 7,32 l/h.

  9. MATLAB-implemented estimation procedure for model-based assessment of hepatic insulin degradation from standard intravenous glucose tolerance test data.

    Science.gov (United States)

    Di Nardo, Francesco; Mengoni, Michele; Morettini, Micaela

    2013-05-01

    Present study provides a novel MATLAB-based parameter estimation procedure for individual assessment of hepatic insulin degradation (HID) process from standard frequently-sampled intravenous glucose tolerance test (FSIGTT) data. Direct access to the source code, offered by MATLAB, enabled us to design an optimization procedure based on the alternating use of Gauss-Newton's and Levenberg-Marquardt's algorithms, which assures the full convergence of the process and the containment of computational time. Reliability was tested by direct comparison with the application, in eighteen non-diabetic subjects, of well-known kinetic analysis software package SAAM II, and by application on different data. Agreement between MATLAB and SAAM II was warranted by intraclass correlation coefficients ≥0.73; no significant differences between corresponding mean parameter estimates and prediction of HID rate; and consistent residual analysis. Moreover, MATLAB optimization procedure resulted in a significant 51% reduction of CV% for the worst-estimated parameter by SAAM II and in maintaining all model-parameter CV% MATLAB-based procedure was suggested as a suitable tool for the individual assessment of HID process.

  10. Thrombocytopenia induced by intravenous infusion of cefuroxime%头孢呋辛静脉滴注致血小板减少

    Institute of Scientific and Technical Information of China (English)

    吴志恒; 杨波

    2011-01-01

    1例70岁女性患者拟行脑膜瘤切除术,术前因肺部感染给予头孢呋辛2 g溶于0.9%氯化钠溶液250 ml,1次/d静脉滴注。用药前血小板166×109/L,用药第2天血小板急剧下降至40×109/L,但无临床出血表现。考虑可能与头孢呋辛有关,遂停用该药,改用氧氟沙星,换药1 d后血小板上升至160×109/L。随后肺部感染好转,手术顺利完成。%A 70-year-old woman was planned to undergo meningeoma resection and received an IV infusion of cefuroxime 2 g dissolved in 250 ml of 0.9% sodium chloride once daily for a lung infection before operation. Her platelet count was 166 × 109/L before drug administration and, on day 2 of treatment, her platelet count rapidly dropped to 40 × 109/L, but no evidence of clinical bleeding. It was considered to be associated with cefuroxime, so the drug was withdrawn and switched to ofloxacin. One day after change to ofloxacin, her platelet count rose to 160 × 109/L. Thereafter, the pulmonary infection improved and the operation completed uneventfully.

  11. Norelgestromin/ethinyl estradiol intravenous infusion formulation optimization, stability and compatibility testing: A case study to overcome polysorbate 80 interference in chromatographic analysis.

    Science.gov (United States)

    Abdallah, Inas A; Hammell, Dana C; Hassan, Hazem E; Stinchcomb, Audra L

    2016-06-01

    Norelgestromin/ethinyl estradiol is a progestin/estrogen combination hormonal contraceptive indicated for the prevention of pregnancy in women. The very poor solubility and wettability of these drugs, along with their high potency (adsorption issues), give rise to difficulties in designing intravenous (IV) formulations to assess absolute bioavailability of products containing both drugs. The purpose of this study was to develop an IV formulation, evaluate its stability under different conditions and evaluate its compatibility with IV sets for potential use in absolute bioavailability studies in humans. Also, a selective high-performance liquid chromatography (HPLC) method for quantification of ethinyl estradiol and norelgestromin in polysorbate 80 matrix was developed and validated. Norelgestromin/ethinyl estradiol IV solution was prepared using sterile water for injection with 2.5% ethanol and 2.5% polysorbate 80 as a cosolvent/surfactant system to obtain a final drug solution of 25μg ethinyl estradiol and 252μg norelgestromin from a concentrated stock drug solution. The stabilities of the concentrated stock and IV solutions were assessed after storing them in the refrigerator (3.7±0.6°C) and at room temperature (19.5±0.5°C), respectively. Additional studies were conducted to examine the stability of the IV solution using an Alarias(®) low sorbing IV administration set with and without an inline filter. The solution was allowed to drip at 1mL/min over a 60min period. Samples were obtained at the beginning, middle and end of the 60min duration. The chemical stability was evaluated for up to 10 days. Norelgestromin and ethinyl estradiol concentration, purity, and degradant levels were determined using the HPLC method. The norelgestromin/ethinyl estradiol IV formulation met the chemical stability criteria when tested on day 1 through day 9 (216h). Norelgestromin concentrations assayed in stock and IV solutions were in the range of 90.0-98.5% and 90

  12. Pharmacokinetics and tissue distribution of ginkgolide A, ginkgolide B, and ginkgolide K after intravenous infusion of ginkgo diterpene lactones in a rat model.

    Science.gov (United States)

    Wang, Shuyao; Ouyang, Bingchen; Aa, Jiye; Geng, Jianliang; Fei, Fei; Wang, Pei; Wang, Jiankun; Peng, Ying; Geng, Ting; Li, Yanjing; Huang, Wenzhe; Wang, Zhenzhong; Xiao, Wei; Wang, Guangji

    2016-07-15

    Ginkgo diterpene lactones are compounds that are extracted from the Ginkgo biloba leaf and possess pharmacologic activities with neuroprotective effects. To address the poor bioavailability of ginkgo diterpene lactones, ginkgo diterpene lactone meglumine injection (GDLI) was formulated and is commercially available. In this study, a simple, sensitive and reliable liquid chromatography-tandem mass spectrometry (LC-MS/MS) method was developed and validated for assessing the total amount and the amount of the prototype forms of ginkgolides A (GA), B (GB) and K (GK) in rat plasma and tissues. This method was used to calculate the concentrations of the hydrolysed carboxylic forms and assess the pharmacokinetics of the ginkgolides after intravenous (i.v.) GDLI administration in rats. Generally, all three ginkgolide forms showed dose-dependent plasma concentrations, and no obvious differences in pharmacokinetic parameters, i.e., area under the curve (AUC) of plasma concentration versus time and half-life, were observed after GDLI administration on 7 consecutive days. These ginkgolides primarily existed in the carboxylic form in the plasma, and the systemic concentrations of the carboxylic forms of GA and GB were 11- to 17- and 3- to 4-fold higher than those of their prototype forms, respectively. In contrast, dramatically increased levels of the GA and GB prototype lactones were detected in the liver and heart. GA, GB, and GK were extensively distributed in various organs/tissues; the highest levels were found in the kidneys, liver, and intestine, and the lowest levels were found in the brain. These data suggest that ginkgolides have difficulty crossing the blood-brain barrier and that their targets for protecting against cerebral ischaemia are located outside the central system.

  13. Suggestion therapy for peripheral intravenous infusion of potassium liquid causes pain effects%暗示疗法对经外周静脉输入含钾液体引起疼痛的效果观察

    Institute of Scientific and Technical Information of China (English)

    郑小凤; 夏彤; 何丹丹

    2013-01-01

    目的:探讨通过暗示疗法减轻经外周静脉输入含钾液体引起病员局部明显疼痛的效果。方法:随机选择我科输入钾盐的病员80例,将她们分为观察组和对照组进行对比,观察组按照常规输液操作程序,事先告知病员药名、药理作用和用药后的不适;对照组通过暗示疗法告知病员今天不用输入钾盐,不会引起疼痛不适,并取得家属的配合,分散病员对疼痛的注意力。结果:对照组的病员通过暗示的方法能够明显的减轻疼痛,输液速度加快,输液时间降低,差异有统计学意义(P<0.05)。%Objectives Explore through suggestion therapy to alleviate the peripheral pain of patients caused by intravenous infusion of po-tassium -containing liquid local apparent effect .Methods Patients in 80 cases of random choice ,I entered the potash ,divide them into Observ-er Group and control group for comparison ,Observer Group in the usual transfusion procedures ,inform patients in advance of medicine ,Phar-macology and medicine do not apply ;Control group by the suggestion of therapy ,inform the patient without entering potash today will not cause pain ,discomfort ,and families cope with scattered patient attention to pain .Results According to the patient by the suggestion of the group could significantly lessen the pain ,speed infusion ,infusion duration has been decreased (P<0 .05) ,a statistically significant difference .

  14. Pain management in emergency department: intravenous morphine vs. intravenous acetaminophen

    Directory of Open Access Journals (Sweden)

    Morteza Talebi Doluee

    2015-01-01

    Full Text Available Pain is the most common complaint in emergency department and there are several methods for its control. Among them, pharmaceutical methods are the most effective. Although intravenous morphine has been the most common choice for several years, it has some adverse effects. There are many researches about intravenous acetaminophen as an analgesic agent and it appears that it has good analgesic effects for various types of pain. We searched some electronic resources for clinical trials comparing analgesic effects of intravenous acetaminophen vs. intravenous morphine for acute pain treatment in emergency setting.In two clinical trials, the analgesic effect of intravenous acetaminophen has been compared with intravenous morphine for renal colic. The results revealed no significant difference between analgesic effects of two medications. Another clinical trial revealed that intravenous acetaminophen has acceptable analgesic effects on the post-cesarean section pain when combined with other analgesic medications. One study revealed that administration of intravenous acetaminophen compared to placebo before hysterectomy decreased consumption of morphine via patient-controlled analgesia pump and decreased the side effects. Similarly, another study revealed that the infusion of intravenous acetaminophen vs. placebo after orthopedic surgery decreased the consumption of morphine after the surgery. A clinical trial revealed intravenous acetaminophen provided a level of analgesia comparable to intravenous morphine in isolated limb trauma, while causing less side effects than morphine.It appears that intravenous acetaminophen has good analgesic effects for visceral, traumatic and postoperative pains compare with intravenous morphine.

  15. Successful use of daily intravenous infusion of C1 esterase inhibitor concentrate in the treatment of a hereditary angioedema patient with ascites, hypovolemic shock, sepsis, renal and respiratory failure.

    Science.gov (United States)

    Pham, Hoang; Santucci, Stephanie; Yang, William H

    2014-01-01

    Hereditary angioedema (HAE) is a rare autosomal dominant disease most commonly associated with defects in C1 esterase inhibitor (C1-INH). HAE manifests as recurrent episodes of edema in various body locations. Atypical symptoms, such as ascites, acute respiratory distress syndrome, and hypovolemic shock, have also been reported. Management of HAE conventionally involves the treatment of acute attacks, as well as short- and long-term prophylaxis. Since attacks can be triggered by several factors, including stress and physical trauma, prophylactic therapy is recommended for patients undergoing surgery. Human plasma-derived C1-INH (pdC1-INH) concentrate is indicated for the treatment of both acute HAE attacks and pre-procedure prevention of HAE episodes in patients undergoing medical, dental, or surgical procedures. We report the first case of a patient with HAE who experienced an abdominal attack precipitated by a retroperitoneal bleed while being converted from warfarin to heparin in preparation for surgery. Subsequently, the patient had a protracted course in hospital with other complications, which included hypovolemic shock, ascites, severe sepsis from nosocomial pneumonia, renal and respiratory failure. Despite intensive interventions, the patient remained in a critical state for months; however, after a trial of daily intravenous infusion of pdC1-INH concentrate (Berinert®, CSL Behring GmbH, Marburg, Germany), clinical status improved, particularly renal function. Therefore, pdC1-INH concentrate may be an effective treatment option to consider for critically-ill patients with HAE.

  16. A Case Report of Long-Term Survival following Hepatic Arterial Infusion of L-Folinic Acid Modulated 5-Fluorouracil Combined with Intravenous Irinotecan and Cetuximab Followed by Hepatectomy in a Patient with Initially Unresectable Colorectal Liver Metastases

    Directory of Open Access Journals (Sweden)

    Kobe Van Bael

    2015-01-01

    Full Text Available A 43-year-old women admitted to our hospital for weight loss, anorexia, and abdominal pain was diagnosed with sigmoid neoplasm and multiple bilobar liver metastases. This patient received six cycles of systemic FOLFOX prior to a laparoscopically assisted anterior resection of the rectosigmoid for a poorly differentiated invasive adenocarcinoma T2N2M1, K-RAS negative (wild type. Hepatic arterial infusion (HAI of L-folinic acid modulated 5-fluorouracil (LV/5-FU with intravenous (iv irinotecan (FOLFIRI and cetuximab as adjuvant therapy resulted in a complete metabolic response (CR with CEA normalization. A right hepatectomy extended to segment IV was performed resulting in (FDG-PET negative remission for 7 months. Solitary intrahepatic recurrence was effectively managed by local radiofrequent ablation following 6c FOLFIRI plus cetuximab iv. Multiple lung lesions and recurrence of pulmonary and local lymph node metastases were successfully treated with fractionated stereotactic radiotherapy (50 Gy and iv LV/5-FU/oxaliplatin (FOLFOX plus cetuximab finally switched to panitumumab with CR as a result. At present the patient is in persistent complete remission of her stage IV colorectal cancer, more than 5 years after initial diagnosis of the advanced disease. Multidisciplinary treatment with HAI of chemotherapy (LV/5-FU + CPT-11 plus EGFR-inhibitor can achieve CR of complex unresectable LM and can even result in hepatectomy with possible long-term survival.

  17. Adverse Reactions of Intravenous Infusion in Children and Nursing Countermeasures%儿童静脉输液药物不良反应与护理对策探讨

    Institute of Scientific and Technical Information of China (English)

    叶红兵

    2016-01-01

    目的:探讨对儿童完成静脉输液后表现出的药物不良反应,研究有效的护理对策降低不良反应发生率。方法选择我院2014年6月~2016年6月收治的静脉输液药物不良反应患儿96例作为此次实验对象;对所有患儿药物不良反应进行观察,并且采用针对性的护理措施以有效降低药物不良反应发生率。结果对于输液患儿,针对其表现出的过敏症状进行分析发现,主要集中于皮肤症状。针对不良反应类型进行统计分析发现,抗生类药物不良反应患儿包括72例,头孢菌素类药物不良反应患儿包括40例,中成药制剂药物不良反应患儿包括24例。对于表现出不良反应的患儿,将临床用药停止后,采取有效方法进行干预治疗,最终不良反应全部获得缓解。结论对于患儿在实施静脉输液的过程中,对药物不良反应类型进行分析发现,主要集中于抗生素类药物不良反应。对此临床需要研究有效措施对不良反应患儿展开护理干预,对患儿进行必要的心理安抚,对于异常可以有效做到早期发现以及早期治疗。%Objective To study on children after intravenous infusion of adverse drug reactions, study the effective nursing countermeasures to reduce the incidence of adverse reactions. Methods 96 cases of adverse drug reactions children were chosen as the experimental object in our hospital from June 2014 to June 2016, for all children with adverse drug reactions were observed, and the corresponding nursing measures to effectively reduce the incidence of adverse drug reactions. Results For the infusion of children, for the analysis of the symptoms of allergic symptoms found, mainly concentrated in the skin symptoms. According to the type of adverse reactions were found in statistical analysis, antibiotics and adverse reactions including 72 cases, cephalosporin class the children including 40 cases of adverse drug reactions

  18. 人体手背掌指关节处静脉逆向穿刺技术的Meta分析%Meta-analysis of intravenous infusion by reverse puncture on dorsal surface of metacarpophalangeal joints

    Institute of Scientific and Technical Information of China (English)

    陈延亭; 郝玉芳; 岳树锦; 周芬; 刘春蕾

    2012-01-01

    Objective To compare the success rate of puncture and stability of the needles by reverse venous puncture versus normal puncture on dorsal surfaces of metacarpophalangeal (MCP) joints for intravenous infusion, and to assess the feasibility of intravenous infusion by reverse puncture. Methods We retrieved all literatures on controlled clinical trials of retrograde venous infusion by reverse puncture from Medline, the Cochrane Library, the China National Knowledge Infrastructure Database, the Chongqing VIP Chinese Science and Wanfang Data. The data were analyzed by using RevMan 5. 1 software. Results A total of 14 randomized controlled trials (RCTs) and controlled clinical trials (CCTs) were retrieved. Compared with the normal puncture, the success rate of reverse puncture is much higher, with statistical significance between the two puncture methods (OR = 4. 46,95%CI:2. 71 - 7. 32, P<0. 01); the liquid leakage rate is lower, with statistical significance between the groups (OR = 0. 26,95%CI:0. 19 - 0. 34,P< 0. 01). Conclusion Reverse puncture has higher success rate, lower liquid leakage rate, which puts reverse puncture into a favorable situation for clinical utilization.%目的 比较逆向穿刺与顺向穿刺的一次穿刺成功率和稳定性,评价掌指关节处静脉输液逆向穿刺的可行性.方法 检索MEDLINE、COCHRANE图书馆数据库、中国期刊全文数据库(CNKI)、重庆维普资讯中文科技期刊数据库(VIP)以及万方数据库,纳入所有关于人体手背掌指关节处逆向穿刺的临床试验,采用RevMan5.1软件分析数据.结果 共纳入14篇文献,与相同部位的顺向穿刺比较,逆向穿刺的成功率高于顺向穿刺(OR=4.46,95%CI:2.71~7.32,P<0.01);逆向穿刺药液渗漏发生率低于顺向穿刺(OR=0.26,95 %CI:0.19~0.34,P<0.01).结论 掌指关节处静脉逆向穿刺在穿刺成功率和稳定性上优于相同部位的顺向穿刺,可作为需要长期静脉输液治疗患者的辅助方法.

  19. Infusion Extractor

    Science.gov (United States)

    Chang-Diaz, Franklin R.

    1988-01-01

    Apparatus and method of removing desirable constituents from an infusible material by infusion extraction, where a piston operating in a first chamber draws a solvent into the first chamber where it may be heated, and then moves the heated solvent into a second chamber containing the infusible material, and where infusion extraction takes place. The piston then moves the solvent containing the extract through a filter into the first chamber, leaving the extraction residue in the second chamber.

  20. What´s cheapest, intravenous iron sucrose- or intravenous iron carboxymaltose treatment in IBD patients?

    DEFF Research Database (Denmark)

    Bager, Palle; Dahlerup, Jens Frederik

    for a total of iron-dose was to 233€ to reduce the numbers of infusion from 7 till 2.    Conclusion: The cost of choosing iron carboxymaltose rather than iron sucrose in treatment of iron deficiency in IBD differs depending of the economic perspective chosen. Only the Budget Impact Analysis showed iron......  What´s cheapest, intravenous iron sucrose- or intravenous iron carboxymaltose treatment in IBD patients? It dependent on the economic evaluation perspective!   Aim: To evaluate the health care cost for intravenous iron sucrose (Venofer®, Vifor) and intravenous iron carboxymaltose (Ferinject......®, Vifor) treatment to IBD patients in an outpatient setting.   Background: Intravenous iron sucrose can be given as a maximum of 200 mg Fe++ per infusion vs. intravenous iron carboxymaltose that can be given as a maximum of 1000 mg Fe++ in a single infusion leading to fewer infusions and visits. The drug...

  1. Corticosteroid treatment and intensive insulin therapy for septic shock in adults: a randomized controlled trial.

    Science.gov (United States)

    Annane, Djillali; Cariou, Alain; Maxime, Virginie; Azoulay, Elie; D'honneur, Gilles; Timsit, Jean François; Cohen, Yves; Wolf, Michel; Fartoukh, Muriel; Adrie, Christophe; Santré, Charles; Bollaert, Pierre Edouard; Mathonet, Armelle; Amathieu, Roland; Tabah, Alexis; Clec'h, Christophe; Mayaux, Julien; Lejeune, Julie; Chevret, Sylvie

    2010-01-27

    Corticosteroid therapy induces potentially detrimental hyperglycemia in septic shock. In addition, the benefit of adding fludrocortisone in this setting is unclear. To test the efficacy of intensive insulin therapy in patients whose septic shock was treated with hydrocortisone and to assess, as a secondary objective, the benefit of fludrocortisone. A multicenter, 2 x 2 factorial, randomized trial, involving 509 adults with septic shock who presented with multiple organ dysfunction, as defined by a Sequential Organ Failure Assessment score of 8 or more, and who had received hydrocortisone treatment was conducted from January 2006 to January 2009 in 11 intensive care units in France. Patients were randomly assigned to 1 of 4 groups: continuous intravenous insulin infusion with hydrocortisone alone, continuous intravenous insulin infusion with hydrocortisone plus fludrocortisone, conventional insulin therapy with hydrocortisone alone, or conventional insulin therapy with intravenous hydrocortisone plus fludrocortisone. Hydrocortisone was administered in a 50-mg bolus every 6 hours, and fludrocortisone was administered orally in 50-microg tablets once a day, each for 7 days. In-hospital mortality. Of the 255 patients treated with intensive insulin, 117 (45.9%), and 109 of 254 (42.9%) treated with conventional insulin therapy died (relative risk [RR], 1.07; 95% confidence interval [CI], 0.88-1.30; P = .50). Patients treated with intensive insulin experienced significantly more episodes of severe hypoglycemia (insulin therapy, intensive insulin therapy did not improve in-hospital mortality among patients who were treated with hydrocortisone for septic shock. The addition of oral fludrocortisone did not result in a statistically significant improvement in in-hospital mortality. clinicaltrials.gov Identifier: NCT00320099.

  2. Anesthesia with propofol induces insulin resistance systemically in skeletal and cardiac muscles and liver of rats

    Energy Technology Data Exchange (ETDEWEB)

    Yasuda, Yoshikazu; Fukushima, Yuji; Kaneki, Masao [Department of Anaesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Shriners Hospitals for Children, Harvard Medical School, Boston, MA 02114 (United States); Martyn, J.A. Jeevendra, E-mail: jmartyn@partners.org [Department of Anaesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Shriners Hospitals for Children, Harvard Medical School, Boston, MA 02114 (United States)

    2013-02-01

    Highlights: ► Propofol, as a model anesthetic drug, induced whole body insulin resistance. ► Propofol anesthesia decreased glucose infusion rate to maintain euglycemia. ► Propofol decreased insulin-mediated glucose uptake in skeletal and cardiac muscles. ► Propofol increased hepatic glucose output confirming hepatic insulin resistance. -- Abstract: Hyperglycemia together with hepatic and muscle insulin resistance are common features in critically ill patients, and these changes are associated with enhanced inflammatory response, increased susceptibility to infection, muscle wasting, and worsened prognosis. Tight blood glucose control by intensive insulin treatment may reduce the morbidity and mortality in intensive care units. Although some anesthetics have been shown to cause insulin resistance, it remains unknown how and in which tissues insulin resistance is induced by anesthetics. Moreover, the effects of propofol, a clinically relevant intravenous anesthetic, also used in the intensive care unit for sedation, on insulin sensitivity have not yet been investigated. Euglycemic hyperinsulinemic clamp study was performed in rats anesthetized with propofol and conscious unrestrained rats. To evaluate glucose uptake in tissues and hepatic glucose output [{sup 3}H]glucose and 2-deoxy[{sup 14}C]glucose were infused during the clamp study. Anesthesia with propofol induced a marked whole-body insulin resistance compared with conscious rats, as reflected by significantly decreased glucose infusion rate to maintain euglycemia. Insulin-stimulated tissue glucose uptake was decreased in skeletal muscle and heart, and hepatic glucose output was increased in propofol anesthetized rats. Anesthesia with propofol induces systemic insulin resistance along with decreases in insulin-stimulated glucose uptake in skeletal and heart muscle and attenuation of the insulin-mediated suppression of hepatic glucose output in rats.

  3. Administration costs of intravenous biologic drugs for rheumatoid arthritis

    OpenAIRE

    Soini, Erkki J.; Leussu, Miina; Hallinen, Taru

    2013-01-01

    Background Cost-effectiveness studies explicitly reporting infusion times, drug-specific administration costs for infusions or real-payer intravenous drug cost are few in number. Yet, administration costs for infusions are needed in the health economic evaluations assessing intravenously-administered drugs. Objectives To estimate the drug-specific administration and total cost of biologic intravenous rheumatoid arthritis (RA) drugs in the adult population and to compare the obtained costs wit...

  4. Fiscal 2000 achievement report on the research and development of medical and welfare apparatus/technology. Implantable insulin infusion system utilizing optical blood glucose monitor; 2000 nendo iryo fukushi kiki gijutsu kenkyu kaihatsu seika hokokusho. Kogakuteki kettochi sokutei system wo oyoshita tainai umekomigata insulin chunyu system

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2001-05-01

    In the study of an optical blood glucose monitoring system, basic data were collected and studied by measuring, for example, the absorption spectra of a glucose solution and rabbit blood in the near infrared domain. A simulation program was prepared based on the Monte Carlo method for the reproduction of light propagation in living organisms. As for the implanted insulin infusion system, requirements to be satisfied, technical problems to solve for their satisfaction, and system specifications were studied. As for the insulin infusion pump, methods for pump driving, manufacturing, and evaluating were studied, and a diaphragm type pump was fabricated. As for percutaneous signal transmission, studies were made about information to be transmitted and received between the intracorporeal and extracorporeal units, method of communication, charging of power to the intracorporeal unit, and so forth. (NEDO)

  5. Use of real time continuous glucose monitoring and intravenous insulin in type 1 diabetic mothers to prevent respiratory distress and hypoglycaemia in infants

    Directory of Open Access Journals (Sweden)

    Passaro Patrizia

    2008-07-01

    Full Text Available Abstract Background Pregnancy in Type 1 diabetic patients is a precarious condition, both for mother and fetus with increased the risk of prematurity and, immediately after delivery with risk of respiratory distress syndrome and hypoglycaemia in newborns. A strict control and monitoring of diabetes throughout pregnancy is important in reducing the impact of the disease on the fetus and newborn. In recent years many new technologies have been introduced to ameliorate diabetes monitoring, where the last is the Real-time Continuous Glucose Monitoring System (RT-CGMS. Methods In the last three years, 72 h continuous glucose monitoring system (RT-CGMS (Medtronic, CA was performed in 18 pregnant women with Type 1 diabetes in two moments of pregnancy: during treatment with betamethasone to prevent respiratory distress and during delivery. In both cases insulin was administered intravenous and the dose was changed on the basis of glycaemia. Results The results present the use of this new technique during two topics moments of pregnancy of type 1 diabetes patients when is very important intensively to monitor diabetes and to obtain the well being of the fetus. No infant experimented hypoglycaemia or respiratory distress syndrome at the moment and in the first hours after the birth. Conclusion We wish to stress the importance reducing glycaemia during administration of betamethasone and during labor. It is conceivable that the scarce attention paid to monitoring glucose levels in diabetic mothers during labor in gynaecological world may be due to the difficulty in glucose monitoring with the devices until now available. Hopefully, our anecdotal account may prompt improvements with RT-CGMS, and may lead to a better approach to the problem, thereby changing the prognosis of infants born to diabetic mothers.

  6. Medanta insulin protocols in patients undergoing cardiac surgery

    Directory of Open Access Journals (Sweden)

    Beena Bansal

    2014-01-01

    Full Text Available Hyperglycemia is common in patients undergoing cardiac surgery and is associated with poor outcomes. This is a review of the perioperative insulin protocol being used at Medanta, the Medicity, which has a large volume cardiac surgery setup. Preoperatively, patients are usually continued on their preoperative outpatient medications. Intravenous insulin infusion is intiated postoperatively and titrated using a column method with a choice of 7 scales. Insulin dose is calculated as a factor of blood glucose and patient′s estimated insulin sensitivity. A comparison of this protocol is presented with other commonly used protocols. Since arterial blood gas analysis is done every 4 hours for first two days after cardiac surgery, automatic data collection from blood gas analyzer to a central database enables collection of glucose data and generating glucometrics. Data auditing has helped in improving performance through protocol modification.

  7. Determination of Content and Related Substances of Oxaliplatin Intravenous Infusion%奥沙利铂静脉输液的有关物质检查与含量测定

    Institute of Scientific and Technical Information of China (English)

    徐静; 张伟明; 李健和; 易利丹; 彭六保

    2013-01-01

    Objective To establish a HPLC method to determine the oxaliplatin content and the related substances of oxaliplatin intravenous infusion.Methods The HPLC method was adopted to determine the oxaliplatin content and related substances in oxaliplatin intravenous infusion.The Polaris C18-A column (200 mm×4.6 mm; 5 μm) was adopted with methanol-water(10 ∶ 90) as the mobile phase at the flow rate of 0.8 mL/min.The detection wavelength was set at 249 nm.The theoretical plate number was not less than 2 000 according to the peak of oxaliplatin.At the same time,the classic oxidimetry method for the determination of isotonic regulator mannite was established,which using the back titration with sodium thiosulfate titrant.Results The linear relation of oxaliplatin was excellent within the concentration range of 0.10-1.00 g/L(r=0.999 8),the limit of the detection was 0.06 μg.The average recovery rates of oxaliplatin and mannitol were 100.17% (RSD =0.53%) and 100.54% (RSD =0.34%),respectively.Conclusion This method is specific,accurate,sensitive and rapid with the reliable detection Results.%目的 建立测定奥沙利铂静脉输液中有关物质和奥沙利铂含量的高效液相色谱(HPLC)法.方法 采用HPLC法测定奥沙利铂静脉输液的有关物质和奥沙利铂的含量,Polaris C18-A色谱柱(200 mm×4.6 mm,5 μm),流动相为甲醇-水(10∶90),流速为0.8 mL/min,检测波长为249 nm,理论板数按奥沙利铂峰计不低于2 000.等渗调节剂甘露醇采用经典的氧化还原法,用硫代硫酸钠滴定液进行回滴定测定.结果 奥沙利铂进样质量浓度在0.10~1.00 g/L范围与峰面积线性关系良好(r=0.999 8),最低检测限为0.06 μg,平均回收率为100.17%(RSD =0.53%).甘露醇平均回收率为100.54% (RSD =0.34%).结论 该方法专属性好,准确、灵敏、快速,结果可靠.

  8. 骨髓间充质干细胞静脉输注对猕猴细胞免疫功能的影响%Effects on cellular immunity caused by intravenous infusion of allogenic rhesus mesenchymal stem cells

    Institute of Scientific and Technical Information of China (English)

    范传波; 王朝晖; 王磊; 胡锴勋; 刘丽辉; 孙琪云; 边莉; 乌庆超

    2011-01-01

    目的 评价猕猴间充质干细胞( MSC)静脉异体输注后对细胞免疫功能的影响。方法分离培养MSC;不做其他处理,将异体MSC静脉输注给受者猴,通过定期监测外周血象、混合淋巴细胞反应( MLR)、T细胞亚群来判断MSC输注后受者细胞免疫功能的变化。结果成功培养了猕猴的MSC。异体MSC输注后,受者无明显毒性反应、排异表现及血象变化。可以在一定时间内(2周左右)抑制受者T细胞在MLR中的增殖活性,受者猴A2、A3及A4输注MSC的数量分别为4.0×105/kg、1.0×106/kg、2.0×106/kg,在输注后第14天时,MLR的相对反应值(RR)与输注前比较均明显降低,分别从(46.0±2.6)%、( 40.9±2.3)%、(48.3±2.0)%降至(40.4±1.73)%、(33.0±2.1)%、(39.0±1.0)%(F=1O.19,P=0.023;F=2.593,P= 0.013;F= 28.431,P=0.003),输注后第30天时RR均恢复到输注前水平;统计结果显示,抑制程度(△RR)与输注MSC数量呈正相关(F=27.413,P=0.038)。A4是输注MSC数量最多的受者,输注后第14天开始,外周血CD3+、CD3+ CD4+、CD3+CD8+细胞的百分比与输注前相比有所降低,在输注后第30天左右恢复至输注前水平。结论单纯体内输注异体MSC,可以在一定时间内抑制受者T细胞的免疫活性;免疫抑制程度与输注MSC数量呈正相关。MSC特殊的免疫学特性使其具有深远的临床应用价值。%Objective To study the changes of cellular immunity caused by intravenous infusion of allogenic rhesus mesenchymal stem cells (MSCs). Methods MSCs were isolated and cultured. Then the immunomodulatory effects after MSCs infusion were evaluated by means of peripheral blood counts, mixed lymphocyte reaction (MLR) and analysis of lymphocytic subgroup. Results MSCs of rehsus were successfully cultivated. No acute toxicities or GVHD were observed in recipients. No obvious changes of peripheral blood counts were present. Recipients A2, A3, A4 were administered with

  9. Direct effects of TNF-α on local fuel metabolism and cytokine levels in the placebo-controlled, bilaterally infused human leg: increased insulin sensitivity, increased net protein breakdown, and increased IL-6 release.

    Science.gov (United States)

    Bach, Ermina; Nielsen, Roni R; Vendelbo, Mikkel H; Møller, Andreas B; Jessen, Niels; Buhl, Mads; K-Hafstrøm, Thomas; Holm, Lars; Pedersen, Steen B; Pilegaard, Henriette; Biensø, Rasmus S; Jørgensen, Jens O L; Møller, Niels

    2013-12-01

    Tumor necrosis factor-α (TNF-α) has widespread metabolic actions. Systemic TNF-α administration, however, generates a complex hormonal and metabolic response. Our study was designed to test whether regional, placebo-controlled TNF-α infusion directly affects insulin resistance and protein breakdown. We studied eight healthy volunteers once with bilateral femoral vein and artery catheters during a 3-h basal period and a 3-h hyperinsulinemic-euglycemic clamp. One artery was perfused with saline and one with TNF-α. During the clamp, TNF-α perfusion increased glucose arteriovenous differences (0.91 ± 0.17 vs. 0.74 ± 0.15 mmol/L, P = 0.012) and leg glucose uptake rates. Net phenylalanine release was increased by TNF-α perfusion with concomitant increases in appearance and disappearance rates. Free fatty acid kinetics was not affected by TNF-α, whereas interleukin-6 (IL-6) release increased. Insulin and protein signaling in muscle biopsies was not affected by TNF-α. TNF-α directly increased net muscle protein loss, which may contribute to cachexia and general protein loss during severe illness. The finding of increased insulin sensitivity, which could relate to IL-6, is of major clinical interest and may concurrently act to provide adequate tissue fuel supply and contribute to the occurrence of systemic hypoglycemia. This distinct metabolic feature places TNF-α among the rare insulin mimetics of human origin.

  10. Mechanisms Underlying the Onset of Oral Lipid–Induced Skeletal Muscle Insulin Resistance in Humans

    Science.gov (United States)

    Nowotny, Bettina; Zahiragic, Lejla; Krog, Dorothea; Nowotny, Peter J.; Herder, Christian; Carstensen, Maren; Yoshimura, Toru; Szendroedi, Julia; Phielix, Esther; Schadewaldt, Peter; Schloot, Nanette C.; Shulman, Gerald I.; Roden, Michael

    2013-01-01

    Several mechanisms, such as innate immune responses via Toll-like receptor-4, accumulation of diacylglycerols (DAG)/ceramides, and activation of protein kinase C (PKC), are considered to underlie skeletal muscle insulin resistance. In this study, we examined initial events occurring during the onset of insulin resistance upon oral high-fat loading compared with lipid and low-dose endotoxin infusion. Sixteen lean insulin-sensitive volunteers received intravenous fat (iv fat), oral fat (po fat), intravenous endotoxin (lipopolysaccharide [LPS]), and intravenous glycerol as control. After 6 h, whole-body insulin sensitivity was reduced by iv fat, po fat, and LPS to 60, 67, and 48%, respectively (all P < 0.01), which was due to decreased nonoxidative glucose utilization, while hepatic insulin sensitivity was unaffected. Muscle PKCθ activation increased by 50% after iv and po fat, membrane Di-C18:2 DAG species doubled after iv fat and correlated with PKCθ activation after po fat, whereas ceramides were unchanged. Only after LPS, circulating inflammatory markers (tumor necrosis factor-α, interleukin-6, and interleukin-1 receptor antagonist), their mRNA expression in subcutaneous adipose tissue, and circulating cortisol were elevated. Po fat ingestion rapidly induces insulin resistance by reducing nonoxidative glucose disposal, which associates with PKCθ activation and a rise in distinct myocellular membrane DAG, while endotoxin-induced insulin resistance is exclusively associated with stimulation of inflammatory pathways. PMID:23454694

  11. HIV protease inhibitors acutely impair glucose-stimulated insulin release.

    Science.gov (United States)

    Koster, Joseph C; Remedi, Maria S; Qiu, Haijun; Nichols, Colin G; Hruz, Paul W

    2003-07-01

    HIV protease inhibitors (PIs) acutely and reversibly inhibit the insulin-responsive glucose transporter Glut 4, leading to peripheral insulin resistance and impaired glucose tolerance. Minimal modeling analysis of glucose tolerance tests on PI-treated patients has revealed an impaired insulin secretory response, suggesting additional pancreatic beta-cell dysfunction. To determine whether beta-cell function is acutely affected by PIs, we assayed glucose-stimulated insulin secretion in rodent islets and the insulinoma cell line MIN6. Insulin release from MIN6 cells and rodent islets was significantly inhibited by the PI indinavir with IC(50) values of 1.1 and 2.1 micro mol/l, respectively. The uptake of 2-deoxyglucose in MIN6 cells was similarly inhibited (IC(50) of 2.0 micro mol/l), whereas glucokinase activity was unaffected at drug levels as high as 1 mmol/l. Glucose utilization was also impaired at comparable drug levels. Insulin secretogogues acting downstream of glucose transport mostly reversed the indinavir-mediated inhibition of insulin release in MIN6 cells. Intravenous infusion of indinavir during hyperglycemic clamps on rats significantly suppressed the first-phase insulin response. These data suggest that therapeutic levels of PIs are sufficient to impair glucose sensing by beta-cells. Thus, together with peripheral insulin resistance, beta-cell dysfunction likely contributes to altered glucose homeostasis associated with highly active antiretroviral therapy.

  12. Insulin glargine overdose

    Directory of Open Access Journals (Sweden)

    Fatma Sari Dogan

    2012-01-01

    Full Text Available Insulin glargine is a long acting novel recombinant human insulin analogue indicated to improve glycemic control, in adults and children with type 1 diabetes mellitus and in adults with type 2 diabetes mellitus. The time course of action of insulins including insulin glargine may vary between individuals and/or within the same individual. Insulin glargine is given as a 24-h dosing regimen and has no documented half-life or peak effect. Hypoglycemia is the most common adverse effect of insulin, including insulin glargine. As with all insulins, the timing of hypoglycemia may differ among various insulin formulations. We present a case of a 76-year-old male insulin-dependent diabetic patient with refractory hypoglycemia secondary to an intentional overdose of insulin glargine. We would like to highlight the necessity of prolonging IV glucose infusion, for a much longer period than expected from pharmacokinetic properties of these insulin analogues after intentional massive overdose.

  13. Acute administration of unacylated ghrelin has no effect on Basal or stimulated insulin secretion in healthy humans.

    Science.gov (United States)

    Tong, Jenny; Davis, Harold W; Summer, Suzanne; Benoit, Stephen C; Haque, Ahrar; Bidlingmaier, Martin; Tschöp, Matthias H; D'Alessio, David

    2014-07-01

    Unacylated ghrelin (UAG) is the predominant ghrelin isoform in the circulation. Despite its inability to activate the classical ghrelin receptor, preclinical studies suggest that UAG may promote β-cell function. We hypothesized that UAG would oppose the effects of acylated ghrelin (AG) on insulin secretion and glucose tolerance. AG (1 µg/kg/h), UAG (4 µg/kg/h), combined AG+UAG, or saline were infused to 17 healthy subjects (9 men and 8 women) on four occasions in randomized order. Ghrelin was infused for 30 min to achieve steady-state levels and continued through a 3-h intravenous glucose tolerance test. The acute insulin response to glucose (AIRg), insulin sensitivity index (SI), disposition index (DI), and intravenous glucose tolerance (kg) were compared for each subject during the four infusions. AG infusion raised fasting glucose levels but had no effect on fasting plasma insulin. Compared with the saline control, AG and AG+UAG both decreased AIRg, but UAG alone had no effect. SI did not differ among the treatments. AG, but not UAG, reduced DI and kg and increased plasma growth hormone. UAG did not alter growth hormone, cortisol, glucagon, or free fatty acid levels. UAG selectively decreased glucose and fructose consumption compared with the other treatments. In contrast to previous reports, acute administration of UAG does not have independent effects on glucose tolerance or β-cell function and neither augments nor antagonizes the effects of AG.

  14. Efficacy of intravenous infusion of doripenem.

    Science.gov (United States)

    Restrepo, Marcos I

    2009-08-15

    Initial treatment of nosocomial pneumonia (NP), including ventilator-associated pneumonia (VAP), is usually empirical. The use of a broad-spectrum antibiotic regimen to treat NP-VAP that is active against suspected multidrug-resistant pathogens maximizes the likelihood of a favorable outcome. In a post hoc analysis of pooled data from 2 prospective, randomized, open-label, phase 3 NP-VAP trials, doripenem, a new broad-spectrum carbapenem with antipseudomonal activity, demonstrated noninferiority to standard comparator regimens (imipenem and piperacillin-tazobactam) with regard to clinical and microbiological outcomes. In subgroup analyses, doripenem continued to show noninferiority to the comparator drugs in achieving clinical and microbiological cures in populations at high risk of multidrug-resistant infection, such as patients with late-onset VAP (defined as patients who develop VAP >5 days after intubation) or those with NP-VAP caused by Pseudomonas aeruginosa or complicated by bacteremia. Overall, the clinical data indicate that doripenem has the potential to be an important option in the treatment of NP, including VAP.

  15. Effect of intravenous dexmedetomidine infusion on some ...

    African Journals Online (AJOL)

    Ahmed G. Yacout

    2011-12-17

    Dec 17, 2011 ... plasma interleukin-6, cortisol and blood glucose level. It also assessed its ... able metabolic consequences.1 This stress response has been considered as the ... dexmedetomidine is accompanied by virtually no respiratory depression at ..... agonist-induced peripheral vasoconstriction in humans. Anesthe-.

  16. High serum resistin is associated with an increase in adiposity but not a worsening of insulin resistance in Pima Indians

    DEFF Research Database (Denmark)

    de Courten, Barbora; Degawa-Yamauchi, Mikako; Considine, Robert V

    2004-01-01

    ) and hepatic glucose output during low-dosage insulin infusion of a hyperinsulinemic clamp (HGO; a measure of hepatic insulin resistance), and acute insulin secretory response (AIR; assessed by 25-g intravenous glucose tolerance test). Follow-up measurements of M, BHGO, HGO, and AIR were available for 34......Resistin is an adipokine with putative prodiabetogenic properties. Like other hormones secreted by adipose tissue, resistin is being investigated as a possible etiologic link between excessive adiposity and insulin resistance. Although there is growing evidence that circulating levels...... of this adipokine are proportional to the degree of adiposity, an effect on insulin resistance in humans remains unproven. To evaluate the relations among resistin, obesity, and insulin resistance, we measured fasting serum resistin levels in 113 nondiabetic (75-g oral glucose tolerance test) Pima Indians (ages 29...

  17. Palmitoleic acid reduces intramuscular lipid and restores insulin sensitivity in obese sheep

    OpenAIRE

    Duckett SK; Volpi-Lagreca G; Alende M; Long NM

    2014-01-01

    Susan K Duckett, Gabriela Volpi-Lagreca, Mariano Alende, Nathan M LongAnimal and Veterinary Sciences Department, Clemson University, Clemson, SC, USAAbstract: Obese sheep were used to assess the effects of palmitoleic (C16:1 cis-9) acid infusion on lipogenesis and circulating insulin levels. Infusion of 10 mg/kg body weight (BW)/day C16:1 intravenously in obese sheep reduced (P<0.01) weight gain by 77%. Serum palmitoleic levels increased (P<0.05) in a linear manner with increasi...

  18. Anestesia venosa total em regime de infusão alvo-controlada: uma análise evolutiva Anestesia venosa total en régimen de infusión objeto controlada: un análisis evolutivo Total intravenous anesthesia as a target-controlled infusion: an evolutive analysis

    Directory of Open Access Journals (Sweden)

    Fernando Squeff Nora

    2008-04-01

    ón objeto controlada (IOC. El primer modelo farmacocinético descrito para uso en IOC, fue descrito por Schwilden en 1981. Quedó demostrado a partir de entonces, que era posible mantener la concentración plasmática deseada de un fármaco utilizando bomba de infusión por computador. CONTENIDO: Este artigo quiso dejar sentadas las bases teóricas de la IOC, presentar una propuesta de desarrollo de un vocabulario común en IOC todavía no publicado en Brasil y hacer un análisis crítico de los aspectos actuales de la IOC en el mundo y en Brasil. CONCLUSIONES: La llegada de nuevas bombas de infusión dotadas de los modelos farmacocinéticos del remifentanil, sufentanil y propofol inaugura otro capítulo de la AVT y coloca a Brasil a tono con la tendencia mundial en IOC. Esos sistemas facilitarán la IOC de hipnóticos y opioides concomitantemente. La conclusión más importante, sin embargo, se refiere a la economía en la medida en que los fármacos utilizados en esas bombas no quedarán restrictos a solamente una empresa farmacéutica, como por ejemplo lo que ocurrió con el propofol. Hoy ya disponemos de equipos para la utilización de propofol y opioides en IOC, que aceptan cualquier presentación farmacéutica con la ventaja de poder alterar la concentración del fármaco en la jeringuilla de acuerdo con la dilución que se desee.BACKGROUND AND DOBJECTIVES: Total intravenous anesthesia (TIVA has seen several developments since it was first used. Since the synthesis of the first intravenous anesthetics, with the introduction of barbiturates (1921 and thiopental (1934, TIVA has evolved until the development of TIVA with target-controlled infusion pumps (TCI. The first pharmacokinetic model for the use of TCI was described by Schwilden in 1981. From that moment on, it was demonstrated that it is possible to maintain the desired plasma concentration of a drug using an infusion pump managed by a computer. CONTENTS: The objective of this report was to describe the

  19. Palmitoleic acid reduces intramuscular lipid and restores insulin sensitivity in obese sheep.

    Science.gov (United States)

    Duckett, Susan K; Volpi-Lagreca, Gabriela; Alende, Mariano; Long, Nathan M

    2014-01-01

    Obese sheep were used to assess the effects of palmitoleic (C16:1 cis-9) acid infusion on lipogenesis and circulating insulin levels. Infusion of 10 mg/kg body weight (BW)/day C16:1 intravenously in obese sheep reduced (Psubcutaneous adipose tissue was not altered. Total lipid content of the liver was also unchanged with C16:1 infusion. Palmitoleic acid infusion upregulated (Psubcutaneous adipose, and ST muscle compared to the controls. However, mRNA expression of glucose transporter type 4 (GLUT4) and carnitine palmitoyltransferase 1b (CPT1B) differed between tissues. In the subcutaneous adipose and liver, C16:1 infusion upregulated (P<0.05) GLUT4 and CPT1B, whereas these genes were downregulated (P<0.05) in ST muscle with C16:1 infusion. These results show that C16:1 infusion for 28 days reduced weight gain, intramuscular adipocyte size and total lipid content, and circulating insulin levels. These changes appear to be mediated through alterations in expression of genes regulating glucose uptake and fatty acid oxidation specifically in the muscles.

  20. Influence of ketone body infusion on plasma growth hormone and glucagon in man.

    Science.gov (United States)

    Quabbe, H J; Trompke, M; Luyckx, A S

    1983-09-01

    The influence of ketone body infusion on the serum GH and glucagon response to FFA depression and insulin hypoglycemia was investigated in 10 healthy men. Intravenous infusion of nicotinic acid induced suppression of both FFA and ketone bodies. This was accompanied by a delayed GH increase to 21.1 +/- 6.9 ng/ml (at 300 min). During an additional beta-hydroxybutyrate (OHB) infusion, FFA remained depressed, but ketone bodies were elevated, and the GH response was abolished (maximum 5.6 +/- 1.6 ng/ml). During infusion of OHB alone, FFA were suppressed. GH increased significantly, although less markedly than during suppression of both FFA and ketone bodies (to 9.3 +/- 3.1 ng/ml at 270 min). No GH rise occurred when both FFA and ketone bodies were kept elevated by the addition of a lipid infusion. The GH rise in response to insulin hypoglycemia was not changed by an OHB infusion (43.2 +/- 4.6 vs. 48.0 +/- 7.3 ng/ml). However, OHB increased the net GH output by significantly delaying the return to basal concentrations in the presence of a reduced FFA rebound. An effect of OHB infusion on the plasma glucagon concentration during all experiments was small, and its physiological significance is doubtful. These results confirm that FFA depression induces delayed GH secretion. They suggest that this is not wholly dependent on concomitant depression of ketone bodies. On the other hand, when ketone bodies are elevated, the GH response to FFA depression is diminished or absent. The net GH response to changes in lipid substrates probably depends on the concentration of both FFA and ketone bodies.

  1. Effect of IL-6 on the insulin sensitivity in patients with type 2 diabetes

    DEFF Research Database (Denmark)

    Harder-Lauridsen, Nina Majlund; Krogh-Madsen, R; Holst, J J;

    2014-01-01

    Elevated interleukin-6 (IL-6) levels are associated with type 2 diabetes, but its role in glucose metabolism is controversial. We investigated the effect of IL-6 on insulin-stimulated glucose metabolism in type 2 diabetes patients and hypothesized that an acute, moderate IL-6 elevation would...... increase the insulin-mediated glucose uptake. Men with type 2 diabetes not treated with insulin [n = 9, age 54.9 ± 9.7 (mean ± SD) yr, body mass index 34.8 ± 6.1 kg/m(2), HbA1c 7.0 ± 1.0%] received continuous intravenous infusion with either recombinant human IL-6 (rhIL-6) or placebo. After 1 h...... in muscle biopsies. Whole body energy expenditure was measured using indirect calorimetry. In response to the infusion of rhIL-6, circulating levels of IL-6 (P

  2. Analysis on Application of Intravenous Infusion for 53 Diseases in Outpatient and Emergency Department of Suzhou Municipal Hospital Before and After Comprehensive InterventionΔ%综合干预前后宿州市立医院门、急诊53种疾病静脉输液应用分析Δ

    Institute of Scientific and Technical Information of China (English)

    刘洪峰; 范秀英; 孟现奇; 代玉琦

    2016-01-01

    OBJECTIVE:To probe into the effects of comprehensive intervention on application of intravenous infusion in outpatient and emergency department of Suzhou Municipal Hospital ( hereinafter referred to as “our hospital”) , so as to establish long-term mechanism of intravenous infusion of supervision by comprehensive intervention measures.METHODS:Statistical analysis was conducted on the intravenous infusion rate in outpatient and emergency department, intravenous infusion rate of antibiotics, intravenous infusion rate of 53 diseases and rational rate of prescriptions with intravenous infusion in our hospital from Jul.to Dec.2014 ( before intervention) and from Jul.to Dec.2015 ( after intervention).RESULTS: The average intravenous infusion rate in outpatient department decreased from 24.03%before intervention to 16.49%after intervention, the decreasing range was 7.54%; and in emergency department, it decreased from 65.19% before intervention to 54.64% after intervention, the decreasing range was 10.55%.Meanwhile, the average intravenous infusion rate for 53 diseases in outpatient department decreased from 22.40%before intervention to 12.66%after intervention, the decreasing range was 9.74%; and in emergency department, it decreased from 63.74% before intervention to 55.68% after intervention, the decreasing range was 8.06%.The rational rate of prescriptions with intravenous infusion in outpatient and emergency department increased from 83.00% before intervention to 95.50% after intervention, the increasing range was 12.50%.After intervention, the related indicators were significantly better than before intervention, the differences were statistically significant(P<0.05).CONCLUSIONS:Comprehensive intervention can effectively decrease intravenous infusion rate in outpatient and emergency department and improve the level of rational application of drugs.%目的:探讨综合干预对宿州市立医院(以下简称“我院”)门、急诊静脉输液使用情况

  3. Effects of Liraglutide Combined with Short-Term Continuous Subcutaneous Insulin Infusion on Glycemic Control and Beta Cell Function in Patients with Newly Diagnosed Type 2 Diabetes Mellitus: A Pilot Study.

    Science.gov (United States)

    Ke, Weijian; Liu, Liehua; Liu, Juan; Chen, Ailing; Deng, Wanping; Zhang, Pengyuan; Cao, Xiaopei; Liao, Zhihong; Xiao, Haipeng; Liu, Jianbin; Li, Yanbing

    2016-01-01

    The objective of this paper is to investigate the effects of liraglutide in combination with short-term continuous subcutaneous insulin infusion (CSII) therapy on glycemic control and beta cell function in patients with newly diagnosed type 2 diabetes mellitus (T2DM). Thirty-nine eligible newly diagnosed T2DM patients were recruited and randomized to receive either of two therapies: short-term CSII alone (CSII alone group) or CSII in combination with liraglutide (CSII + Lira group) for 12 weeks. Blood glucose control, homeostasis model assessment (HOMA) indices, and acute insulin response (AIR) were compared between the two groups. The patients in CSII + Lira group achieved euglycemia with equivalent insulin dosage in shorter time (1 (0) versus 2 (3) days, P = 0.039). HbA1c at the end of study was comparable between two groups (6.3 ± 0.7% versus 6.0 ± 0.5%, for CSII alone group and CSII + Lira group, resp., P = 0.325). The increment of AIR was higher in CSII + Lira group (177.58 (351.57) μU · min/mL versus 58.15 (51.30) μU · min/mL, P < 0.001). However, after stopping liraglutide, its effect on beta cell function disappeared completely. Liraglutide combined with short-term CSII was effective in further improving beta cell function, but the beneficial effects did not sustain after suspension of the therapy.

  4. Lack of relationship between 11 beta-hydroxysteroid dehydrogenase setpoint and insulin sensitivity in the basal state and after 24h of insulin infusion in healthy subjects and type 2 diabetic patients

    NARCIS (Netherlands)

    Kerstens, MN; Riemens, SC; Sluiter, WJ; Pratt, JJ; Wolthers, BG; Dullaart, RPF

    OBJECTIVES To test whether insulin resistance in type 2 diabetes mellitus is associated with an altered overall setpoint of the 11 beta-hydroxysteroid dehydrogenase (11 beta HSD) mediated cortisol to cortisone interconversion towards cortisol, and to evaluate whether changes in insulin sensitivity

  5. Establishing glycaemic control with continuous subcutaneous insulin infusion in children and adolescents with type 1 diabetes : experience of the PedPump Study in 17 countries

    NARCIS (Netherlands)

    Danne, T.; Battelino, T.; Jarosz-Chobot, P.; Kordonouri, O.; Pankowska, E.; Ludvigsson, J.; Schober, E.; Kaprio, E.; Saukkonen, T.; Nicolino, M.; Tubiana-Rufi, N.; Klinkert, C.; Haberland, H.; Vazeou, A.; Madacsy, L.; Zangen, D.; Cherubini, V.; Rabbone, I.; Toni, S.; de Beaufort, C.; Waarde, W. Bakker-van; van den Berg, N.; Volkov, I.; Barrio, R.; Hanas, R.; Zumsteg, U.; Kuhlmann, B.; Aebi, C.; Schumacher, U.; Gschwend, S.; Hindmarsh, P.; Torres, M.; Shehadeh, N.; Phillip, M.

    2008-01-01

    Aims/hypothesis To assess the use of paediatric continuous subcutaneous infusion (CSII) under real-life conditions by analysing data recorded for up to 90 days and relating them to outcome. Methods Pump programming data from patients aged 0-18 years treated with CSII in 30 centres from 16 European c

  6. Establishing glycaemic control with continuous subcutaneous insulin infusion in children and adolescents with type 1 diabetes : experience of the PedPump Study in 17 countries

    NARCIS (Netherlands)

    Danne, T.; Battelino, T.; Jarosz-Chobot, P.; Kordonouri, O.; Pankowska, E.; Ludvigsson, J.; Schober, E.; Kaprio, E.; Saukkonen, T.; Nicolino, M.; Tubiana-Rufi, N.; Klinkert, C.; Haberland, H.; Vazeou, A.; Madacsy, L.; Zangen, D.; Cherubini, V.; Rabbone, I.; Toni, S.; de Beaufort, C.; Waarde, W. Bakker-van; van den Berg, N.; Volkov, I.; Barrio, R.; Hanas, R.; Zumsteg, U.; Kuhlmann, B.; Aebi, C.; Schumacher, U.; Gschwend, S.; Hindmarsh, P.; Torres, M.; Shehadeh, N.; Phillip, M.

    Aims/hypothesis To assess the use of paediatric continuous subcutaneous infusion (CSII) under real-life conditions by analysing data recorded for up to 90 days and relating them to outcome. Methods Pump programming data from patients aged 0-18 years treated with CSII in 30 centres from 16 European

  7. Partial intravenous anesthesia in cats and dogs.

    Science.gov (United States)

    Duke, Tanya

    2013-03-01

    The partial intravenous anesthesia technique (PIVA) is used to lower the inspired concentration of an inhalational anesthetic by concurrent use of injectable drugs. This technique reduces the incidence of undesirable side-effects and provides superior quality of anesthesia and analgesia. Drugs commonly used for PIVA include opioids, alpha-2 adrenergic agonists, injectable anesthetic agents, and lidocaine. Most are administered by intravenous infusion.

  8. Glucose Infusion into Exercising Dogs after Confinement: Rectal and Active Muscle Temperatures

    Science.gov (United States)

    Greenleaf, J. E.; Kruk, B.; Nazar, K.; Falecka-Wieczorek, I.; Kaciuba-Uscilko, H.

    1995-01-01

    Intravenous glucose infusion into ambulatory dogs results in attenuation of exercise-induced increase of both rectal and thigh muscle temperatures. That glucose (Glu) infusion attenuates excessive increase in body temperature from restricted activity during confinement deconditioning. Intravenous glucose infusion attenuates the rise in exercise core temperature in deconditioned dogs by a yet undefined mechanism.

  9. Clinical observation of 10% calcium gluconate intravenous infusion in the treatment of vitamin D deficiency rickets%10%葡萄糖酸钙注射液静脉滴注治疗维生素D缺乏性佝偻病的临床观察

    Institute of Scientific and Technical Information of China (English)

    陈彩玲; 苏攀宏

    2015-01-01

    Objective:To explore the clinical effect of 10% calcium gluconate intravenous infusion in the treatment of vitamin D deficiency rickets.Methods:120 patients with vitamin D deficiency rickets were selected.They were divided into the treatment group and the control group with 60 cases in each group.The treatment group was treated with 10 mL 10% calcium gluconate intravenous infusion,and the control group was treated by simple oral vitamin D.We compared the efficacy of two groups.Results:The therapeutic effect of the treatment group was significantly better than that of the control group(P<0.05).Conclusion:The clinical effect of 10% calcium gluconate intravenous infusion in the treatment of vitamin D deficiency rickets was significant.%目的:探讨10%葡萄糖酸钙注射液静脉滴注治疗维生素D缺乏性佝偻病的临床效果.方法:收治维生素D缺乏性佝偻病患儿120例,分为治疗组和对照组各60例,治疗组采用10%的葡萄糖酸钙注射液10 mL静脉滴注,对照组单纯口服维生素D,比较两组疗效.结果:治疗组的治疗效果明显优于对照组(P<0.05).结论:10%的葡萄糖酸钙溶液静脉滴注治疗维生素D缺乏性佝偻病的临床效果显著.

  10. Defective insulin secretion by chronic glucagon receptor activation in glucose intolerant mice.

    Science.gov (United States)

    Ahlkvist, Linda; Omar, Bilal; Valeur, Anders; Fosgerau, Keld; Ahrén, Bo

    2016-03-01

    Stimulation of insulin secretion by short-term glucagon receptor (GCGR) activation is well characterized; however, the effect of long-term GCGR activation on β-cell function is not known, but of interest, since hyperglucagonemia occurs early during development of type 2 diabetes. Therefore, we examined whether chronic GCGR activation affects insulin secretion in glucose intolerant mice. To induce chronic GCGR activation, high-fat diet fed mice were continuously (2 weeks) infused with the stable glucagon analog ZP-GA-1 and challenged with oral glucose and intravenous glucose±glucagon-like peptide 1 (GLP1). Islets were isolated to evaluate the insulin secretory response to glucose±GLP1 and their pancreas were collected for immunohistochemical analysis. Two weeks of ZP-GA-1 infusion reduced insulin secretion both after oral and intravenous glucose challenges in vivo and in isolated islets. These inhibitory effects were corrected for by GLP1. Also, we observed increased β-cell area and islet size. We conclude that induction of chronic ZP-GA-1 levels in glucose intolerant mice markedly reduces insulin secretion, and thus, we suggest that chronic activation of the GCGR may contribute to the failure of β-cell function during development of type 2 diabetes.

  11. Quality of life in Danish children and adolescents with type 1 diabetes treated with continuous subcutaneous insulin infusion or multiple daily injections

    DEFF Research Database (Denmark)

    Birkebæk, Niels; Kristensen, Lene Juel; Mose, Anne

    2014-01-01

    for more than one year) and 405 with MDI (238 for more than one year). Participants and their parents completed the Pediatric Quality of Life Inventory Diabetes and Generic Module. HbA1c was analyzed centrally. RESULTS: Parents reported children and adolescents on CSII for more than one year to have less......AIMS: The aims of the study were to compare health-related quality of life (HRQoL) in a National Danish population of children and adolescents with type 1 diabetes (T1D) treated with either continuous subcutaneous insulin injection (CSII) or multiple daily insulin injections (MDI...

  12. Influence of insulin on plasma concentration and renal excretion of sodium and potassium in normal, electrolytes depleted and aldosterone treated dogs.

    Science.gov (United States)

    Bak, M; Szczepańska-Sadowska, E; Krzymień, J; Kozłowski, S; Czyzyk, A

    1987-10-01

    Effects of insulin on plasma concentration and renal excretion of sodium and potassium were compared in conscious dogs 1) maintained in water and electrolytes balance (Series 1, 10 dogs), 2) depleted of electrolytes by repeated i.v. loading with 20% mannitol (Series 2, 10 dogs), and 3) aldosterone treated (0.8 micrograms.kg-1.h-1 i.v., Series 3, 10 dogs). In each Series intravenous infusion of insulin at a rate of 0.05 U.kg-1.h-1 elicited transient increase in plasma sodium concentration and prolonged hypokalemia. Repeated loading with mannitol in Series 2 elicited significant elevation of plasma sodium, ADH and aldosterone concentrations, as well as decrease in extracellular fluid volume. Infusion of insulin in this Series elicited smaller decrease in plasma potassium concentration and longer lasting hypernatremia than in dogs in water-electrolytes balance. Aldosterone infusion in Series 3 did not change hypokalemic effect of insulin but attenuated hypernatremia. Infusion of insulin in Series 1 elicited increase of sodium excretion and decrease in potassium excretion. These effects were absent in Series 2 and 3. The results indicate that depletion of electrolytes and blood aldosterone elevation modify the effects of insulin on plasma concentration and renal excretion of sodium and potassium.

  13. Comparative study of amino acid, ammonia and pancreatic hormone levels in the blood of cirrhotic patients following intragastric and intravenous administration of a branched-chain amino acid-enriched solution.

    Directory of Open Access Journals (Sweden)

    Watanabe,Akiharu

    1983-10-01

    Full Text Available The blood levels of amino acids, ammonia and pancreatic hormones following the intragastric and intravenous administration of a branched-chain amino acid (BCAA-enriched solution were comparatively investigated in control subjects and patients with liver cirrhosis. There was no essential difference in the time course of serum amino acid and blood ammonia levels between the intragastric and intravenous infusions. Elevation of serum insulin concentrations in cirrhotic patients was significant only immediately after the administration through the enteral route. However, plasma glucagon levels increased similarly when the BCAA-enriched solution was administered through either route. The results indicate that both enteral and intravenous infusions will have similar therapeutic effects on the impaired protein metabolism in cirrhotic patients with protein-calorie malnutrition.

  14. Brain functional magnetic resonance imaging response to glucose and fructose infusions in humans.

    Science.gov (United States)

    Purnell, J Q; Klopfenstein, B A; Stevens, A A; Havel, P J; Adams, S H; Dunn, T N; Krisky, C; Rooney, W D

    2011-03-01

    In animals, intracerebroventricular glucose and fructose have opposing effects on appetite and weight regulation. In humans, functional brain magnetic resonance imaging (fMRI) studies during glucose ingestion or infusion have demonstrated suppression of hypothalamic signalling, but no studies have compared the effects of glucose and fructose. We therefore sought to determine if the brain response differed to glucose vs. fructose in humans independently of the ingestive process. Nine healthy, normal weight subjects underwent blood oxygenation level dependent (BOLD) fMRI measurements during either intravenous (IV) glucose (0.3 mg/kg), fructose (0.3 mg/kg) or saline, administered over 2 min in a randomized, double-blind, crossover study. Blood was sampled every 5 min during a baseline period and following infusion for 60 min in total for glucose, fructose, lactate and insulin levels. No significant brain BOLD signal changes were detected in response to IV saline. BOLD signal in the cortical control areas increased during glucose infusion (p = 0.002), corresponding with increased plasma glucose and insulin levels. In contrast, BOLD signal decreased in the cortical control areas during fructose infusion (p = 0.006), corresponding with increases of plasma fructose and lactate. Neither glucose nor fructose infusions significantly altered BOLD signal in the hypothalamus. In normal weight humans, cortical responses as assessed by BOLD fMRI to infused glucose are opposite to those of fructose. Differential brain responses to these sugars and their metabolites may provide insight into the neurologic basis for dysregulation of food intake during high dietary fructose intake. © 2011 Blackwell Publishing Ltd.

  15. Long-term effects of continuous subcutaneous infusion versus daily subcutaneous injections of growth hormone (GH) on the insulin-like growth factor system, insulin sensitivity, body composition, and bone and lipoprotein metabolism in GH-deficient adults

    DEFF Research Database (Denmark)

    Laursen, Torben; Gravholt, Claus Højbjerg; Heickendorff, Lene

    2001-01-01

    = 0.72), IGFBP-2 (P = 0.34), and GH-binding protein (P = 0.75) were unaffected by treatment regimen. Serum levels of free fatty acids, reflecting lipolysis, decreased significantly (16%) in the group switched to GH infusion (difference, -99.8 vs. +5 micromol/L; P

  16. An audit of hospital based outpatient infusions and a pilot program of community-based monoclonal antibody infusions.

    LENUS (Irish Health Repository)

    Doran, J-P

    2012-02-01

    INTRODUCTION: Infliximab, a chimeric monoclonal antibody to tumour necrosis factor alpha, is administered as an intravenous infusion requiring a costly hospital day case or inpatient admission. METHODS: An audit of all current therapies given by intravenous infusions in an outpatient setting in St Vincent\\'s University Hospital (SVUH) was undertaken. Furthermore, in conjunction with TCP homecare, we established in a general practise health clinic, the first Irish community infusion centre for the administration of infliximab in August 2006. RESULTS: All outpatient departments indicated that they would favour a centralized hospital infusion unit. There were no adverse events and the mean global satisfaction improved in the community infliximab infusion pilot programme of seven patients. CONCLUSION: This study suggests efficiencies in providing centralized infusion facilities, while the community based infusion of infliximab is feasible and safe in this small cohort and identifies the community infusion unit as a viable and cost efficient alternative for administration of infliximab.

  17. Effect of intravenous infusion team (Ⅳ team) training mode in safety management of PICC%静脉治疗小组培训模式在PICC安全管理中的应用效果

    Institute of Scientific and Technical Information of China (English)

    邓立华; 张瑜; 刁同进

    2013-01-01

    Objective To explore the effect of intravenous infusion team (Ⅳ team) combined with systematic training in safety management of peripherally inserted central catheter (PICC).Methods Totals of 150 PICC patients before training from October 2010 to September 2011 were the control group,and 150 PICC patients after training from October 2011 to September 2012 were the experimental group.Incidence rate of complication and unplanned extubation as well as patients' satisfaction rate were compared between two groups before and after training.Results There were total 10 cases of complication in the experimental group,including 2 cases of catheter infection,3 cases of phlebitis,1 case of catheter separation,2 cases of obstruction and 2 cases of unplanned extubation,while there were total 64 cases of complication in the control group,including 10 cases of catheter infection,15 cases of phlebitis,9 cases of catheter separation,14 cases of obstruction and 16 cases of unplanned extubation,and the difference was statistically significant (x2 =52.30,P <0.01).Patients' satisfaction rate was 88.33% in the control group and 98.3% in the experimental group,and the difference was statistically significant (x2 =4.82,P < 0.05).Conclusions Ⅳ team plays a leading and radiation role in nursing,which can improve safety management of PICC nursing and the overall service level of hospital care.%目的 探讨静脉治疗小组(Ⅳ Team)建立与系统化培训相结合在提高PICC护理安全管理中的应用效果.方法 随机抽取2010年10月至2011年9月培训前PICC置管患者150例为对照组,2011年10月至2012年9月培训后150例为研究组,比较两组患者在培训前后并发症及非计划性拔管等情况的发生率和患者的满意度.结果 研究组患者发生并发症者总计10例,其中导管感染2例,静脉炎3例,导管脱出1例,阻塞2例,非计划性拔管2例;对照组总计64例,其中导管感染10例,静脉炎15例,导管脱出9

  18. Humanin: a novel central regulator of peripheral insulin action.

    Directory of Open Access Journals (Sweden)

    Radhika H Muzumdar

    Full Text Available BACKGROUND: Decline in insulin action is a metabolic feature of aging and is involved in the development of age-related diseases including Type 2 Diabetes Mellitus (T2DM and Alzheimer's disease (AD. A novel mitochondria-associated peptide, Humanin (HN, has a neuroprotective role against AD-related neurotoxicity. Considering the association between insulin resistance and AD, we investigated if HN influences insulin sensitivity. METHODS AND FINDINGS: Using state of the art clamp technology, we examined the role of central and peripheral HN on insulin action. Continuous infusion of HN intra-cerebro-ventricularly significantly improved overall insulin sensitivity. The central effects of HN on insulin action were associated with activation of hypothalamic STAT-3 signaling; effects that were negated by co-inhibition of hypothalamic STAT-3. Peripheral intravenous infusions of novel and potent HN derivatives reproduced the insulin-sensitizing effects of central HN. Inhibition of hypothalamic STAT-3 completely negated the effects of IV HN analog on liver, suggesting that the hepatic actions of HN are centrally mediated. This is consistent with the lack of a direct effect of HN on primary hepatocytes. Furthermore, single treatment with a highly-potent HN analog significantly lowered blood glucose in Zucker diabetic fatty rats. Based upon the link of HN with two age-related diseases, we examined if there were age associated changes in HN levels. Indeed, the amount of detectable HN in hypothalamus, skeletal muscle, and cortex was decreased with age in rodents, and circulating levels of HN were decreased with age in humans and mice. CONCLUSIONS: We conclude that the decline in HN with age could play a role in the pathogenesis of age-related diseases including AD and T2DM. HN represents a novel link between T2DM and neurodegeneration and along with its analogues offers a potential therapeutic tool to improve insulin action and treat T2DM.

  19. Cognitive status of junior pediatric nurses on intravenous infusion of high risk drugs and analysis of its influencing factors%低年资儿科护士对静脉输注高危药物的认知现状与影响因素分析

    Institute of Scientific and Technical Information of China (English)

    杨卫红; 赵丽; 吴月丽

    2015-01-01

    Objective:To probe into the cognitive status quo of junior pediatric nurses on intravenous infusion of high risk drugs and analysis of its influencing factors .Methods:A total of 539 cases of junior pediatric nurses in many hospitals in the region were surveyed by using general questionnaire and intravenous infusion of high risk drugs cognitive questionnaire ,and analyzing the influencing factors .Results:the total cognition score of nurses on intravenous infusion of high risk drugs was 85 .20 ± 6 .33 .Single factor analysis showed that sex ,marital sta‐tus ,educational background ,title ,gender ,age ,working years ,employment way had the influences on total cognition score of nurses on intravenous infusion of high risk drugs (P<0 .05) .Conclusion:The junior pediatric nurses had cognition deficiency on intravenous infusion of high risk drugs ,and it was related to employment way ,marital status ,working years and title .The hospital should take the targeted management training posi‐tively and improve the cognition level of junior pediatric nurses .%[目的]探讨低年资儿科护士对静脉输注高危药物的认知现状与影响因素。[方法]采用一般情况调查表和静脉输注高危药物认知调查表对选取的本地区多家医院儿科低年资护士539人进行调查,并分析其影响因素。[结果]护士对于静脉输注高危药物的认知总分为85.20分±6.33分。单因素分析显示,性别、婚姻状况、学历、职称、性别、聘用形式、年龄、工作年限都对静脉输注高危药物认知总分有影响(P<0.05);多因素逐步回归分析结果显示,聘用形式、婚姻状况、工作年限与职称对护士的静脉输注高危药物认知有影响(P<0.05)。[结论]低年资儿科护士静脉输注高危药物的认知存在不足,与护士的聘用形式、婚姻状况、工作年限与职称有关,医院应积极进行有针对性的管理培训,提高低年资护士的认知水平。

  20. The Impact Evaluation of Essential Medicine Policies on Joint Usage of Antibiotics, Steroids and Intravenous Infusion in Township Health Care%基本药物制度对乡镇卫生院使用“两素一汤”的影响评价*

    Institute of Scientific and Technical Information of China (English)

    金承刚; 杨洪伟; 梁小云; 武宁; 李珍; 陈丽

    2013-01-01

    Objective: To evaluate the impact of essential medicine policy on joint usage of antibiotics, steroids and intravenous infusion in township health care Health care. Methods: A township hospital implementing essential medicine policy was chosen as experimental group, and a similar township hospital which has not applied the essential medicine system was chosen as control group. It employs a pre-post with non-equivalent control design and logistic regression to estimate whether there is joint usage of antibiotics, hormone, and intravenous infusion in those prescriptions. Results: Essential medicine policy has increased the probability of joint usage of antibiotics, steroids and intravenous infusion increased by 1.27-fold ( P<0.001) in township health care. Conclusion: Essential medicine policy has increased the joint usage of antibiotics, hormones, and intravenous, and it needs further improvement in policy implement and rational medicine use.%  目的:评价基本药物政策对抗生素、激素和静脉输液联合使用的作用。方法:选取东南沿海某省一个已实施基本药物制度的中心乡镇卫生院作为试点组,一个未开展基本药物制度的中心乡镇卫生院作为对照组,进行非随机对照前后比较的类实验研究,对两个机构的处方中是否联合使用抗生素、激素类药物和静脉输液进行Logistic回归。结果:基本药物制度实施使乡镇卫生院的门诊中联合使用两素一汤的概率增加了1.27倍(P<0.001)。结论:基本药物政策增加了抗生素、激素和静脉输液的联合用药的使用,需要进一步完善政策,促进合理用药。

  1. Continuous subcutaneous infusion of glucagon-like peptide 1 lowers plasma glucose and reduces appetite in type 2 diabetic patients

    DEFF Research Database (Denmark)

    Toft-Nielsen, M B; Madsbad, Sten; Holst, J J

    1999-01-01

    under the curve for insulin and C-peptide levels were significantly higher during the GLP-1 administration, whereas glucagon levels were unchanged. Neither triglycerides nor free fatty acids were affected. GLP-1 administration decreased hunger and prospective food intake and increased satiety, whereas......OBJECTIVE: The gut hormone glucagon-like peptide 1 (GLP-1) has insulinotropic and anorectic effects during intravenous infusion and has been proposed as a new treatment for type 2 diabetes and obesity. The effect of a single subcutaneous injection is brief because of rapid degradation. We therefore...

  2. [Continuous insulin therapy versus multiple insulin injections in the management of type 1 diabetes: a longitutinal study].

    Science.gov (United States)

    Ribeiro, Maria Estela Bellini; Del Roio Liberatore Junior, Raphael; Custodio, Rodrigo; Martinelli Junior, Carlos Eduardo

    2016-01-01

    To compare multiple doses of insulin and continuous insulin infusion therapy as treatment for type 1 diabetes melito. 40 patients with type 1 diabetes melito (21 female) with ages between 10 and 20 years (mean=14.2) and mean duration of diabetes of 7 years used multiple doses of insulin for at least 6 months and after that, continuous insulin infusion therapy for at least 6 months. Each one of the patients has used multiple doses of insulin and continuous insulin infusion therapy. For analysis of HbA1c, mean glycated hemoglobin levels (mHbA1c) were obtained during each treatment period (multiple doses of insulin and continuous insulin infusion therapy period). Although mHbA1c levels were lower during continuous insulin infusion therapy the difference was not statistically significant. During multiple doses of insulin, 14.2% had mHbA1c values below 7.5% vs. 35.71% while on continuous insulin infusion therapy; demonstrating better glycemic control with the use of continuous insulin infusion therapy. During multiple doses of insulin, 15-40 patients have severe hypoglycemic events versus 5-40 continuous insulin infusion therapy. No episodes of ketoacidosis events were recorded. This is the first study with this design comparing multiple doses of insulin and continuous insulin infusion therapy in Brazil showing no significant difference in HbA1c; hypoglycemic events were less frequent during continuous insulin infusion therapy than during multiple doses of insulin and the percentage of patients who achieved a HbA1c less than 7.5% was greater during continuous insulin infusion therapy than multiple doses of insulin therapy. Copyright © 2015 Sociedade de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

  3. Central nervous insulin administration does not potentiate the acute glucoregulatory impact of concurrent mild hyperinsulinemia.

    Science.gov (United States)

    Ott, Volker; Lehnert, Hendrik; Staub, Josefine; Wönne, Kathrin; Born, Jan; Hallschmid, Manfred

    2015-03-01

    Experiments in rodents suggest that hypothalamic insulin signaling essentially contributes to the acute control of peripheral glucose homeostasis. Against this background, we investigated in healthy humans whether intranasal (IN) insulin, which is known to effectively reach the brain compartment, impacts systemic glucose metabolism. Twenty overnight-fasted healthy, normal-weight men were IN administered 210 and 420 international units [IU] (10 and 20 IU every 15 min) of the insulin analog aspart (ins-asp) and placebo, respectively, during experimental sessions lasting 6 h. The use of ins-asp rather than human insulin enabled us to disentangle exogenous and endogenous insulin kinetics. IN insulin dose-dependently decreased plasma glucose concentrations while reducing C-peptide and attenuating endogenous insulin levels. However, we also observed a slight dose-dependent permeation of ins-asp into the circulation. In control experiments mimicking the systemic but not the central nervous uptake of the IN 210 IU dose via intravenous infusion of ins-asp at a dose of 0.12 IU/kg/24 h (n = 10), we obtained essentially identical effects on fasting plasma glucose concentrations. This pattern indicates that sustained IN insulin administration to the human brain to enhance central nervous insulin signaling does not acutely alter systemic glucose homeostasis beyond effects accounted for by concurrent mild hyperinsulinemia.

  4. Effects of metoclopramide and metoclopramide/dopamine on blood pressure and insulin release in normotensive, hypertensive, and type 2 diabetic subjects.

    Science.gov (United States)

    Contreras, Freddy; Fouillioux, Christian; Lares, Mary; Bolívar, Hector; Hernández, Rafael Hernández; Velasco, Manuel; Cano, Raquel; Chacin, Maricarmen; Bermúdez, Valmore

    2010-01-01

    The objective is to determine cardiovascular and insulin release effects under metoclopramide (MTC) and dopamine (DA) infusion by using an acute comparative design with the intravenous infusion of both drugs. We evaluated 15 normal (normotensive and normoglycemic) subjects, 13 hypertensive, and 15 type 2 diabetic subjects. Subjects were submitted to an experimental design in which we first gave them a 0.9% saline solution for 30 minutes, and then administered MTC at 7.5 microg kg min through an intravenous infusion during a period of 30 minutes. Although subjects were receiving MTC, we added an intravenous infusion of DA at 1-3 microg kg min during 30 minutes. Blood pressure, heart rate, serum lipid profile, and insulin levels were measured. Sympathetic reactivity by the cold pressor test was also measured. In normotensive subjects, there was a systolic blood pressure and heart rate increase during MTC plus DA infusion. In subjects with diabetes mellitus there was a heart rate increase without changes in blood pressure during the MTC plus DA infusion period. In hypertensive subjects, MTC induced a significant decrease of systolic and diastolic blood pressure. During MTC plus DA period there was an increase of heart rate but no significant changes in blood pressure. During cold pressor test in both diabetic and hypertensive subjects, there were significant increases of both blood pressure and heart rate. Insulin serum levels increased in normotensive and hypertensive subjects but were attenuated in subjects with diabetes mellitus. We conclude that there is a pharmacologic interaction between MTC and DA, that the pressor effects of DA are due to activation to beta and alpha adrenergic receptors, and that the cardiovascular effects of DA in type 2 diabetic subjects are attenuated by a probable defect in sympathetic system and to endothelial dysfunction.

  5. Preliminary Study for Continuous Subcutaneous Insulin Infusion in Type 2 Diabetes Patients With Heart Diseases%合并心脏病的2型糖尿病患者胰岛素泵强化治疗初探

    Institute of Scientific and Technical Information of China (English)

    李肖珏; 李光伟; 陈燕燕; 巩秋红; 安雅莉; 张丽红; 回园敕; 沈晓霞; 冯新星; 王慧

    2014-01-01

    目的:评估14天胰岛素泵强化治疗合并心脏病的2型糖尿病(病程小于5年)的疗效及安全性。  方法:既往有心脏病史的2型糖尿病患者22例,平均年龄(48.15±9.80)岁,男女比例20:2。既往未行系统降糖治疗,入院后给予14天胰岛素泵强化降糖治疗,比较治疗前后的血糖水平、胰岛功能、胰岛素敏感性。  结果:胰岛素泵强化治疗后,血糖水平显著下降,空腹血糖及馒头餐试验30、60、120分钟血糖差异均有统计学意义(P  结论:合并心脏病的2型糖尿病患者可行短期的胰岛素泵强化降糖治疗。该治疗方式可快速解除高糖毒性,改善胰岛素敏感性。部分患者停用降糖药物,减轻其过多的用药负担。%Objectives: To evaluate the effect and safety of 14-day continuous subcutaneous insulin infusion (CSII) in type 2 diabetes patients with heart diseases. Methods: A total of 22 consecutive type 2 diabetes patients (history ≤ 5 years) with heart diseases treated in our hospital from 2011-03 to 2013-08 were studied. There were 20 male, and the with the mean age of patieuts (48.15 ± 9.80) years, all patients without standard hypoglycemic treatment before admission. The patients received 14-day CSII for enhanced treatment and the blood glucose level, insulin function and insulin sensitivity were compared before and after the treatment. Results: After CSII treatment, the blood glucose level was obviously decreased, fasting blood glucose (FBG) and postprandial blood glucose at 30, 60 and 120 min were improved, all P Conclusion: CSII may quickly relieve glucotoxicity and improve insulin sensitivity in type 2 diabetes patients with heart diseases. Some patients may alleviate drug burden in clinical practice.

  6. Nutritional education and carbohydrate counting in children with type 1 diabetes treated with continuous subcutaneous insulin infusion: the effects on dietary habits, body composition and glycometabolic control.

    Science.gov (United States)

    Marigliano, Marco; Morandi, Anita; Maschio, Maddalena; Sabbion, Alberto; Contreas, Giovanna; Tomasselli, Francesca; Tommasi, Mara; Maffeis, Claudio

    2013-12-01

    Carbohydrate counting (CHC) in combination with nutritional education has been used to optimize the insulin dose in patients with type 1 diabetes (T1D). The aim of this study was to test the impact of CHC and nutritional education on changes in dietary habits, body composition and body fat distribution in children with T1D treated with insulin pumps (CSII). Twenty-five children with T1D and CSII were recruited and valuated at baseline and after 18 months of follow-up. They were trained in CHC and following standard nutrition education program (based on American Diabetes Association and International Society of Pediatric and Adolescent Diabetes guidelines); clinical, biochemical and nutritional variables were measured. In the total population, body composition, body fat distribution and biochemical variables did not change, at follow-up; HbA1c was significantly reduced (8.50 ± 0.77 vs 7.92 ± 0.74 %; p nutritional education, does not affect dietary habits, body composition and body fat distribution in children with T1D treated with CSII. Moreover, the sub-group of subjects showing a significant improvement in glycometabolic control reported an increase in CHO intake and a reduction in fat and protein intake.

  7. INFUSION LOUNGE

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    Infusion Lounge——颇具亚洲风情的的夜店——坐落于旧金山市区大受追捧的联合广场之上,福森酒店之下。此夜店兼具了酒吧与餐厅的功能,它将提供加州与亚洲风味融为一体的佳肴及优雅的环境和一流的服务。Infusion Lounge不仅为旧金山当地,也将为整个行业重新定义高消费夜生活的概念。

  8. Mercury excretion and intravenous ascorbic acid.

    Science.gov (United States)

    Dirks, M J; Davis, D R; Cheraskin, E; Jackson, J A

    1994-01-01

    We tested the hypothesis that intravenous ascorbic acid increases urinary excretion of mercury in subjects with low mercury levels from dental amalgam, food, and other sources. From 89 adult volunteers we selected 28 subjects with the highest mercury excretions (2 to 14 micrograms/24 h). We administered intravenous infusions of 500 ml lactated Ringer's solution with and without addition of 750 mg of ascorbic acid/kg body weight, up to 60 g ascorbic acid. Average mercury excretion during the 24 h after infusion of ascorbic acid was 4.0 +/- 0.5 micrograms (mean +/- SEM), which was not significantly more than after infusion of Ringer's solution alone (3.7 +/- 0.5 micrograms). Lead excretion was similarly unaffected. If ascorbic acid administered intravenously benefits some persons with suspected adverse reactions to mercury, the benefit in subjects similar to ours appears unrelated to short-term enhanced excretion of mercury or lead.

  9. Quality of life in Danish children and adolescents with type 1 diabetes treated with continuous subcutaneous insulin infusion or multiple daily injections.

    Science.gov (United States)

    Birkebaek, N H; Kristensen, L J; Mose, A H; Thastum, M

    2014-12-01

    The aims of the study were to compare health-related quality of life (HRQoL) in a National Danish population of children and adolescents with type 1 diabetes (T1D) treated with either continuous subcutaneous insulin injection (CSII) or multiple daily insulin injections (MDI), and to investigate whether HRQoL assessments were influenced by treatment duration. Participants were recruited through the Danish Registry for Diabetes in Childhood and Adolescence. A total of 700 children and adolescents (360 girls), 8-17 years, were included. Of these, 295 were treated with CSII (160 for more than one year) and 405 with MDI (238 for more than one year). Participants and their parents completed the Pediatric Quality of Life Inventory Diabetes and Generic Module. HbA1c was analyzed centrally. Parents reported children and adolescents on CSII for more than one year to have less diabetes-related symptoms and worry, less problems in communicating diabetes, and better generic functioning compared with those on MDI. Children and adolescents on CSII for more than one year reported less diabetes-related symptoms, but more treatment problems, and better generic functioning in all subscales except social functioning compared with those on MDI for more than one year. Comparing those on CSII and MDI for less than one year, no differences in HRQoL ratings were found, apart from better rating of treatment barriers in the MDI group. This Danish national study on HRQoL in children and adolescents on CSII or MDI showed better HRQoL in children and adolescents on long time CSII, particularly concerning generic HRQoL. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  10. Influence of music relaxation therapy on the anxiety and depression of pregnant women with intravenous infusion of Anpo%音乐放松疗法对静脉点滴安宝孕妇焦虑、抑郁情绪的影响

    Institute of Scientific and Technical Information of China (English)

    彭惠诗; 余一海; 卢敏; 欧阳卫贞; 刘全弟

    2015-01-01

    Objective To explore the influence of music relaxation therapy on the anxiety and depression of pregnant women with intravenous infusion of Anpo. Methods 60 pregnant women with intravenous infusion of Anpo from February 2013 to January 2014 were randomly divided into control group(30 cases) and research group(30 cases). Patients in the control group were accepted conventional nurisng. Patients in re-search group were accepted music relaxation therapy as well as the actions of control group. Assess and compare the SAS scores and SDS score before intervention ,after seven days and forteen days with the Zung self rating anxiety scale and Zung depression self rating scale. Results The research group’s SAS scores and SDS scores after seven days and forteen days were higher than those of the control group(P<0. 05). Conclusion Music relaxation therapy can significantly improve the anxiety and depression situation of pregnant women with intravenous infu-sion of Anpo. Music relaxation therapy can also help pregnant women improve the self-confidence and overcome the disturbances in psycho-logical and physiological.%目的:探讨音乐放松疗法改善静脉点滴安宝孕妇焦虑和抑郁情绪的效果。方法将2013年2月~2014年1月在本院接受安宝治疗的60例孕妇随机分为对照组(30例)和实验组(30例)。对照组接受常规护理,实验组接受常规护理并采用音乐放松疗法。于用药前、用药后第7天、第14天,分别采用Zung焦虑自评量表、Zung抑郁自评量表对孕妇的焦虑、抑郁情绪进行评分并比较。结果用药后第7、第14天实验组孕妇的焦虑及抑郁评分均优于对照组,比较差异具有统计学意义(P<0.05)。结论音乐放松疗法可以明显改善静脉点滴安宝孕妇焦虑、抑郁情绪,帮助孕妇克服心理、生理的干扰,增强其自信心。

  11. Plasma volume substitution does not inhibit plasma noradrenaline and muscle nerve sympathetic responses to insulin-induced hypoglycaemia in healthy humans

    DEFF Research Database (Denmark)

    Frandsen, Henrik Lund; Berne, C; Fagius, J;

    1989-01-01

    underly the sympathetic activation. To study the effect of prevention of plasma volume reduction during hypoglycaemia, saline containing albumin was infused intravenously in healthy adult volunteers during hypoglycaemia. Hypoglycaemia was induced by an intravenous injection of soluble insulin in a dose...... of 0.15 IU/kg body weight. Peripheral venous plasma noradrenaline concentrations were identical in experiments without and with plasma volume substitution. Muscle nerve sympathetic activity increased to the same extent during hypoglycaemia with and without plasma volume substitution. It is concluded...

  12. Switching from multiple daily injections to CSII pump therapy: insulin expenditures in type 2 diabetes

    National Research Council Canada - National Science Library

    David, Guy; Gill, Max; Gunnarsson, Candace; Shafiroff, Jeff; Edelman, Steven

    2014-01-01

    To identify variations in expenditures and utilization of insulin and other antidiabetes medications by comparing patients with type 2 diabetes mellitus using continuous subcutaneous insulin infusion (CSII...

  13. Intravenous caffeine versus intravenous ketorolac for the management of moderate to severe migraine headache

    Directory of Open Access Journals (Sweden)

    Alireza Baratloo

    2016-06-01

    Full Text Available The aim of this study was to determine if intravenous caffeine is as effective as intravenous ketorolac for the treatment of moderate to severe migraine headaches. Eligible patients randomly received 60 mg caffeine citrate or 60 mg ketorolac infused intravenously. Their pain score were measured at baseline, one hour and two hours after infusion. Therapeutic success was defined as decreasing of at least 3 points on the pain score. In total 110 patients were enrolled (75.5% women. Therapeutic success after 60 min was achieved by 63.6% of patients in the caffeine and 70.1% of patients in the ketorolac group (p = 0.23. After 120 min, 87.3% of the caffeine group and 83.6% of the ketorolac group achieved therapeutic success (p = 0.49. In this multi-center, randomized double blind study, intravenous caffeine was as effective as intravenous ketorolac for first line abortive management of acute migraine.

  14. Efeitos cardiorrespiratórios e analgésicos da cetamina por via epidural, por infusão intravenosa contínua ou pela associação de ambas, em cães submetidos à osteossíntese de fêmur Cardiorespiratory and analgesic effects of ketamine via epidural route, intravenous continuous infusion or association of both, in dogs submitted to femoral osteosynthesis

    Directory of Open Access Journals (Sweden)

    Adriano Bonfim Carregaro

    2010-07-01

    route, intravenous continuous infusion or association of both, in dogs submitted to femoral osteosynthesis. Twenty-five healthy bitches were randomly assigned to four groups: CEP (2mg kg-1 of ketamine associated with lidocaine 2% via epidural route, CIV (lidocaine 2% via epidural route and 1mg kg-1 of ketamine IV, followed by IV continuous infusion of 100µg kg min-1 of ketamine, CIVEP (epidural anesthesia identical to CEP and ketamine infusion as in CIV and CON (epidural anesthesia with lidocaine 2%. HR, RR, SAP, MAP, DAP and T°C, sensitive blockade time and post operative analgesia measured with visual analog scale were evaluated. There was an increase in HR in CIV and decrease of this parameter in CEP. Arterial pressures kept within physiological values and differences in RR and T°C were not observed. The anesthetic blockade time was augmented in the groups which received epidural ketamine, differing significantly in relation to the control. The time for rescue analgesia did not differ between the groups. It can be concluded the administration of ketamine via epidural route, intravenous continuous infusion or the association of both promoted cardiorespiratory stability during the operative period; however, it was not able to extend the duration of post operative analgesia in dogs submitted to femoral osteosynthesis.

  15. Isoproterenol infusion increases level of consciousness during catheter ablation of atrial fibrillation.

    Science.gov (United States)

    O'Neill, Daniel K; Aizer, Anthony; Linton, Patrick; Bloom, Marc; Rose, Emily; Chinitz, Larry

    2012-08-01

    The objective of this study was to determine the effects of isoproterenol infusion on level of consciousness during ablation using total intravenous anesthesia. Seven patients undergoing total intravenous anesthesia for atrial fibrillation ablation were monitored for level of consciousness using bispectral EEG levels (BIS). Isoproterenol infusion was performed after the ablation during anesthesia. BIS levels prior to, during, and post-isoproterenol infusion were recorded and correlated to isoproterenol infusion doses. In all patients, BIS levels significantly increased during isoproterenol infusion (median BIS prior to infusion, 46; during infusion, 64 (p levels could again be reduced. Isoproterenol infusion alters consciousness level during total intravenous anesthesia for atrial fibrillation ablation. BIS monitoring is a novel way to modulate anesthesia during ablation to potentially optimize patient comfort and ablation success.

  16. Assessment of myocardial perfusion by myocardial contrast echocardiography combined with intravenous infusion of levovist in patients with post-myocardial infaction%利声显经静脉心肌声学造影评价心肌梗死后患者的心肌灌注

    Institute of Scientific and Technical Information of China (English)

    仲肇舒; 孔繁荣; 张新琳; 朱正明

    2001-01-01

    Objective To evaluate myocardial perfusion by myocardial contrast echocardiography (MCE) with intermittent harmonic power Doppler imaging combined with intravenous infusion levovist in post-myocardial infaction patients.Methods The study was performed with a HP Sonos 5500 during intravenous infusion levovist (300 mg/ml, 2 ml/min) using harmonic power Doppler mode twenty-five post-myocardial infaction patients [mean age (67±7) years, 21 males]. The imaging was acquired during end-systolic triggering at intervals of 1∶4 beats. Using a 16 segments model, myocardial perfusion both in gray and power Doppler was scored as 0(contrast deficit),0.5(partial and non-homogenous contrast), 1(complete and homogenous contrast).Results ①Compared with baseline, heart rate and blood pressure didn′t show significant changes after MCE.There were no signs and symptoms in all patients during MCE.②Myocardial perfusion was detectable in all the patients. ③Intravenous infusion Levovist(300 mg/ml, 2 ml/min) using intermittent harmonic power Doppler model resulted in 4~5 minites of left ventricular opacification and avoided the attenuation.Conclusions Myocardial perfusion was detectable by using intravenous infusion Levovist with intermittent harmonic power Doppler imaging. MCE thus may be a clinically useful technique for the detection and quantification of coronary artery disease at rest.%目的 心肌造影超声心动图(MCE)采用触发谐频能量多普勒显像模式并用静脉持续输注利声显,观察心肌梗死后患者的心肌灌注情况。方法 使用谐频频率 1.8~3.6 MHz的能量多普勒模式,于心电图T波终末处,按1∶4心动周期进行触发。利声显浓度为300 mg/ml,采用微量输液泵将所配心肌造影剂于患者左肘静脉内持续输注4 min(2 ml/min)。观察25例心肌梗死后患者的血压和心率变化并对心肌灌注情况进行半定量分析。结果 ①MCE前后,患者血压和心率

  17. 中药口服、敷脐联合静脉补液治疗肝胃不和型妊娠剧吐32例%32 Cases of Hyperemesis Gravidarum of Disharmony Pattern between the Liver and Stomach Treated with Oral Administration of Herbal Medicine,Umbilicus Compress and Intravenous Fluid Infusion

    Institute of Scientific and Technical Information of China (English)

    单崇武; 王瑞霞

    2012-01-01

    Objective To explore the clinical efficacy on hyperemesis gravidarum of disharmony pattern between the liver and stomach treated with oral administration of herbal medicine, umbilicus compress and intravenous fluid infusion. Methods From September 2008 to June 2010,66 cases of hyperemesis gravidarum of disharmony pattern between the liver and stomach treated in Digestive Department, Gynecology Clinic and Admission Department were divided randomly into two groups. In a control group( 34 cases ),the intravenous fluid infusion was applied simply. In an observation group( 32 cases ), the oral administration of herbal medicine for clearing away liver fire and harmonizing the stomach,and umbilicus compress were adopted,in combination with intravenous fluid infusion. Results Of 32 cases in treatment group, 13 cases were cured, 12 cases remarkably effective,5 cases effective and 2 cases failed. The total effective rate was 93. 75%. Of 34 cases in control group, 10 cases were cured, 11 cases remarkably effective,7 cases effective and 6 cases failed. The total effective rate was 82. 35% . By the statistical management, the difference was significant statistically in comparison of the total effective rate between two groups( P < 0. 05 ). The efficacy in treatment group was superior to that in control group. Conclusion The combined treatment of the oral administration of herbal medicine for clearing away liver fire and harmonizing the stomach, umbilicus compress and intravenous fluid infusion achieves a significant efficacy on hyperemesis gravidarum. Such treatment program is a kind practical therapy of the integrated Chinese and western medicine and deserves to be promoted in clinical practice.%目的 探讨清肝和胃中药口服、敷脐联合静脉补液治疗肝胃不和型妊娠剧吐的临床疗效.方法 将2008年9月~2010年6月就诊于消化科及妇科门诊、住院部的66例肝胃不和型妊娠剧吐患者随机分为两组.对照组34例,单纯采

  18. Effective observation on prevention for mismatched intravenous infusion by patients' participation in double-identity confirmation%患者参与身份双重确认在预防静脉输液差错中的应用效果

    Institute of Scientific and Technical Information of China (English)

    龚春兰; 文国英; 谢欣倩; 宋梅芳; 赖微; 韦雪

    2012-01-01

    目的 为提高患者身份识别的准确性,规范核对细节,有效预防静脉输液差错.方法 采用随机数字表法,选取2008年9月至2011年5月住院的2713例患者,分为对照组和观察组.对照组患者1410例,静脉输液42026组,采用常规输液查对的流程确认身份;观察组患者1303例,静脉输液41102组,除常规输液查对流程外,让患者说出自己的姓名和年龄并由患者或家属参与亲自查看输液瓶标签上姓名,确认身份.观察两组患者输液穿刺或更换输液瓶时因身份识别而发生临界差错的患者例数和静脉输液组数.结果 对照组患者身份识别准确1 404例,发生临界差错6例,观察组患者身份识别准确1 303例,发生临界差错0例,两组比较差异具有统计学意义(P =0.032);对照组身份识别准确42020组,发生临界差错6组,观察组身份识别准确41 102组,发生临界差错0组,两者比较差异具有统计学意义(P=0.031).结论 患者亲自参与双重身份确认能有效预防静脉输液差错.%Objective To improve the accuracy of patient' s identification and normalize the checking details for preventing from the error intravenous ( i.v.) infusion.Methods Participants who were eligible for this study from Department of Orthopedics,Nanxishan Hospital of Guangxi Zhuang Autonomous Region were assigned to control group and observational group by random number method.The control group included 1 410 patients which had 42 026 set intravenous infusion solutions and confirmed identity by the traditional procedure.The observation group included 41 102 set intravenous infusion solutions in 1 303 patients.In observational group,we confirmed patients' identity by speaking out their name and age and looking over the patient' s label on the infusion bottle by their family members along with the traditional procedure.The number of patients and i.v.solutions set regarding borderline errors of identification during venepuncture or replacing

  19. Analysis of a Case of Unknown Floss in Intravenous Drug Infusion by Clinical Pharmacists%临床药师对1例静脉输液中不明絮状物的分析

    Institute of Scientific and Technical Information of China (English)

    韩毓博; 程指民; 刘艳; 李湘晖

    2013-01-01

    OBJECTIVE: To provide new strategy for clinical pharmacists participating in clinic medication practice to deal with medication dispute caused by unknown floss in infusion of cinepazide maleate. METHODS: The unknown floss was isolated during infusion of cinepazide maleate under sterile condition, and then cultured in agar medium under low temperature. The unknown floss was observed under inverted microscope, and the components were determined by infrared spectroscopy scanning after low temperature drying. The components of unknown floss were determined, and its reasons were analyzed. RESULTS: Infrared spectroscopy scanning showed that the floss displayed classic structural characteristics of saccharide, protein, fatty acid and nucleic acid. Clustering filamentous fungi were seen in the agar culture. Both the floss and the floss culture showed black cross-linked hy-pha with torous spores under the microscope. The morphology observation assisted to prove that fungi contamination existed in the cinepazide maleate infusion. The unknown floss was fungi. CONCLUSIONS: In order to avoid infusion accident, precision filter infusion set should be used and the infusion tube should be rinsed routinely in the interval of two infusions.%目的:通过分析1例马来酸桂哌齐特输液中不明絮状物进而解决用药纠纷,为临床药师参与临床用药实践提供新思路.方法:将马来酸桂哌齐特输液过程中出现的不明絮状物在无菌条件下分离,分别利用营养琼脂低温培养,倒置显微镜下形态观察,以及低温干燥后进行红外光谱扫描等手段,确定絮状物成分,并分析原因.结果:红外光谱分析显示该絮状物具有糖类、蛋白质、脂肪酸和核酸的典型结构特征.琼脂培养基也培养出了成簇的丝状真菌,倒置显微镜下可见该培养物与不明絮状物性状相同,均现黑色交错丝状菌丝,其上还有膨出的孢子,进而从形态学上进行了辅

  20. Numerical and clinical precision of continuous glucose monitoring in Colombian patients treated with insulin infusion pump with automated suspension in hypoglycemia.

    Science.gov (United States)

    Gómez, Ana M; Marín Sánchez, Alejandro; Muñoz, Oscar M; Colón Peña, Christian Alejandro

    2015-12-01

    Insulin pump therapy associated with continuous glucose monitoring has shown a positive clinical impact on diabetes control and reduction of hypoglycemia episodes. There are descriptions of the performance of this device in other populations, but its precision and accuracy in Colombia and Latin America are unknown, especially in the routine outpatient setting. Data from 33 type 1 and type 2 diabetes patients with sensor-augmented pump therapy with threshold suspend automation, MiniMed Paradigm® Veo™ (Medtronic, Northridge, California), managed at Hospital Universitario San Ignacio (Bogotá, Colombia) and receiving outpatient treatment, were analyzed. Simultaneous data from continuous glucose monitoring and capillary blood glucose were compared, and their precision and accuracy were calculating with different methods, including Clarke error grid. Analyses included 2,262 continuous glucose monitoring -reference paired glucose values. A mean absolute relative difference of 20.1% was found for all measurements, with a value higher than 23% for glucose levels ≤75mg/dL. Global compliance with the ISO criteria was 64.9%. It was higher for values >75mg/dl (68.3%, 1,308 of 1,916 readings), than for those ≤ 75mg/dl (49.4%, 171 of 346 readings). Clinical accuracy, as assessed by the Clarke error grid, showed that 91.77% of data were within the A and B zones (75.6% in hypoglycemia). A good numerical accuracy was found for continuous glucose monitoring in normo and hyperglycemia situations, with low precision in hypoglycemia. The clinical accuracy of the device was adequate, with no significant safety concerns for patients. Copyright © 2015 SEEN. Published by Elsevier España, S.L.U. All rights reserved.

  1. High-dose insulin: a consecutive case series in toxin-induced cardiogenic shock.

    Science.gov (United States)

    Holger, Joel S; Stellpflug, Samuel J; Cole, Jon B; Harris, Carson R; Engebretsen, Kristin M

    2011-08-01

    Cardiovascular medication overdoses can be difficult to treat. Various treatment modalities are currently recommended. To describe patient outcomes and adverse events of high-dose insulin therapy in consecutive overdose patients in cardiogenic shock after implementation of a high-dose insulin protocol (1-10 U/kg/h, while avoiding or tapering off vasopressors). This is an observational consecutive case series of patients identified from a registry. Data were collected by retrospective chart review of patients treated by our toxicology service with this protocol from February 2007 until March 2010. Twelve patients were treated with high-dose insulin. The mean age was 36.5 years (SD 11.7). Seven patients had pre-existing vasopressor therapy, and all were tapered off vasopressors while on insulin. Two patients experienced pulseless electrical activity cardiac arrest prior to high-dose insulin therapy. Intravenous fat emulsion was given to two patients. The mean maximum insulin infusion rate was 8.35 U/kg/h (mean = 8.35, SD 6.34). The mean duration of insulin infusion was 23.5 h (SD 19.7). The mean duration of glucose infusion post-insulin was 25.2 h (SD 17.7). The primary toxins were β-blocker in five, calcium channel blocker in two, combined β-blocker/calcium channel blocker in two, tricyclic antidepressant in one, and polydrug in 2. CLINICAL OUTCOMES: Eleven of 12 patients survived. One patient expired 9 h into insulin therapy from cardiac arrest shortly after the insulin was stopped and a vasopressor re-initiated (protocol deviation). Six patients experienced a total of 19 hypoglycemic events. Hypokalemia (defined as insulin therapy. One patient was discharged with mild anoxic injury thought due to pulseless electrical activity arrest prior to insulin therapy. Three of these 12 patients have been previously described in published case reports. High-dose insulin therapy based on a 1-10 U/kg/h dosing guideline and recommending avoidance of vasopressors appears to be

  2. Current use of intraosseous infusion in Danish emergency departments: a cross-sectional study

    DEFF Research Database (Denmark)

    Molin, Rune; Hallas, Peter; Brabrand, Mikkel;

    2010-01-01

    Intraosseous infusion (IOI) is recommended when intravenous access cannot be readily established in both pediatric and adult resuscitation. We evaluated the current use of IOI in Danish emergency departments (EDs).......Intraosseous infusion (IOI) is recommended when intravenous access cannot be readily established in both pediatric and adult resuscitation. We evaluated the current use of IOI in Danish emergency departments (EDs)....

  3. Effect of ethanolic extracts of Ananas comosus L. leaves on insulin sensitivity in rats and HepG2.

    Science.gov (United States)

    Xie, Weidong; Wang, Wei; Su, Hui; Xing, Dongming; Pan, Yang; Du, Lijun

    2006-08-01

    Ethanolic extracts of Ananas comosus L. leaves (AC) enriched with phenols have hypoglycemic activity in diabetic rats. Here, we investigated the effect of AC on insulin sensitivity in rats and HepG2. In high-fat diet-fed and low-dose streptozotozin-treated diabetic Wistar rats subjected to challenge with exogenous human insulin, AC treatment at an oral dose of 0.40 g/kg could significantly improve sensitivity to exogenous insulin. After a sub-acute treatment, AC also could inhibit the development of insulin resistance in high-fat diet-fed and low-dose streptozotozin-treated diabetic rats following the test of loss of tolbutamide-induced blood glucose lowering action. For intravenous insulin/glucose infusion test, high-fat diet-fed and low-dose alloxan-treated Wistar rats were associated with insulin resistance, which was improved after AC or fenofibrate treatment. AC application inhibited the development of insulin resistance in HepG2 cells. The above animal models were well developed to simulate type 2 diabetes. Taken together, our results suggest that AC may improve insulin sensitivity in type 2 diabetes and could be developed into a new potential natural product for handling of insulin resistance in diabetic patients.

  4. Eradicating hepatitis C virus ameliorates insulin resistance without change in adipose depots.

    Science.gov (United States)

    Milner, K-L; Jenkins, A B; Trenell, M; Tid-Ang, J; Samocha-Bonet, D; Weltman, M; Xu, A; George, J; Chisholm, D J

    2014-05-01

    Chronic hepatitis C (CHC) is associated with lipid-related changes and insulin resistance; the latter predicts response to antiviral therapy, liver disease progression and the risk of diabetes. We sought to determine whether insulin sensitivity improves following CHC viral eradication after antiviral therapy and whether this is accompanied by changes in fat depots or adipokine levels. We compared 8 normoglycaemic men with CHC (genotype 1 or 3) before and at least 6 months post viral eradication and 15 hepatitis C antibody negative controls using an intravenous glucose tolerance test and two-step hyperinsulinaemic-euglycaemic clamp with [6,6-(2) H2 ] glucose to assess peripheral and hepatic insulin sensitivity. Magnetic resonance imaging and spectroscopy quantified abdominal fat compartments, liver and intramyocellular lipid. Peripheral insulin sensitivity improved (glucose infusion rate during high-dose insulin increased from 10.1 ± 1.6 to 12 ± 2.1 mg/kg/min/, P = 0.025), with no change in hepatic insulin response following successful viral eradication, without any accompanying change in muscle, liver or abdominal fat depots. There was corresponding improvement in incremental glycaemic response to intravenous glucose (pretreatment: 62.1 ± 8.3 vs post-treatment: 56.1 ± 8.5 mm, P = 0.008). Insulin sensitivity after viral clearance was comparable to matched controls without CHC. Post therapy, liver enzyme levels decreased but, interestingly, levels of glucagon, fatty acid-binding protein and lipocalin-2 remained elevated. Eradication of the hepatitis C virus improves insulin sensitivity without alteration in fat depots, adipokine or glucagon levels, consistent with a direct link of the virus with insulin resistance. © 2013 John Wiley & Sons Ltd.

  5. 品管圈活动对降低留置针静脉输液静脉炎发生率的作用%The application of quality control circle on reducing the incidence of phlebitis with intravenous catheter infusion

    Institute of Scientific and Technical Information of China (English)

    张鸿儒; 姚兰; 祖利; 崔秀珍

    2014-01-01

    目的::探讨品管圈质量管理手段对降低留置针静脉输液发生静脉炎的作用效果。方法:以“降低使用留置针静脉输液静脉炎发生率”为主题,开展为期6个月的品管圈活动,总结降低住院患者使用留置针静脉输液静脉炎发生率的方法,制定出留置针静脉输液的标准化措施。结果:使用留置针静脉输液静脉炎的发生率由实施品管圈活动前24.50%降至活动后的4.00%,差异具有统计学意义(P<0.05),达到预期效果。结论:通过开展品管圈活动,有效改善了使用留置针静脉输液发生静脉炎的临床现状,提高了科室护理团队发现问题、分析问题和解决问题的能力,提高了团队的凝聚力和协助意识,创建了积极向上的科室文化氛围。%Objective:This paper aims to explore the impact of quality control circle ( QCC) to reduce the incidence of phlebitis with intravenous catheter. Methods:This unit carried out a period of six months activity with the theme"to reduce the incidence of phlebitis led by using intravenous catheter"to inves-tigate the method to reduce the patients' incidence of phlebitis led by using intravenous catheter,and develop criteria of the use of intravenous catheter infu-sion. Results:The incidence of phlebitis led by using intravenous catheter had a significant difference before and after the QCC activity (P<0. 05),reducing from 24. 50% to 4. 00%. The QCC activity achieved the desired outcome. Conclusion:The QCC improved clinical situation of the using intravenous catheter infusion leading phlebitis effectively. By this way,QCC can enhance nurse groups' abilities to identify,analyze and solve problems,improve team cohesion and awareness to help each other. At the same time,it created a positive culture atmosphere.

  6. Insulin induced growth hormone response in fast-growing, lean and in slow-growing, obese pigs.

    Science.gov (United States)

    Wangsness, P J; Martin, R J; Gatchel, B B

    1980-12-01

    The effect of intravenous (IV) infusion of insulin on subsequent serum growth hormone (GH) response was studied in fasted lean, fast-growing and in genetically obese, slow-growing pigs at 6 months of age. A smaller GH response in obese compared to lean pigs was observed from 30 to 60 min after insulin infusion. Concurrently, marked hypoglycemia and a decrease in serum free fatty acids (FFA) were evident. Changes in serum glucose and FFA were similar in both pig strains. After IV administration of exogenous GH, the decrease in serum GH (half-life) and the simultaneous increase in serum FFA were not different for lean and obese pigs. The reduced GH secretory potential in obese pigs is consistent with reduced muscle development and growth rate.

  7. Lipid-induced insulin resistance does not impair insulin access to skeletal muscle.

    Science.gov (United States)

    Kolka, Cathryn M; Richey, Joyce M; Castro, Ana Valeria B; Broussard, Josiane L; Ionut, Viorica; Bergman, Richard N

    2015-06-01

    Elevated plasma free fatty acids (FFA) induce insulin resistance in skeletal muscle. Previously, we have shown that experimental insulin resistance induced by lipid infusion prevents the dispersion of insulin through the muscle, and we hypothesized that this would lead to an impairment of insulin moving from the plasma to the muscle interstitium. Thus, we infused lipid into our anesthetized canine model and measured the appearance of insulin in the lymph as a means to sample muscle interstitium under hyperinsulinemic euglycemic clamp conditions. Although lipid infusion lowered the glucose infusion rate and induced both peripheral and hepatic insulin resistance, we were unable to detect an impairment of insulin access to the lymph. Interestingly, despite a significant, 10-fold increase in plasma FFA, we detected little to no increase in free fatty acids or triglycerides in the lymph after lipid infusion. Thus, we conclude that experimental insulin resistance induced by lipid infusion does not reduce insulin access to skeletal muscle under clamp conditions. This would suggest that the peripheral insulin resistance is likely due to reduced cellular sensitivity to insulin in this model, and yet we did not detect a change in the tissue microenvironment that could contribute to cellular insulin resistance. Copyright © 2015 the American Physiological Society.

  8. Intravenous infusion of midazolam: A valuation of patient compliance after teeth extraction for dental fear%静注咪达唑仑镇静对牙科畏惧症患者拔牙术依从性的影响

    Institute of Scientific and Technical Information of China (English)

    芦睿; 朱伟; 闫维; 刘冰; 张国良

    2013-01-01

    Objective To evaluate patients' compliance by intravenous infusion of midazolam in treating dental fear. Methods 120 patients were divided into midazolam and control group randomly. Before local anesthesia, the patients in midazolam group administered intravenous injection of midazolam (0.05mg/kg). The control group only used local anesthesia. The patients filled in the Scales of Frankl Behavior and Houpt Behavior form after tooth extraction. The scores of two groups were analyzed and compared. Results The Frankl scores (3.68±0.29比2.07±0.42,P<0.05) and the Houpt scores (5.81±0.37比3.58±0.72,P<0.01) were significantly different between two groups. Conclusion The use of intravenous infusion of midazolam sedation is satisfactory on dental fear patients and increased patients compliance.%目的 评价静脉注射咪迭唑仑镇静对牙科畏惧症患者智齿拔除术依从性的影响.方法 120例牙科畏惧症患者随机分为两组,其中咪达唑仑组在局部麻醉前使用咪达唑仑进行静脉注射(0.05mg/kg),对照组仅进行局部麻醉.拔牙手术结束后调查两组患者对整个拔牙过程的感受,填写患者Frankl治疗依从性量表和Houpt行为量表.并对两组患者的Frankl治疗依从性分值和Houpt行为值进行统计学分析.结果 咪达唑仑组与对照组的Frankl评分(3.68±0.29比2.07±0.42,P<0.05)和Houpt评分(5.81±0.37比3.58±0.72,P<0.01)比较均有统计学差异.结论 拔牙术前静脉注射咪达唑仑,可使牙科畏惧症患者更加配合治疗,提高患者的依从性.

  9. Treatment of hypertriglyceridemia-induced acute pancreatitis with insulin

    Science.gov (United States)

    Erkan, Nazif; Yakan, Savas; Yildirim, Mehmet; Carti, Erdem; Ucar, Deniz; Oymaci, Erkan

    2015-01-01

    Introduction Hypertriglyceridaemia (HT)-induced pancreatitis rarely occurs unless triglyceride levels exceed 1000 mg/dl. Hypertriglyceridaemia over 1,000 mg/dl can provoke acute pancreatitis (AP) and its persistence can worsen the clinical outcome. In contrast, a rapid decrease in triglyceride level is beneficial. Insulin-stimulated lipoprotein lipase is known to decrease serum triglyceride levels. However, their efficacy in HT-induced AP is not well documented. Aim To present 12 cases of AP successfully treated by insulin administration. Material and methods Three hundred and forty-three cases of AP were diagnosed at our clinic between 2005 and 2012. Twelve (3.5%) of these cases were HT-induced AP. Twelve patients who suffered HT-induced AP are reported. Initial blood triglyceride levels were above 1000 mg/dl. Besides the usual treatment of AP, insulin was administered intravenously in continuous infusion. The patients’ medical records were retrospectively evaluated in this study. Results Serum triglyceride levels decreased to < 500 mg/dl within 2–3 days. No complications of treatment were seen and good clinical outcome was observed. Conclusions Our results are compatible with the literature. Insulin may be used safely and effectively in HT-induced AP therapy. Administration of insulin is efficient when used to reduce triglyceride levels in patients with HT-induced AP. PMID:25960810

  10. Cardiorespiratory fitness predicts insulin action and secretion in healthy individuals.

    Science.gov (United States)

    Larsen, Filip J; Anderson, Martin; Ekblom, Björn; Nyström, Thomas

    2012-01-01

    Long-term cardiorespiratory fitness (CRF) and the development of type 2 diabetes mellitus are inversely correlated. Here, we examined the relationships between peak oxygen uptake (VO(2)peak), on the one hand, and glucose infusion rate at rest (GIR(rest)) and during exercise (GIR(exercise)), as well as insulin secretion (both the early and late phases of response [area under the curve {AUC}(insulin)]), on the other. Eight male and 4 female healthy, lean, nonsmoking volunteers were recruited. The VO(2)peak was measured during graded exercise on a cycle ergometer until exhaustion was reached. The GIR(rest) and GIR(exercise) were determined using a euglycemic-hyperinsulinemic clamp, and insulin secretion at rest was evaluated with an intravenous glucose tolerance test. The VO(2)peak correlated positively to GIR(rest) (r = 0.81, P = .001) and GIR(exercise) (r = 0.87, P exercise) (r = 0.86, P healthy population, CRF and RER were highly correlated to insulin sensitivity and secretion, as well as to the ability to alter the substrate being oxidized during exercise. These findings highlight the importance of good CRF to maintaining normal insulin action.

  11. High heritability and genetic correlation of intravenous glucose- and tolbutamide-induced insulin secretion among non-diabetic family members of type 2 diabetic patients

    DEFF Research Database (Denmark)

    Gjesing, Anette Marianne Prior; Hornbak, Malene; Allin, Kristine H.

    2014-01-01

    ∈±∈SE: 0.49∈±∈0.14) and beta cell responsiveness to glucose (h 2∈±∈SE: 0.66∈±∈0.12). Additionally, strong genetic correlations were found between measures of beta cell response after glucose and tolbutamide stimulation, with correlation coefficients ranging from 0.77 to 0.88. Furthermore, we identified......Aims/hypothesis: The aim of this study was to estimate the heritability of quantitative measures of glucose regulation obtained from a tolbutamide-modified frequently sampled IVGTT (t-FSIGT) and to correlate the heritability of the glucose-stimulated beta cell response to the tolbutamide......-induced beta cell response. In addition, single nucleotide polymorphisms (SNPs) having an exclusive effect on either glucose- or tolbutamide-stimulated insulin release were identified. Methods: Two hundred and eighty-four non-diabetic family members of patients with type 2 diabetes underwent a t...

  12. Anestesia venosa total com infusão alvo-controlada de remifentanil e propofol para ablação de fibrilação atrial Anestesia venosa total con infusión objeto-controlada de remifentanil y propofol para ablación de la fibrilación atrial Total intravenous anesthesia with target-controlled infusion of remifetanil and propofol for ablation of atrial fibrillation

    Directory of Open Access Journals (Sweden)

    Fernando Squeff Nora

    2009-12-01

    choice of anesthesia, monitors, and anesthesiologic care for this procedure performed outside the surgical center has not been described. The objective of this report was to describe an anesthesia technique for ablation of AF. CASE REPORT: This is a 49-year old female weighing 73 kg, 155 cm, and ASA II due to hypertension. The patient was monitored with a 12-lead ECG, pulse oximetry, heart rate, bispectral electroencephalography for BIS measurement, suppression rate (SR, and SEF95, and mean arterial pressure (MAP. Intravenous target-controlled infusion (TCI of propofol with a target of 4 µg.mL-1, intravenous TCI of remifentanil with a target of 3 ng.mL-1, and intravenous bolus of rocuronium 0.2 mg.kg-1 were used for induction of anesthesia. The pharmacokinetic model of propofol described by Marsh was used and incorporated into the propofol PFS pump®. The pharmacokinetic model of remifentanil described by Minto was incorporated into the Alaris PK® infusion pump. Local effector, or biophase, concentrations corresponded to the information obtained from the infusion pumps and represented predictive measurements of the concentrations of both drugs on their sites of action. The concentrations of propofol and remifentanil were regulated according to BIS and MAP, respectively. CONCLUSIONS: Total intravenous anesthesia for ablation of AF can be a safe option considering the lack of electrophysiological changes in accessory pathways. The literature on this subject is scarce and new publications could justify, or not, this type of anesthesia during ablation of AF.

  13. Massive Levemir (Long-Acting Insulin Overdose: Case Report

    Directory of Open Access Journals (Sweden)

    Mamatha Oduru

    2012-01-01

    Full Text Available A 52-year-old insulin-dependant diabetic man presented to the Emergency Department 2 hours after a deliberate massive overdose of 2100 units of long-acting Levemir insulin and a large quantity of whisky. On initial assessment, his GCS was 3/15 and his capillary blood sugar was 2.6 mmol/L. The patient was given a 50 ml bolus of 50% dextrose, followed by intravenous infusions of both 5% and 10% dextrose. Despite the continuous infusions, he experienced 4 symptomatic hypoglycaemic episodes in the first 12 hours after admission. These were managed with oral glucose, IM glucagon, and further dextrose boluses. Blood electrolytes and pH were monitored throughout. Insulin overdoses are relatively common and often occur with an excess of other drugs or alcohol which can enhance its action. Overdoses can result in persistent hypoglycaemia, liver enzyme derangement, electrolyte abnormalities, and neurological damage. Overall mortality is 2.7% with prognosis poorest in patients who are admitted with decreased Glasgow Coma scale (GCS 12 hours after overdose.

  14. Estudos hemodinâmicos e da função endotelial em porcas saudáveis após injeção em bolus endovenoso de azul de metileno Hemodynamic and vascular endothelium function studies in healthy pigs after intravenous bolus infusion of methylene blue

    Directory of Open Access Journals (Sweden)

    Antonio Carlos Menardi

    2006-10-01

    vasoplegia, não se esperando que a inibição da guanilatociclase tenha algum efeito. CONCLUSÃO: A infusão em bolus endovenoso in vivo na dose investigada (3 mg/kg não causou alterações hemodinâmicas e comprometimento da liberação in vitro de NO.OBJECTIVE: Clinical benefit of methylene blue (MB treating NO-induced vasoplegia has been reported in sepsis, systemic inflammatory response syndrome (SIRS in cardiac surgery and anaphylactic shock, but its safety is sometimes questioned, mainly regarding its hemodynamic effects and the possibility of causing endothelium dysfunction. To examine the nitric oxide plasma levels and cardiovascular effects of the infusion of MB in vivo and its effects on endothelium-dependent and endothelium-independent in vitro vascular relaxation. METHODS: The study protocol included two experimental groups of female pigs: Group I (Control - the animals (n=6 did not receive MB; Group II (MB - the animals received 3 mg/kg of MB intravenous bolus infusion. After fifteen minutes of hemodynamic parameter recording the animals were sacrificed by exsanguination, and in vitro studies were conducted using segments of coronary, hepatic, superior mesenteric and renal arteries, to determine the effect of MB on the arterial endothelium function with regard to NO release. Nitric oxide plasma levels (NOx were measured in each of the experimental groups. RESULTS: The results obtained in the present investigation were: 1 intravenous infusion of MB (3.0 mg/kg caused no hemodynamic changes; 2 absolute and percent plasma NOx values did not differ between the experimental groups; and 3 in vitro study of vascular relaxation showed no significant difference between groups. These results show that MB intravenous infusion seems to be safe. This finding agrees with data from clinical experiments where MB was used to treat vasoplegic syndrome after cardiopulmonary bypass, systemic inflammatory response syndrome (SIRS and anaphylaxis. These results were not unexpected

  15. Subcutaneous versus intravenous immunoglobulin in multifocal motor neuropathy

    DEFF Research Database (Denmark)

    Harbo, T; Andersen, Henning; Hess, A

    2009-01-01

    Background and purpose: For treatment of multifocal motor neuropathy (MMN), we hypothesized that (i) infusion of equivalent dosages of subcutaneous immunoglobulin (SCIG) is as effective as intravenous immunoglobulin (IVIG) and that (ii) subcutaneous infusion at home is associated with a better...

  16. Continuous postoperative insulin infusion reduces deep sternal wound infection in patients with diabetes undergoing coronary artery bypass grafting using bilateral internal mammary artery grafts: a propensity-matched analysis.

    Science.gov (United States)

    Ogawa, Shinji; Okawa, Yasuhide; Sawada, Koshi; Goto, Yoshihiro; Yamamoto, Masanori; Koyama, Yutaka; Baba, Hiroshi; Suzuki, Takahiko

    2016-02-01

    Deep sternal wound infection (DSWI), especially in patients with diabetes mellitus (DM), is a major concern after coronary artery bypass grafting (CABG) with bilateral internal mammary artery (BIMA) grafts. We evaluated the risk of DSWI and other clinical outcomes between continuous insulin infusion therapy (CIT) and insulin sliding scale therapy (IST) in a cohort of DM patients who underwent CABG with BIMA. The clinical records of DM patients who underwent isolated CABG with BIMA were retrospectively reviewed. The study population consisted of 95 patients who received CIT and 126 patients who received IST. Furthermore, a one-to-one matched analysis based on estimated propensity scores for patients who received CIT or IST yielded two groups comprising 58 patients each. The proportion of patients with DSWI, overall survival rates and major adverse cardiac events were compared between the two groups in the overall and the propensity-matching cohort. The prevalence of DSWI requiring debridement and closure was significantly reduced in the CIT group compared with that in the IST group [1/95 (1.1%) vs 9/126 (7.1%), P = 0.031]; these results were not attenuated even after propensity-matching analysis [0/58 (0%) vs 6/58 (10.3%), P = 0.031]. The mean preoperative glucose levels were similar between the two groups (157.5 ± 54.6 vs 176.1 ± ±70 mg/dl, P = 0.063), whereas the mean glucose values were significantly lower on the first and second operative days in the CIT group than in the IST group (132.9 ± 44.1 vs 197.8 ± 78.6 mg/dl, P propensity-matching models. The CIT approach reduced the variability in glucose concentration and resulted in fewer instances of DSWI after CABG with BIMA grafts. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  17. Cost-minimization of mabthera intravenous versus subcutaneous administration

    NARCIS (Netherlands)

    Bax, P.; Postma, M.J.

    2013-01-01

    Objectives: To identify and compare all costs related to preparing and administrating MabThera for the intravenous and subcutaneous formulations in Dutch hematological patients. The a priori notion is that the costs of subcutaneous MabThera injections are lower compared to intravenous infusion due t

  18. Cost-minimization of mabthera intravenous versus subcutaneous administration

    NARCIS (Netherlands)

    Bax, P.; Postma, M.J.

    2013-01-01

    Objectives: To identify and compare all costs related to preparing and administrating MabThera for the intravenous and subcutaneous formulations in Dutch hematological patients. The a priori notion is that the costs of subcutaneous MabThera injections are lower compared to intravenous infusion due

  19. Intravenous and intramuscular magnesium sulphate regimens in ...

    African Journals Online (AJOL)

    1993-09-03

    Sep 3, 1993 ... Pritchard' and a continuous intravenous (IV) infusion described by Zuspan! ... in the treatment of severe pre-eclampsia with the IM regimen of ..... people under the age of 50 years and more men died than women. In 40% of ...

  20. Avaliação da efetividade e segurança do protocolo de infusão de insulina de Yale para o controle glicêmico intensivo Assessment of effectiveness and safety of Yale insulin infusion protocol in a brazilian medical and surgical Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    José Roberto Carvalho Diener

    2006-09-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O controle glicêmico intensivo ocupa lugar de destaque no manuseio dos pacientes críticos. O objetivo desde estudo foi avaliar a efetividade e a segurança do protocolo de insulinoterapia por via venosa de Yale nos pacientes críticos internados em unidade de terapia intensiva geral em hospital comunitário. MÉTODO: Foi realizado um estudo retrospectivo e comparativo entre 2 coortes de pacientes críticos, antes e após a implantação do controle glicêmico intensivo. Os desfechos de interesse do estudo foram glicemia média durante o tratamento, tempo para atingir a faixa alvo de 80 a 140 mg/dL, percentual de glicemia dentro desta faixa e incidência de hipoglicemia. RESULTADOS: Foram estudados 112 pacientes, divididos em dois grupos. Sessenta pacientes constituíram o grupo controle (GC e 52 o grupo protocolo (GP. A glicemia média no GP foi de 131,2 ± 14,7 mg/dL versus 181,7 ± 36,1 mg/dL no GC. Os pacientes no GP alcançaram a faixa alvo mais rápido [mediana 7h (4 - 10h versus mediana 96h (46 - 278h] no GC. O percentual de glicemia dentro da faixa-alvo foi de 65% no GP e de 32% no GC. Não houve diferença estatística significativa na incidência de hipoglicemia grave; 4 pacientes no GP versus 2 pacientes no GC. CONCLUSÕES: O protocolo de insulinoterapia por via venosa contínua de Yale, mostrou-se efetivo e seguro para o manuseio do controle glicêmico em unidade de terapia intensiva que atende pacientes clínicos e cirúrgicos.BACKGROUND AND OBJECTIVES: Actually tight glycemic control is a major concern in critical care. The objective of this study was to evaluate effectiveness and safety of Yale insulin infusion protocol in a Brazilian medical and surgical intensive care unit. METHODS: Retrospective, before-after cohort study. Selected end-points were mean blood glucose levels, time-to-reach target range of 80 - 140 mg/dL, and percent of blood glucose in target range and hypoglycemia incidence. RESULTS

  1. 经深静脉和外周静脉泵入腺苷三磷酸测量血流储备分数的比较研究%Comparative study of fractional lfow reserve measurement by intravenous ATP infusion through ;femoral veins and hand dosal veins

    Institute of Scientific and Technical Information of China (English)

    刘晶晶; 曲涛; 张萌; 靳维华; 高炬; 王斌

    2014-01-01

    Objective To compare and evaluate fractional flow reserve (FFR) by intravenous infusion of adenosine 5’-triphosphate (ATP) through femoral veins and hand dosal veins. To find the feasibility of measuring FFR through ATP infusion at hand dosal veins. Methods A total of 27 patients receiving coronary angiography (CAG) were enrolled. FFR was measured by intravenous injection of ATP through femoral veins and hand dosal veins separately in 31 stenosed coronary arteries. Results A linear correlation between ATP infusion measuring FFR through femoral and hand dosal veins was observed. Heart rates, PR intervals and side effects were of no difference between the 2 routes of ATP infusion (P=0.79, P=0.56, P=0.85). It indicated that ATP infusion[160μg/(kg·min)]measuring FFR through hand dosal veins was compatable to which measuring FFR though femoral veins (y=0.945x+0.0043, R2=0.904, P=0.001). Compared with ATP infusion by femoral vein[from (53.7±15.8) s to (58.2±11.6) s], the time to FFR by infusion ATP measurement by hand dosal veins was longer[(48.7±17.9) s, P=0.015]. Conclusions The FFR measurement through ATP infusion at hand dosal veins has similar results with the FFR measured by femoral veins ATP infusion.%目的:经外周静脉(手背静脉)泵入腺苷三磷酸(ATP)的方法测定血流储备分数(FFR),并通过与标准的测量方法[深静脉(股静脉)泵入ATP]测量FFR的对比研究,评价经外周静脉泵入不同剂量ATP测定FFR的可行性。探讨经手背静脉泵入ATP测定是否能够准确测量FFR。方法针对航天中心医院27例患者冠状动脉造影术中的31条冠状动脉病变血管,进行外周静脉和股静脉冠状动脉造影术及两种途径测定的FFR数值测量与数据分析。结果经手背静脉泵入ATP[≥140μg/(kg · min)]测量的4组FFR值与标准方法测量FFR值的一致性、相关性。两种途径注射ATP后心率、PR间期、不良反应发生率比较,差异无统

  2. Inhaled insulin: overview of a novel route of insulin administration

    Directory of Open Access Journals (Sweden)

    Lucy D Mastrandrea

    2010-01-01

    Full Text Available Lucy D MastrandreaDepartment of Pediatrics, School of Medicine and Biochemical Sciences, University at Buffalo, Buffalo, NY, USAAbstract: Diabetes is a chronic disease characterized by inadequate insulin secretion with resulting hyperglycemia. Diabetes complications include both microvascular and macrovascular disease, both of which are affected by optimal diabetes control. Many individuals with diabetes rely on subcutaneous insulin administration by injection or continuous infusion to control glucose levels. Novel routes of insulin administration are an area of interest in the diabetes field, given that insulin injection therapy is burdensome for many patients. This review will discuss pulmonary delivery of insulin via inhalation. The safety of inhaled insulin as well as the efficacy in comparison to subcutaneous insulin in the various populations with diabetes are covered. In addition, the experience and pitfalls that face the development and marketing of inhaled insulin are discussed.Keywords: glycemic control, hemoglobin A1c, inhalation, insulin, type 1 diabetes, type 2 diabetes

  3. Effects of specialized team building on quality of intravenous infusion and job satisfaction of senior ;nurses%专科化团队建设对静脉输液质量和高年资护士工作满意度的影响

    Institute of Scientific and Technical Information of China (English)

    周宁宁; 杨红萍; 王咏梅; 曹莉; 陈丽丽

    2016-01-01

    目的:探讨专科化团队建设在静脉输液治疗中的应用效果及对高年资护士工作满意度的影响。方法2014年1月选择杭州市第一人民医院高年资护士50名组建静脉输液专科化团队,由护理部领导,其他医疗科室协助指导,高年资护士担任团队的专业执行角色。比较团队化护理实施前(2012年1月—2013年12月)及实施后(2014年1月—2015年12月)的患者满意度、护理缺陷和差错事故发生率、护士对工作的满意度。结果实施前患者对护理服务的满意度为90.03%,实施后为96.08%,差异有统计学意义(χ2=140.412,P<0.01)。实施前的护理缺陷和差错事故发生率为1.02%,实施后为0.46%,差异有统计学意义(χ2=10.748,P<0.01)。实施前后,护士对工作的高度满意率从12.0%提高至82.0%,差异有统计学意义(χ2=49.177,P<0.01)。结论专科化团队建设可提高静脉输液治疗的质量和高年资护士对工作的满意度,从而增强自我效能和职业认同感,稳定护理队伍。%Objective To explore the application effects of specialized team building in intravenous infusion and its influences on job satisfaction of senior nurses. Methods A specialized team of intravenous infusion was built which was composed of 50 senior nurses selected in January 2014 from Hangzhou First People′s Hospital. The team was headed by nursing department and assisted by other medical departments. Senior nurses played the role of professional execution on the team. And then, were compared the patients′ satisfaction, incidence of nursing defect, errors, and accidents, job satisfaction of nurses before ( January 2012 to December 2013) and after ( January 2014 to December 2015 ) implementing team nursing. Results There was a statistically significant difference in patients′ satisfaction with nursing service before ( 90. 03%) and after (96.08%) implementation (χ2=140.412,P<0.01). The incidence of nursing defect

  4. Insulin versus Lipid Emulsion in a Rabbit Model of Severe Propranolol Toxicity: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Martyn Harvey

    2011-01-01

    Full Text Available Background and objective. Beta-blocker overdose may result in intractable cardiovascular collapse despite conventional antidotal treatments. High dose insulin/glucose (ING, and more recently intravenous lipid emulsion (ILE, have been proposed as potentially beneficial therapies in beta blocker intoxication. We compare efficacy of the novel antidotes ING, with ILE, in a rabbit model of combined enteric/intravenous propranolol toxicity. Methods. Sedated, mechanically ventilated and invasively monitored New Zealand White rabbits underwent mini-laparotomy and enterostomy formation with 40 mg/kg propranolol instilled into the proximal small bowel. At 30 minutes propranolol infusion was commenced at 4 mg/kg/hr and continued to a target mean arterial pressure (MAP of 50% baseline MAP. Animals were resuscitated with insulin at 3 U/kg plus 0.5 g/kg glucose (ING group, or 10 mL/kg 20% Intralipid (ILE group. Results. Rate pressure product (RPP; RPP = heart rate × mean arterial pressure was greatest in the ING group at 60 minutes (P<.05. A trend toward greater heart rate was observed in the ING group (P=.06. No difference was observed in survival between groups (4/5 ING versus 2/5 ILE; P=.524. Conclusions. High dose insulin resulted in greater rate pressure product compared with lipid emulsion in this rabbit model of severe enteric/intravenous propranolol toxicity.

  5. Developing a System for Integraded Automatic Control of Mutiple Infusion Pumps : The Multiplex infusion system

    NARCIS (Netherlands)

    Doesburg, Frank

    2013-01-01

    Most errors in ICUs are related to intravenous (IV) therapy. Previous studies suggested that hard to operate infusion pumps and the high cognitive workload for ICU nurses contribute to these errors. Conventional IV therapy requires separate lumens for incompatible IV drugs. This often requires the p

  6. Allergic Reactions Induced by Intravenous Vitamin K1 Infusion and Pharmaceutical Intervention%静脉滴注维生素K1致过敏反应3例及药学干预

    Institute of Scientific and Technical Information of China (English)

    傅征然; 王晓玲

    2013-01-01

    Three children who underwent renal biopsy received an infusion of vitamin K1 10 mg once daily to prevent puncture site bleeding.They developed allergic reactions such as chest tightness,shortness of breath,dyspnea,and skin rash one to five minutes after starting therapy.The medication was stopped immediately.Ten to twenty minutes after drug withdrawal,the allergic symptoms subsided.Clinical pharmacists analyzed the cause of allergic reaction,and implemented pharmaceutical intervention effectively.%3例肾内科患儿拟行肾穿刺术接受维生素K110 mg静脉滴注预防穿刺部位出血,用药后1~5 min出现胸闷、喘憋、呼吸困难、皮疹等过敏反应.立即停用维生素K1,过敏反应相关症状于停药后10~20 min消失.本文分析了过敏反应发生的原因,并实施了有效的药学干预.

  7. Review of pharmacokinetic models for target controlled infusions in anesthesia

    Directory of Open Access Journals (Sweden)

    Subash Kennedy Sivasubramaniam

    2014-06-01

    Full Text Available Intravenous injection of anesthetic drugs dates back to the 17th Century when opium and chloral hydrate have been injected intravenously. It was not until the 1930s intravenous anesthesia became popular with the invention of barbiturates.Early intravenous anesthetic agents such as barbiturates were ideal for induction of anesthesia, but not suitable for maintenance of anesthesia. Most of these drugs accumulated significantly with increasing durations of infusion and also resulted in cardiorespiratory depression. The invention of propofol and shorter acting opioid analgesics such as remifentanil and alfentanil have revolutionized intravenous anesthesia. The rapid onset and offset of these drugs lends itself to being suitable agents for maintenance of anesthesia over prolonged periods of time. Detailed understanding of the pharmacokinetics of propofol and remifentanil, combined with technological advances in intravenous pumps capable of accurate delivery of drugs have resulted in great development of the field of total intravenous anesthesia and target controlled infusions. I would like to discuss, in this article, the pharmacokinetics and pharmacokinetic models behind these intravenous infusion pumps. [Int J Basic Clin Pharmacol 2014; 3(3.000: 417-423

  8. Protective effect of continuous intravenous infusion of Isoproterenol on myocardial mitochondria of early septic rats and the corresponding mechanism%持续输注异丙肾上腺素对早期脓毒症大鼠心肌线粒体的保护作用及其机制

    Institute of Scientific and Technical Information of China (English)

    谢美燕; 项丹; 吕娟娟; 郑贵浪; 黄锦达; 刘翠; 曾其毅

    2015-01-01

    Objective To investigate the protective effect of continuous intravenous infusion of Isoproterenol (ISO)on myocardial mitochondria of early septic rats and the corresponding mechanism.Methods Thirty Sprague Dawley (SD)rats were randomly divided into 5 groups (6 cases per group):control group,endotoxin group,ISO small-dose group,ISO medium-dose group and ISO large-dose group.Endotoxin group and ISO intervene group received same management apart from drug intervention:receiving intravenous injection of lipopolysaccharide (LPS)10 mg/kg followed by an continuous intravenous infusion of 9 g/L saline 1 mL/h or ISO 0.06 μg/(kg · min),0.30 μg/(kg · min)and 0.60 μg/(kg · min).Control group received intraperitoneal injection and continuous intravenous infusion with the same amount of 9 g/L saline.The primary endpoint of the study was 24 hours after injection of 9 g/L saline or LPS.Serum creatine kinase (CK) and creatine kinase isoenzyme (CK-MB),oxidative and nitrosative stress levels and swelling of isolated heart mitochondrion were detected.The pathological changes of the myocardium and morphologic changes of the heart mitochondria were observed through light microscope and scanning electron microscope,respectively.Results The levels of CK,CK-MB,nitric oxide (NO) content,inducible nitric oxide synthase (iNOS) activity and malondialdehyde (MDA)content in endotoxin group were increased compared with control group (all P < 0.05),while the superoxide dismutase (SOD) activity decreased [(11.543 ± 1.080) U/mg prot vs (9.892 ±0.815) U/mg prot,P <0.05].The morphology of the heart mitochondria significantly changed (such as swelling,disordered arrangement,crest fracture,fusion and cavitations,and so on).ISO intervention significantly decreased the levels of CK,CK-MB and mitochondrial swelling (all P < 0.05) and increased the SOD activity (all P < 0.05).The levels of NO content,iNOS activity and MDA content were significantly decreased in small-dose group [(10.823

  9. 糖尿病开展胰岛素泵连续皮下输注的临床意义%Clinical significance of continuous subcutaneous insulin infusion for diabetes

    Institute of Scientific and Technical Information of China (English)

    陈俏蓉

    2014-01-01

    Objective To explore the differences of clinical curative effect of continuous subcutaneous insulin infusion (CSII) and multiple subcutaneous insulin injection (MSII) on blood sugar control for patients with diabetes type 2 and to accumulate experience for the treatment of the disease.Methods78 patients with diabetes type 2 who were admitted to the department of endocrinology in our hospital from March 2010 to September 2013 were selected. They were allocated to a research group and a control group according to random number table, with 39 patients in each group. The research group received CSII and the control group received MSII. FBG, 2hBG, HbA1C, insulin dosage and incidence of adverse events before and after the treatment in the two groups were recorded.ResultsAt the end of the fourth treatment week, FBG and 2hBG in the research group were both lower than those in the control group (P0.05). Recovery time of blood sugar in the research group was shorter than that in the control group (P<0.05), and the insulin dosage was less than that in the control group (P<0.05). Incidence of hypoglycemia and dawn phenomenon were both lower than those in the control group (P<0.05). Conclusion Compared with MSII, CSII for patients with diabetes type 2 has a better effect of blood sugar control, less insulin dosage, a low incidence of adverse events and a satisfactory clinical effect.%目的:探讨2型糖尿病患者采取胰岛素泵连续皮下输注(CSⅡ)与多次胰岛素皮下注射(MSⅡ)对血糖控制的临床疗效差异,并为该病治疗积累经验。方法选取我院内分泌科于2010年3月~2013年9月收治的78例2型糖尿病患者,利用随机数字表法进行分组,分别设为研究组和对照组,每组各39例。其中研究组开展CSⅡ治疗,对照组开展MSⅡ治疗。记录两组患者在治疗前后空腹血糖(FBG)、餐后2h血糖(2hBG)、糖化血红蛋白(HbA1C)及胰岛素用量、不良反应

  10. [Intravenous remifentanyl for labor analgesia].

    Science.gov (United States)

    Arnal, D; Serrano, M L; Corral, E M; García del Valle, S

    2009-04-01

    Intravenous remifentanil may be the preferred analgesic when regional techniques are contraindicated. To perform a systematic review on the use of remifentanil for analgesia in labor. We searched MEDLINE (January 1995-August 2007) for studies on obstetric analgesia with remifentanil. We found 32 references representing the use of remifentanil in 257 women in labor. In most cases, patients reported relief of pain and a high level of satisfaction, with no severe side effects in mothers or neonates. When compared with meperidine and nitrous oxide in clinical trials, remifentanil provided better analgesia with fewer adverse effects. Analgesia with intravenous remifentanil is more effective and safer than other alternatives to regional analgesic techniques in obstetrics. Nevertheless, the optimum system for infusing the drug must b e established and further studies of maternal and fetal safety should be carried out.

  11. Intravenous bicarbonate and sodium chloride both prolong endurance during intense cycle ergometer exercise.

    Science.gov (United States)

    Mitchell, T H; Abraham, G; Wing, S; Magder, S A; Cosio, M G; Deschamps, A; Marliss, E B

    1990-08-01

    To determine the effects of neutralizing exercise systemic acidosis via the intravenous route upon endurance and metabolic responses, eight lean, normal, postabsorptive men exercised to exhaustion at about 80% of their VO2 max (69 +/- 3%, mean +/- SEM, of maximum power output) on a cycle ergometer. Exercise studies were performed either with no infusion (control) or with a total infusion volume of about 1.5 L, mainly as 1.3% sodium bicarbonate or as 0.9% sodium chloride (NaCl), infused (double-blind) throughout exercise. The sodium bicarbonate was to prevent acid-base change, the sodium chloride was as a control for the volume infused. Arterialized venous blood and breath-by-breath analysis of expired gases were obtained. [H+] (nmol.L-1) and [HCO3-] (mmol.L-1) at exhaustion were similar in control and NaCl (46.5 +/- 1.8, 19.9 +/- 0.9), but remained unchanged from rest values with bicarbonate (38.4 +/- 0.9, 24.8 +/- 1.5, p less than 0.005 vs control and NaCl). At exhaustion, VO2, VCO2, RER, heart rate, and systolic BP as well as FFA, glycerol, alanine, insulin, norepinephrine, and epinephrine did not differ among protocols. Endurance was markedly prolonged (p less than 0.01) with bicarbonate (31.9 +/- 5.8 min) and NaCl (31.8 +/- 4.1 min) compared with the control (19.0 +/- 2.9 min) condition. Plasma glucose at exhaustion was higher (p less than 0.025) in the control compared to bicarbonate and NaCl experiments, while lactate was higher (p less than 0.025) in the bicarbonate than in the control and NaCl experiments. Thus, the prolonged endurance with sodium bicarbonate infusion could not be explained either by its effect of maintaining blood acid-base equilibrium or concomitant metabolic changes.

  12. Safe intravenous administration in pediatrics: A 5-year Pediatric Intensive Care Unit experience with smart pumps.

    Science.gov (United States)

    Manrique-Rodríguez, S; Sánchez-Galindo, A C; Fernández-Llamazares, C M; Calvo-Calvo, M M; Carrillo-Álvarez, Á; Sanjurjo-Sáez, M

    2016-10-01

    To estimate the impact of smart pump implementation in a pediatric intensive care unit in terms of number and type of administration errors intercepted. Observational, prospective study carried out from January 2010 to March 2015 with syringe and great volumen infusion pumps available in the hospital. A tertiary level hospital pediatric intensive care unit. Infusions delivered with infusion pumps in all pediatric intensive care unit patients. Design of a drug library with safety limits for all intravenous drugs prescribed. Users' compliance with drug library as well as number and type of errors prevented were analyzed. Two hundred and eighty-three errors were intercepted during 62 months of study. A high risk drug was involved in 58% of prevented errors, such as adrenergic agonists and antagonists, sedatives, analgesics, neuromuscular blockers, opioids, potassium and insulin. Users' average compliance with the safety software was 84%. Smart pumps implementation has proven effective in intercepting high risk drugs programming errors. These results might be exportable to other critical care units, involving pediatric or adult patients. Interdisciplinary colaboration is key to succeed in this process. Copyright © 2016 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  13. Intravenous infusion of erythromycin enhances the interdigestive migrating motor complex in dogs%静脉注射红霉素增强狗的胃肠移行性复合运动

    Institute of Scientific and Technical Information of China (English)

    杨春敏; 毛高平; 张秀荣; 张映辉; 步晓华; 曹传平

    2001-01-01

    目的 观察静脉注射红霉素对狗消化间期胃肠移行性复合运动(MMC)的作用。 方法 应用低顺应性毛细管水灌注消化道腔内测压系统记录清醒狗胃肠收缩活动。在MMCⅠ相静脉注射红霉素记录胃肠运动变化并抽血测定血浆胃动素浓度。 结果 (1)血浆胃动素随MMC不同时相呈周期性波动,血浆胃动素浓度在MMCⅢ相时最高,MMCⅠ相时最低。(2)在MMCⅠ相时从静脉注射红霉素可以激发胃和十二指肠MMCⅢ相收缩,但不伴有血浆胃动素升高。引起狗MMCⅢ相收缩的最适红霉素浓度为0.5mg.kg-1;红霉素10mg.kg-1引起胃肠持续收缩并出现十二指肠-胃逆蠕动,导致恶心呕吐。(3)阿托品明显抑制红霉素所致的胃和十二指肠MMCⅢ相收缩。 结论 红霉素有促进胃肠动力作用,红霉素引起胃肠收缩作用的机制与胃动素释放无关,可能部分通过胆碱能神经介导。%Aims To observe the effect of intravenous injection oferythromycin (EM) on interdigestive migrating motor complex (MMC) and postprandial gastrointestinal contraction in conscious dogs. Methods Gastrointestinal contractile activity was recorded using low compliance capillary water perfusion manometric system. EM was administered intravenously during phaseⅠand after meal, and blood samples were drawn for measuring plasma motilin concentrations. Results (1) Plasma motilin levels showed cyclical fluctuations in different phases of MMC, and plasma motilin reached peak during phaseⅢ and lowest during phaseⅠ.(2) EM induced phaseⅢ-like contractions in the antrum and duodenum, which was not accompanied by a peak in plasma motilin level. The optimum dose of EM for resulting in a premature phaseⅢ with the same characteristics as the spontaneously occurring phaseⅢ was established to be 0.5 mg.kg-1. The dose of 10 mg.kg-1 EM induced gastrointestinal continuous contractions and duodeno-gastric retrograde

  14. Progressive muscle weakness with respiratory insufficiency in a young patient with tetanus during magnesium sulfate infusion.

    Science.gov (United States)

    Mathew, Preethy Joseph; Muthurajan, Narayanan; Wig, Jyotsna

    2010-09-01

    Magnesium sulfate administered as an intravenous infusion is considered safe. However, there have been concerns about the neuromuscular blocking properties of magnesium that can cause respiratory insufficiency. We report a patient with mild tetanus who, after being started on magnesium infusion, developed progressive respiratory insufficiency, proximal muscle weakness and ptosis. On discontinuation of magnesium infusion, the muscular weakness improved and respiration became normal. The safety of magnesium sulfate infusion for the management of tetanus needs to be re-evaluated.

  15. Endothelial Cell Toxicity of Vancomycin Infusion Combined with Other Antibiotics.

    Science.gov (United States)

    Drouet, Maryline; Chai, Feng; Barthélémy, Christine; Lebuffe, Gilles; Debaene, Bertrand; Décaudin, Bertrand; Odou, Pascal

    2015-08-01

    French guidelines recommend central intravenous (i.v.) infusion for high concentrations of vancomycin, but peripheral intravenous (p.i.v.) infusion is often preferred in intensive care units. Vancomycin infusion has been implicated in cases of phlebitis, with endothelial toxicity depending on the drug concentration and the duration of the infusion. Vancomycin is frequently infused in combination with other i.v. antibiotics through the same administrative Y site, but the local toxicity of such combinations has been poorly evaluated. Such an assessment could improve vancomycin infusion procedures in hospitals. Human umbilical vein endothelial cells (HUVEC) were challenged with clinical doses of vancomycin over 24 h with or without other i.v. antibiotics. Cell death was measured with the alamarBlue test. We observed an excess cellular death rate without any synergistic effect but dependent on the numbers of combined infusions when vancomycin and erythromycin or gentamicin were infused through the same Y site. Incompatibility between vancomycin and piperacillin-tazobactam was not observed in our study, and rinsing the cells between the two antibiotic infusions did not reduce endothelial toxicity. No endothelial toxicity of imipenem-cilastatin was observed when combined with vancomycin. p.i.v. vancomycin infusion in combination with other medications requires new recommendations to prevent phlebitis, including limiting coinfusion on the same line, reducing the infusion rate, and choosing an intermittent infusion method. Further studies need to be carried out to explore other drug combinations in long-term vancomycin p.i.v. therapy so as to gain insight into the mechanisms of drug incompatibility under multidrug infusion conditions.

  16. Incretin effect potentiates beta-cell responsivity to glucose as well as to its rate of change: OGTT and matched intravenous study.

    Science.gov (United States)

    Campioni, Marco; Toffolo, Gianna; Shuster, Lynne T; Service, F John; Rizza, Robert A; Cobelli, Claudio

    2007-01-01

    The aim of this study is to gain greater insight into the mechanism whereby "incretins" (greater insulinemia after oral than intravenous glucose) enhance insulin secretion. To do so, we use a model of C-peptide secretion to reanalyze data from a previously published study in which glycemic profiles observed following glucose ingestion were matched in the same 10 subjects by means of an intravenous glucose infusion. We report that incretins increase insulin secretion by enhancing both the dynamic (to the rate of increase of glucose) and static (to given glucose concentration) response with an increase of 58% for the static (Phi(s) = 16.4 +/- 1.8 vs. 24.6 +/- 2.0 10(-9) min(-1), P = 0.01) and 63% for the dynamic (Phi(d) = 278 +/- 32 vs. 463 +/- 86 10(-9), P = 0.02) indexes. Since increases in the dynamic response to glucose are believed to be due to an increase in the rate of docking, and exocytosis of insulin containing granules and increases in the static response to glucose are believed to be caused by a shift in the sensitivity of the beta-cell to glucose, these results suggest that incretins may modulate more than one step in the beta-cell insulin secretory cascade.

  17. Early tumour response as a survival predictor in previously- treated patients receiving triplet hepatic artery infusion and intravenous cetuximab for unresectable liver metastases from wild-type KRAS colorectal cancer.

    Science.gov (United States)

    Bouchahda, Mohamed; Boige, Valérie; Smith, Denis; Karaboué, Abdoulaye; Ducreux, Michel; Hebbar, Mohamed; Lepère, Céline; Focan, Christian; Guimbaud, Rosine; Innominato, Pasquale; Awad, Sameh; Carvalho, Carlos; Tumolo, Salvatore; Truant, Stephanie; De Baere, Thierry; Castaing, Denis; Rougier, Philippe; Morère, Jean-François; Taieb, Julien; Adam, René; Lévi, Francis

    2016-11-01

    Early tumour shrinkage has been associated with improved survival in patients receiving cetuximab-based systemic chemotherapy for liver metastases from colorectal cancer (LM-CRC). We tested this hypothesis for previously treated LM-CRC patients receiving cetuximab (500 mg/m(2)) and triplet hepatic artery infusion (HAI) within European trial OPTILIV. Irinotecan (180 mg/m(2)), 5-fluorouracil (2800 mg/m(2)) and oxaliplatin (85 mg/m(2)) were given as chronomodulated or conventional delivery. Patients were retrospectively categorised as early responders (complete or partial RECIST response after three courses) or non-early responders (late or no response). Prognostic factors were determined using multivariate logistic or Cox regression models. Response was assessed in 57 of 64 registered patients (89%), who had previously received one to three prior systemic chemotherapy protocols. An early response occurred at 6 weeks in 16 patients (28%; 9 men, 7 women), aged 33-76 years, with a median of 12 liver metastases (LMs) (2-50), involving five segments (1-8). Ten patients had a late response, and 31 patients had no response. Grade 3-4 fatigue selectively occurred in the non-early responders (0% versus 26%; p = 0.024). Early tumour response was jointly predicted by chronomodulation-odds ratio (OR): 6.0 (1.2-29.8; p = 0.029)-and LM diameter ≤57 mm-OR: 5.3 (1.1-25.0; p = 0.033). Early tumour response predicted for both R0-R1 liver resection-OR: 11.8 (1.4-100.2; p = 0.024) and overall survival-hazard ratio: 0.39 (0.17-0.88; p = 0.023) in multivariate analyses. Early tumour response on triplet HAI and systemic cetuximab predicted for complete macroscopic liver resection and prolonged survival for LM-CRC patients within a multicenter conversion-to-resection medicosurgical strategy. Confirmation is warranted for early response on HAI to guide decision making. Protocol numbers: EUDRACT 2007-004632-24 NCT00852228. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. 门冬胰岛素与人普通胰岛素及胰岛素泵在2型糖尿病患者围手术期的疗效比较%Comparison Between Infusion Use of Insulin Aspart and Novolin R during Perioperative Period of Patients with Type2 Diabetes Mellitus

    Institute of Scientific and Technical Information of China (English)

    王紫晨; 冯明; 李耘; 钱玉英; 鲁梅花; 马雅辉

    2011-01-01

    Objective: To compare the efficacy and safety of rapid-acting human insulin analogue (Aspart) and regular human in sulin (Novolin R) delivered with continuous subcutaneous insulin infusion (CSII) pump and multiple subcutaneous insulin infusion (MSII) on perioperative period of patients with type 2 diabetes mellitus. Methods: 1S8 perioperative patients with poorly-controlled type 2 dia betes in hospital were randomized to Group CSII (n=52,treated with insulin Aspart), Group MSII(A) (n=56,treated with insulin Aspart) and Group MSII(B) (n=50, treated with insulin Novolin R). All patients were treated to achieve target glycaemic control. The blood glu cose, the time and the dose of insulin needed for good glycaemia control were compared of the three groups, the complications of surgery and incidence of hypoglycemia were evaluated too. Results: The levels of blood glucose in all groups were reduced after the treatments. The time for good glycaemia control was shorter in Group CSII than that in Group MSII(A) and Group MSII(B) (P<0.05). The mean of the postprandial blood glucose was significantly lower in Group CSII than that in Group MSH(A) and Group MSII(B) (P<0.01). The com plications of surgery and incidence of hypoglycemia were significantly lower in Group CSII than that in Group MSII(A) and Group MSII (B) (P<0.05). Conclusion: For the perioperative period of patients with type 2 diabetes mellitus, insulin Aspart provides a more effective and safety control of blood glucose, it can control the hyperglycemia rapidly with lower fluctuations of blood glucose than Novolin R. The insulin pump could be the best mode of insulin infusion for perioperative type 2 diabetes.%目的:探讨速效胰岛素类似物(门冬胰岛素,诺和锐)与人普通胰岛素(诺和灵R)及胰岛素泵在2型糖尿病(T2DM)围手术期治疗中的有效性和安全性.方法:158例围手术期T2DM患者随机分为胰岛素泵输注门冬胰岛素治疗CSⅡ组52例,门冬胰岛素多

  19. 系统评价区域灌注和全身给药治疗重症急性胰腺炎的效果%Comparison on continuous regional arterial infusion and intravenous administration in the treatment of severe acute pancreatitis: A systematic review

    Institute of Scientific and Technical Information of China (English)

    李宝华; 王文辉; 周怀琪

    2013-01-01

    Objective To assess the clinical effectiveness of continuous regional arterial infusion (CRAI) and intravenous administration in the treatment of severe acute pancreatitis (SAP). Methods The database such as PubMed, Cochrane Library, EMbase, CNKI, and CBM were searched to collect randomized controlled trials (RCTs) from the establishment to July 2012, and articles about CRAI and intravenous administration in the treatment of SAP were retrieved. Studies were screened, data were extracted, and the methodological quality was assessed. Meta-analyses were conducted by using Rev-Man 5. 0 software. Results A total of 10 RCTs involving 597 patients were included. Results of Meta-analysis showed that CRAI was better than intravenous administration in the cure rates (OR=3. 42, 95%CI [2. 14, 5. 45], P<0. 00001), the rates of surgical intervention (OR=0. 39, 95%CI [0. 23, 0. 64], P=0. 0002), the secondary infection rates (OR=0. 24, 95%CI [0. 14, 0.42], P<0. 00001) and the complications morbidity rates (OR=0.28, 95%CI [0.13, 0.59], P = 0. 0009). Conclusion There are differences in the modes of administration between CARI and intravenous administration. CARI is superior to intravenous administration in the aspects of cure rate, rate of surgical intervention, secondary infection rates and complications and morbidity rates.%目的 系统评价持续性区域动脉灌注(CRAI)和全身给药治疗重症急性胰腺炎(SAP)的临床疗效.方法 计算机检索PubMed、Cochrane Library、EMbase、CNKI、CBM,同时手工检索相关期刊和会议论文集,均从建库至2012年7月,查找关于CRAI和全身给药治疗SAP的临床对照试验研究.按照纳入与排除标准选择试验、提取资料和评价其方法质量学后,采用RevMan manager 5.0软件进行Meta分析.结果 共纳入10个研究,597例患者.Meta分析结果显示:①治愈率:两种给药方式差异有统计学意义[OR=3.42,95%CI(2.14,5.45),P<0.00001];②中转手术率:两种给药方

  20. Intravenous drug delivery in neonates: lessons learnt.

    Science.gov (United States)

    Sherwin, Catherine M T; Medlicott, Natalie J; Reith, David M; Broadbent, Roland S

    2014-06-01

    Intravenous drug administration presents a series of challenges that relate to the pathophysiology of the neonate and intravenous infusion systems in neonates. These challenges arise from slow intravenous flow rates, small drug volume, dead space volume and limitations on the flush volume in neonates. While there is a reasonable understanding of newborn pharmacokinetics, an appreciation of the substantial delay and variability in the rate of drug delivery from the intravenous line is often lacking. This can lead to difficulties in accurately determining the pharmacokinetic and pharmacodynamic relationship of drugs in the smallest patients. The physical variables that affect the passage of drugs through neonatal lines need to be further explored in order to improve our understanding of their impact on the delivery of drugs by this route in neonates. Through careful investigation, the underlying causes of delayed drug delivery may be identified and administration protocols can then be modified to ensure predictable, appropriate drug input kinetics.

  1. 盐酸氨溴索静脉用药协同雾化吸入治疗29例老年呼吸系统感染性疾病疗效观察%The effect of intravenous infusion of ambroxol hydrochloride collaborated with inhalation in the treatment of 29 cases of the elderly respiratory infectious disease

    Institute of Scientific and Technical Information of China (English)

    赵英

    2016-01-01

    Objective: To observe the effect of inhalation of ambroxol atomization in the treatment of the elderly respiratory infectious disease. Methods:From July 2014 to June 2015, 58 elderly cases of the respiratory infectious diseases were collected and randomly divided into a treatment group with 29 cases who were treated with ambroxol hydrochloride (intravenous infusion of 60 mg daily and inhalation of 15 mg twice a day with 15 min each). The control group with 29 cases intravenously received 60 mg of ambroxol hydrochloride daily. The two groups were treated with the conventional antibiotics and antispasmodic asthma. Results:The total effective rate of the treatment group was 86.21%(25/29), which was signiifcantly higher than 75.86%(22/29) of the control group (P<0.05). The improvement or termination time of the clinical signs such as cough and expectoration were shorter in the treatment group than in the control group. The pulmonary rales disappeared faster in the treatment group than in the control one. The duration of antibiotics was shorter in the treatment group than in the control one. Conclusion:The effect of intravenous infusion of ambroxol hydrochloride collaborated with inhalation in the treatment of the elderly respiratory infectious disease is rapid and safe, which is worthy of clinical promotion.%目的:观察盐酸氨溴索雾化吸入治疗老年呼吸系统感染性疾病的效果。方法:收集2014年7月-2015年6月年龄>80岁的老年呼吸系统感染性疾病患者58例,随机分为治疗组29例,静脉滴注盐酸氨溴索60 mg,每天1次,同时雾化吸入盐酸氨溴索15 mg,每天2次,每次15 min;对照组29例,静脉滴注盐酸氨溴索60 mg,每天1次。两组均给予常规抗生素和解痉平喘治疗,观察两组治疗效果。结果:治疗组总有效率为86.21%(25/29),显著高于对照组的75.86%(22/29,P<0.05)。临床体征咳嗽、咳痰好转或终止时间短于对照组,肺部啰

  2. Extreme hypertriglyceridemia managed with insulin.

    Science.gov (United States)

    Thuzar, Moe; Shenoy, Vasant V; Malabu, Usman H; Schrale, Ryan; Sangla, Kunwarjit S

    2014-01-01

    Extreme hypertriglyceridemia can lead to acute pancreatitis and rapid lowering of serum triglycerides (TG) is necessary for preventing such life-threatening complications. However, there is no established consensus on the acute management of extreme hypertriglyceridemia. We retrospectively reviewed 10 cases of extreme hypertriglyceridemia with mean serum TG on presentation of 101.5 ± 23.4 mmol/L (8982 ± 2070 mg/dL) managed with insulin. Serum TG decreased by 87 ± 4% in 24 hours in those patients managed with intravenous insulin and fasting and 40 ± 8.4% in those managed with intravenous insulin alone (P = .0003). The clinical course was uncomplicated in all except 1 patient who subsequently developed a pancreatic pseudocyst. Thus, combination of intravenous insulin with fasting appears to be an effective, simple, and safe treatment strategy in immediate management of extreme hypertriglyceridemia. Crown Copyright © 2014. Published by Elsevier Inc. All rights reserved.

  3. Marrow Stromal Cell Infusion Rescues Hematopoiesis in Lethally Irradiated Mice despite Rapid Clearance after Infusion

    Directory of Open Access Journals (Sweden)

    Xiaodong Yang

    2012-01-01

    Full Text Available Marrow stromal cells (MSCs, also termed mesenchymal stem cells have been proposed as a promising cellular therapy for tissue injury including radiation-induced marrow failure, but evidence for a direct effect is lacking. To assess the effects of MSCs on survival after lethal irradiation, we infused syngeneic MSCs (either as immortalized MSCs clones or primary MSCs intravenously into wild-type C57/Bl6 mice within 24 hours of lethal total body irradiation (TBI. Mice receiving either of the MSC preparations had significantly improved survival when compared to controls. In vivo imaging, immune histochemistry, and RT-PCR employed to detect MSCs indicated that the infused MSCs were predominantly localized to the lungs and rapidly cleared following infusion. Our results suggest that a single infusion of MSCs can improve survival after otherwise lethal TBI but the effect is not due to a direct interaction with, or contribution to, the damaged marrow by MSCs.

  4. Exogenous glucose administration impairs glucose tolerance and pancreatic insulin secretion during acute sepsis in non-diabetic mice.

    Directory of Open Access Journals (Sweden)

    Yoshio Watanabe

    Full Text Available OBJECTIVES: The development of hyperglycemia and the use of early parenteral feeding are associated with poor outcomes in critically ill patients. We therefore examined the impact of exogenous glucose administration on the integrated metabolic function of endotoxemic mice using our recently developed frequently sampled intravenous glucose tolerance test (FSIVGTT. We next extended our findings using a cecal ligation and puncture (CLP