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Transitioning the Nutritional Support Patient to Homecare
Published in Michael M. Rothkopf, Jennifer C. Johnson, Optimizing Metabolic Status for the Hospitalized Patient, 2023
Michael M. Rothkopf, Jennifer C. Johnson
In such cases, my preference has been to use a 24-hour infusion at home. Although this may be cumbersome, it has the advantage of protecting the patient from significant fluid and electrolyte shifts. Its main disadvantage is that it tethers the patient to an infusion set throughout the entire day. On the other hand, it simplifies tubing and catheter care issues for the patient. Since the infusion is continuous, the bag and tubing are replaced together every 24 hours. Continuous home infusion also removes the requirement of flushing the IV catheter between infusions. This further reduces the number of opportunities for catheter contamination.
Nutrition for children with chronic diseases and syndromes
Published in Judy More, Infant, Child and Adolescent Nutrition, 2021
There are several options for giving the insulin and the medical team will discuss and agree what is the best regimen for each child. Insulin may be given via:1, 2 or 3 insulin injections per day: these are usually injections of short-acting insulin or rapid-acting insulin analogue mixed with intermediate-acting insulin.multiple daily injection basal–bolus insulin regimens: injections of short-acting insulin or rapid-acting insulin analogue before meals, together with 1 or more separate daily injections of intermediate-acting insulin or long-acting insulin analogue.a small programable insulin pump which delivers fast-acting insulin either continuously or in precise amounts at pre-programmed times. It is about the size of a mobile phone and worn outside the body, often on a belt or in a pocket. It delivers the insulin into the body via an infusion set — a thin plastic tube ending in a small, flexible plastic cannula or a very thin needle. The cannula is inserted beneath the skin at the infusion site, usually in the abdomen or upper buttocks. The infusion set is kept in place for 2 to 3 days (sometimes more) and is then moved to a new location. All insulin is delivered through the infusion set.
Surgery and traumatology: Surgical management of severely injured patients when resources are limited
Published in Jan de Boer, Marcel Dubouloz, Handbook of Disaster Medicine, 2020
Take an infusion set, a sterile funnel, open-weave gauze as filter and a scoop. The most primitive procedure is to scoop the blood from sterile areas such as the thorax or the abdominal cavity, pour it back into the funnel which has been attached to the infusion set and from there reinfuse it immediately. You may also suck up the collected blood into a sterile bottle, if possible via blood filter, and reinfuse it from there by a pressure-pump. In order to avoid clotting add heparin or sodium citrate. After the autotransfusion the sodium citrate has again to be compensated by calcium citrate.
The improved survival rate and cost-effectiveness of a 7-day continuous subcutaneous insulin infusion set
Published in Journal of Medical Economics, 2021
Timothy Kwa, Gina Zhang, Katie Shepard, Kael Wherry, Sarnath Chattaraj
The insulin wastage calculations also included a few constraints. Both the reservoir and infusion set are sterile, single-use devices. For the current 2- to 3-day infusion sets, due to design limitations, the reservoir and the infusion set have to be changed simultaneously (i.e. users have an equal number of the infusion set and reservoir changes each year). For the 7-day EIS, the reservoir may be changed independently of the infusion set change. Therefore, while the number of 7-day EIS changes is not impacted by TDD of insulin, individuals in the upper quartile of TDD will require more frequent reservoir changes with 7-day EIS than those in the lower quartile of TDD. Additional waste, based on experimental findings, was generated through reservoir fills. A 10 mL insulin vial was able to fully supply a 3 mL reservoir 3 times, or a 1.8 mL reservoir 5 times, without compromising the integrity of the insulin filling process. There was about 10% insulin wastage associated with the process of filling the reservoir from the insulin vial, which contributed to the essential insulin waste calculations presented in the results.
A clinical review of the t:slim X2 insulin pump
Published in Expert Opinion on Drug Delivery, 2020
Cari Berget, Samantha Lange, Laurel Messer, Gregory P. Forlenza
An insulin pump, also referred to as continuous subcutaneous insulin infusion (CSII), is a digital device that administers insulin continuously into subcutaneous tissue in the users’ abdomen, buttocks, legs, or hips. Most insulin pumps consist of (1) the pump body, which contains a reservoir that holds the insulin and buttons for operating the pump, (2) flexible tubing for the insulin to flow from the pump to the user, and (3) an infusion set, which connects to the tubing and includes a small teflon or steel cannula that inserts under the skin and releases the insulin doses into subcutaneous tissue. Infusion sets are adhered to the skin with adhesive and can be detached from the tubing for showers or swimming while leaving the cannula in place. One type of insulin pump, a ‘patch pump,’ does not include tubing. With a patch pump, the pump is adhered directly to the user’s body, with the infusion set contained within the pump patch itself. Insulin pumps use rapid-acting insulin formulations (i.e. lispro, aspart, glulisine). Ultra-rapid insulin formulations (Fiasp) are also used in insulin pumps. Fiasp is FDA approved for use in insulin pumps for adults and is sometimes used off-label for youth [20].
Human studies with microneedles for evaluation of their efficacy and safety
Published in Expert Opinion on Drug Delivery, 2018
Thuy Trang Nguyen, Jung Hwan Park
In the insulin MN delivery field, after 3 days wearing either the ID infusion system or the SC system, patients reported that both routes of insertion had high rate of acceptability (100% and 96%, respectively); however, assessment of infusion set overall favored SC administration, with 96% reporting it as very acceptable versus 83% for the ID route. Additionally, when asked about their willingness to receive the next injection, 61% favored ID and 80% preferred SC [64]. In a subject preference survey of 14 patients after the MicronJet™450 device was used for ID insulin administration, 5 patients preferred ID injection in the future, 8 patients were neutral, and 1 preferred the SC route [73]. Obviously, MN insulin delivery has not yet been shown to be the most preferred method among participants in studies; thus, further investigation is needed to demonstrate the advantages of the MN system in term of patient acceptance.