Related Experiment Video

Updated: Aug 24, 2026

Improving IV Insulin Administration in a Community Hospital
12:08

Improving IV Insulin Administration in a Community Hospital

Published on: June 11, 2012

Intravenous insulin decreases protein breakdown in infants on extracorporeal membrane oxygenation

Michael S D Agus1, Patrick J Javid, Daniel P Ryan

  • 1Department of Medicine, Children's Hospital Boston, Harvard Medical School, Boston, MA 02115, USA.

Journal of Pediatric Surgery
|June 9, 2004
PubMed

Insights

Infants on extracorporeal membrane oxygenation (ECMO) experience severe protein breakdown. Insulin therapy significantly reduced this protein degradation, offering a potential new treatment for critically ill infants.

Area of Science:

  • Biochemistry
  • Pediatric Critical Care

Background:

  • Infants requiring extracorporeal membrane oxygenation (ECMO) exhibit extreme protein catabolism.
  • Conventional nutritional support is often ineffective in managing this severe protein breakdown.

Purpose of the Study:

  • To investigate the efficacy of the anabolic hormone insulin in reducing protein degradation in infants on ECMO.

Main Methods:

  • A prospective, randomized, crossover trial involving four parenterally fed infants on ECMO.
  • Utilized a 4-hour hyperinsulinemic euglycemic clamp followed by a saline control infusion.
  • Quantified whole-body protein flux and breakdown using stable isotope L-[1-13C]leucine infusion.

Main Results:

  • Insulin infusion increased serum insulin levels 15-fold compared to saline control.
  • Insulin significantly decreased total leucine flux and leucine flux from protein breakdown.
  • Insulin administration resulted in a 32% reduction in protein breakdown.

Conclusions:

  • The anabolic hormone insulin effectively reduced protein breakdown in critically ill infants on ECMO.
  • Intravenous insulin may offer significant benefits for metabolic management in critically ill infants, potentially improving outcomes.
Abstract

More Related Videos

Intravenous Injections in Neonatal Mice05:17

Intravenous Injections in Neonatal Mice

Published on: November 11, 2014

Related Concept Videos

Insulin: Dosing Regimen and Adverse Effects01:16

Insulin: Dosing Regimen and Adverse Effects

Insulin-replacement therapy usually includes both long-acting insulin (basal) and short-acting insulin (to cater to postprandial needs). In a diverse group of type 1 diabetes patients, the average daily insulin dose is typically 0.5-0.7 units/kg body weight. However, obese patients and pubertal adolescents may need more due to insulin resistance.
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
Extracorporeal Removal of Drugs: Continuous Renal Replacement Therapy01:26

Extracorporeal Removal of Drugs: Continuous Renal Replacement Therapy

Continuous Renal Replacement Therapy (CRRT) is an essential intervention for patients experiencing severe kidney dysfunction. This therapy offers a continuous mechanism for removing fluids and toxins from the bloodstream, leveraging the patient’s blood pressure to facilitate filtration through a specialized filter. This method contrasts with intermittent dialysis, providing a gentler and more consistent removal of waste products and excess fluid, which is particularly beneficial in critically...
One-Compartment Model: IV Infusion01:09

One-Compartment Model: IV Infusion

Intravenous (IV) infusion is often utilized when continuous and controlled drug delivery is necessary, such as during surgery or in the treatment of chronic diseases. This method offers numerous advantages, including immediate drug action, precise control over dosage, and bypassing the first-pass metabolism.
The one-compartment model for IV infusion uses mathematical equations to describe the rate of change in drug quantity in the body. At steady-state or infusion equilibrium, the drug input...
Drug Accumulation During Multiple Dosing: Intermittent IV Infusions01:24

Drug Accumulation During Multiple Dosing: Intermittent IV Infusions

Intermittent intravenous (IV) infusion is a method of drug administration where medications are delivered over short infusion periods followed by intervals of no drug delivery. This approach helps to prevent sustained high drug concentrations in the bloodstream, reducing the risk of adverse effects associated with prolonged exposure. Unlike continuous infusion, steady-state concentrations may not be achieved during a single dosing cycle but can be reached through repeated...
Drug Dosing: Infants and Children01:29

Drug Dosing: Infants and Children

Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
Insulin Formulations: Types and Delivery01:27

Insulin Formulations: Types and Delivery

Insulin preparations are categorized by their duration of action into short-acting and long-acting types. Two strategies are used to modify insulin's absorption and pharmacokinetic profile: slowing the absorption post-subcutaneous injection, or altering human insulin's amino acid sequence or protein structure. These changes retain the insulin's ability to bind to the insulin receptor, but alter its behavior in solution or after injection.
Short-acting insulins are divided into rapid-acting...