HPN用高カロリー輸液製剤の処方設計(第4報)―ワンバッグ・ツインバッグTPN製剤におけるインスリン残存率の長期試験―

We herein report a case in which insulin was added to a high-calorie infusion preparation administered for 7 days to patients with HPN. In our previous study, the residual ratio of insulin was measured based on the formula ; Hicaliq® solution-No.2 (700mL) +Proteamin® 12X (200mL) + 10% NaCl (20mL). As a result, the residual ratio decreased daily until the 7th day.In the present study, the residual ratio of insulin was measured in the infusion bags and the drip solution of other high-calorie infusion solutions ; Unicaliq® N and Aminotripa® No.2.The residual ratio of insulin in the drip solution of Unicaliq® N began to decrease gradually from the 3rd day, and it decreased to approximately 71 % on the 7th day. In contrast, there were no successive decreases in residual ratio of insulin during the 7day period in either the infusion bags or drip solution of Aminotripa® No.2.The residual ratio was constant at approximately 85%. In other words, with Unicaliq® N, as with Hicaliq® solution-No.2, the residual ratio of insulin decreased due to a decrease in the daily insulin titer. Based on these findings as determined using the above formulas, the control of blood sugar level may be hindered on the 5th day and thereafter. Conversely, with Aminotripa® No.2, the residual ratio of insulin did not decrease for 7days.Therefore, Aminotripa® No.2 seems to be the most appropriate formula among the three evaluated ones for the high-calorie infusion in patients undergoing HPN, when the stability of insulin is regarded as important.