Rapid vascular glucose uptake via enzyme-assisted subcutaneous infusion: Enzyme-Assisted Subcutaneous Infusion Access Study

Soremekun, Olan A.; Shear, Melissa L.; Patel, Sagar; Kim, Gina J.; Biddinger, Paul D.; Parry, Blair A.; Yialamas, Maria A.; Thomas, Stephen

doi:10.1016/j.ajem.2008.08.028

Cited by 7 publications

(29 citation statements)

References 19 publications

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“…Although there are other good quality studies that examine patients' preferences [18][19][20][21][22][23][24], none are RCTs. For example, one study measured preferences of IBD patients for two anti-TNF agents in terms of their mode of administration by using hypothetical scenarios [18].…”

Section: Discussionmentioning

confidence: 99%

“…There are in fact few studies where patients' preferences or acceptance for IV and SC drug administration are primary outcomes [18][19][20][21][22][23][24]. A good example is the report by Barbee et al (2013) [19] in which patients with MM who received at least one dose each of IV and SC bortezomib were asked via a questionnaire about their preference for route of drug delivery; 68% preferred SC whilst 25% favoured IV.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Intravenous versus Subcutaneous Drug Administration. Which Do Patients Prefer? A Systematic Review

Stoner

Harder

Fallowfield

et al. 2014

Patient

112

102

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Intravenous versus Subcutaneous Drug Administration. Which Do Patients Prefer? A Systematic Review

Stoner

Harder

Fallowfield

et al. 2014

Patient

112

102

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“…The studies with the most likely relevance to the prehospital and MCI situation are probably the EASI Access I and EASI Access II trials (conducted in part by some of this review's authors) [1, 2]. These studies are important, because of two major “new” angles: (1) institution of HRH-facilitated infusion lines by prehospital providers and (2) use of stable-isotope labeling techniques to definitively demonstrate rapid and significant uptake into the intravascular compartment of SC-infused (glucose-containing) fluid.…”

Section: Existing Evidence and Methods For Use Of Subcutaneous Infumentioning

confidence: 99%

“…The authors have found that infusion rates in the 400 mL/hr range are easily attainable (and painless) [1, 2]. Other investigators have used small-gauge catheters (24 g) and infused isotonic solution (lactated Ringer's) with no discomfort, at maximal gravity-assisted rates exceeding 500 mL/hr [24].…”

Section: Existing Evidence and Methods For Use Of Subcutaneous Infumentioning

confidence: 99%

“…Building on reports of EASI use in other settings, namely, in hospice care and in pediatric patients, prehospital investigators have assessed EASI as placed by first EMT-paramedics (EMT-Ps) [1] and then in a follow-up study with EASI placed by EMT-basic (EMT-B) level providers [2]. In its first two studies in simulated prehospital situations, EASI access was placed with 100% effectiveness and no significant complications.…”

Section: Introductionmentioning

confidence: 99%

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Subcutaneous Fluid Administration: A Potentially Useful Tool in Prehospital Care

Arthur

Goodloe

Thomas

2012

Emergency Medicine International

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Mass casualty incidents (MCIs) and disaster medical situations are ideal settings in which there is need for a novel approach to infusing fluids and medications into a patient's intravascular space. An attractive new approach would avoid the potentially time-consuming needlestick and venous cannulation requiring a trained practitioner. In multiple-patient situations, trained practitioners are not always available in sufficient numbers to enable timely placement of intravenous catheters. The novel approach for intravascular space infusion, described in this paper involves the preadministration of the enzyme, human recombinant hyaluronidase (HRH), into the subcutaneous (SC) space, via an indwelling catheter. The enzyme “loosens” the SC space effectively enhancing the absorption of fluids and medication.

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Comparison of routes for achieving parenteral access with a focus on the management of patients with Ebola virus disease

Ker

Tansley

Beecher

et al. 2015

Cochrane Database of Systematic Reviews

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BackgroundDehydration is an important cause of death in patients with Ebola virus disease (EVD). Parenteral fluids are often required in patients with fluid requirements in excess of their oral intake. The peripheral intravenous route is the most commonly used method of parenteral access, but inserting and maintaining an intravenous line can be challenging in the context of EVD. Therefore it is important to consider the advantages and disadvantages of different routes for achieving parenteral access (e.g. intravenous, intraosseous, subcutaneous and intraperitoneal).ObjectivesTo compare the reliability, ease of use and speed of insertion of different parenteral access methods.Search methodsWe ran the search on 17 November 2014. We searched the Cochrane Injuries Group's Specialised Register, Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library), Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations, Ovid MEDLINE(R) Daily, Ovid MEDLINE(R) and Ovid OLDMEDLINE(R), Embase Classic + Embase (OvidSP), CINAHL (EBSCOhost), clinicaltrials.gov and screened reference lists.Selection criteriaRandomised controlled trials comparing different parenteral routes for the infusion of fluids or medication.Data collection and analysisTwo review authors examined the titles and abstracts of records obtained by searching the electronic databases to determine eligibility. Two review authors extracted data from the included trials and assessed the risk of bias. Outcome measures of interest were success of insertion; time required for insertion; number of insertion attempts; number of dislodgements; time period with functional access; local site reactions; clinicians' perception of ease of administration; needlestick injury to healthcare workers; patients' discomfort; and mortality. For trials involving the administration of fluids we also collected data on the volume of fluid infused, changes in serum electrolytes and markers of renal function. We rated the quality of the evidence as 'high', 'moderate', 'low' or 'very low' according to the GRADE approach for the following outcomes: success of insertion, time required for insertion, number of dislodgements, volume of fluid infused and needlestick injuries.Main resultsWe included 17 trials involving 885 participants. Parenteral access was used to infuse fluids in 11 trials and medications in six trials. None of the trials involved patients with EVD. Intravenous and intraosseous access was compared in four trials; intravenous and subcutaneous access in 11; peripheral intravenous and intraperitoneal access in one; saphenous vein cutdown and intraosseous access in one; and intraperitoneal with subcutaneous access in one. All of the trials assessing the intravenous method involved peripheral intravenous access.We judged few trials to be at low risk of bias for any of the assessed domains.Compared to the intraosseous group, patients in the intravenous group were more likely to experience an insertion failure (risk ratio (RR) 3.89, 95% confidence interval (CI) 2.39 to 6.3...

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Rapid vascular glucose uptake via enzyme-assisted subcutaneous infusion: Enzyme-Assisted Subcutaneous Infusion Access Study

Cited by 7 publications

References 19 publications

Intravenous versus Subcutaneous Drug Administration. Which Do Patients Prefer? A Systematic Review

Intravenous versus Subcutaneous Drug Administration. Which Do Patients Prefer? A Systematic Review

Subcutaneous Fluid Administration: A Potentially Useful Tool in Prehospital Care

Comparison of routes for achieving parenteral access with a focus on the management of patients with Ebola virus disease

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