Kazuhiro Hanazaki1, Hiroyuki Kitagawa2, Tomoaki Yatabe3, Masaya Munekage2, Ken Dabanaka2, Yuka Takezaki2, Yuuki Tsukamoto4, Takuji Asano5, Yoshihiko Kinoshita5, Tsutomu Namikawa2. 1. Department of Surgery, Kochi Medical School, Kochi University, Kohasu, Okocho, Nankoku-City, Kochi 783-8505, Japan. Electronic address: hanazaki@kochi-u.ac.jp. 2. Department of Surgery, Kochi Medical School, Kochi University, Kohasu, Okocho, Nankoku-City, Kochi 783-8505, Japan. 3. Department of Anesthesiology, Kochi Medical School, Kochi University, Kohasu, Okocho, Nankoku-City, Kochi 783-8505, Japan. 4. Department of Surgery, Kochi Medical School, Kochi University, Kohasu, Okocho, Nankoku-City, Kochi 783-8505, Japan; Nikkiso Co. Ltd., Tokyo, Japan. 5. Nikkiso Co. Ltd., Tokyo, Japan.
Abstract
BACKGROUND: We examined whether perioperative intensive insulin therapy (IIT) using an artificial pancreas (AP) with a closed-loop glycemic control system can be used to prevent hypoglycemia in surgical patients. METHODS: Between 2006 and 2012, perioperative glycemic control using an AP was performed in 427 patients undergoing general surgery. A total of 305 patients undergoing IIT using an AP in the target blood glucose range of 80 to 110 mg/dL were enrolled in the study. Data were collected prospectively and were reviewed or analyzed retrospectively. RESULTS: No patients had hypoglycemia. Perioperative mean blood glucose level and achievement rates in target blood glucose range of 80 to 110 mg/dL were 100.5 ± 11.9 mg/dL and 88.1% ± 16.0%, respectively. For the 3 primary operative methods, including hepatic, pancreatic, and esophageal resections, there were no significant differences in glycemic control stability between the types of surgery. CONCLUSION: Perioperative IIT using an AP with a closed-loop glycemic control system can be used to prevent hypoglycemia and maintain stable glycemic control with less variability of blood glucose concentration.
BACKGROUND: We examined whether perioperative intensive insulin therapy (IIT) using an artificial pancreas (AP) with a closed-loop glycemic control system can be used to prevent hypoglycemia in surgical patients. METHODS: Between 2006 and 2012, perioperative glycemic control using an AP was performed in 427 patients undergoing general surgery. A total of 305 patients undergoing IIT using an AP in the target blood glucose range of 80 to 110 mg/dL were enrolled in the study. Data were collected prospectively and were reviewed or analyzed retrospectively. RESULTS: No patients had hypoglycemia. Perioperative mean blood glucose level and achievement rates in target blood glucose range of 80 to 110 mg/dL were 100.5 ± 11.9 mg/dL and 88.1% ± 16.0%, respectively. For the 3 primary operative methods, including hepatic, pancreatic, and esophageal resections, there were no significant differences in glycemic control stability between the types of surgery. CONCLUSION: Perioperative IIT using an AP with a closed-loop glycemic control system can be used to prevent hypoglycemia and maintain stable glycemic control with less variability of blood glucose concentration.
Authors: T Miyashita; S Nakanuma; A K Ahmed; I Makino; H Hayashi; K Oyama; H Nakagawara; H Tajima; H Takamura; I Ninomiya; S Fushida; J W Harmon; T Ohta Journal: Eur Surg Date: 2015-10-14 Impact factor: 0.953