Tight perioperative glycemic control using an artificial endocrine pancreas

Hanazaki, Kazuhiro; Maeda, Hiromichi; Okabayashi, Takehiro

doi:10.1007/s00595-009-4061-2

Cited by 45 publications

(30 citation statements)

References 39 publications

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“…This equipment continuously monitors blood glucose concentrations by withdrawing blood from a peripheral vein and administers insulin or glucose at rates determined to maintain the target glucose concentration. Artificial endocrine pancreas was shown to be safe and efficient in achieving tight perioperative blood glucose control without hypoglycemic episodes even immediately after total pancreatectomy [54,55]. …”

Section: Treatmentmentioning

confidence: 99%

Pancreatogenic Diabetes after Pancreatic Resection

2011

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Section: Treatmentmentioning

confidence: 99%

Pancreatogenic Diabetes after Pancreatic Resection

2011

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“…However, we evaluated the usefulness of the artificial pancreas during the 7-day acute phase after surgery in sepsis patients. Thus, the patients’ conditions and the period of use differed from the study by Hanazaki et al [16]. …”

Section: Discussionmentioning

confidence: 81%

“…Hanazaki et al [16 ]reported on the benefit of glucose control using STG-22. However, we evaluated the usefulness of the artificial pancreas during the 7-day acute phase after surgery in sepsis patients.…”

Section: Discussionmentioning

confidence: 99%

Preliminary Study on Glucose Control with an Artificial Pancreas in Postoperative Sepsis Patients

Takahashi¹,

Sato²,

Matsumoto³

et al. 2011

Eur Surg Res

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Background: Glucose control is essential to avoid hypoglycemia in postoperative patients. Aim: To conduct a preliminary examination to evaluate the feasibility of the use of an artificial pancreas for glucose control as well as the accuracy of assessment by the artificial pancreas of the insulin dose required. Subjects and Methods: Glucose control using an artificial pancreas was undertaken in 8 postoperative sepsis patients. The blood glucose level was set at 80–150 mg/dl. Blood glucose levels over time, insulin dose requirements, and occurrence of hypoglycemia (≤40 mg/dl) were recorded for each patient. The patients were divided into 2 groups based on the total insulin dose they received over the 7 days (HG, n = 4: consisting of patients who required a higher insulin dose; LG, n = 4: patients who required a lower insulin dose). The data of the 2 groups were analyzed retrospectively. Results: The blood glucose level before glucose control was 203.3 ± 9.9 mg/dl and could be controlled in all patients to within the target range. No hypoglycemia events were recorded for any of the patients. The insulin dose in the HG and LG groups was 21,824.8 ± 6,030.4 and 6,254.5 ± 3,402.3 mU/kg (p < 0.05). Conclusions: Accurate glucose control could be achieved with the artificial pancreas.

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“…To avoid hypoglycemia in tight glycemic control and improve POI in surgery, the closed-loop artificial endocrine pancreas system is an effective and safe means. Furthermore, novel perioperative glycemic control using an artificial pancreas markedly improved the labor burden on nursing staff, and hence reduced concerns about hypoglycemia [43] . Finally, because an ideal comparative study of tight glycemic control should be carried out under conditions without risk of hypoglycemia, blood glucose control using a closed-loop artificial pancreas system might be beneficial for the detection of the optimal target range for blood glucose in surgical patients.…”

Section: Tight Perioperative Glycemic Control Using a Closed-loop Artmentioning

confidence: 99%

Relationship between perioperative glycemic control and postoperative infections

Hanazaki¹,

Maeda²,

Okabayashi³

2009

WJG

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Perioperative hyperglycemia in critically ill surgery patients increases the risk of postoperative infection (POI), which is a common, and often costly, surgical complication. Hyperglycemia is associated with abnormalities in leukocyte function, including granulocyte adherence, impaired phagocytosis, delayed chemotaxis, and depressed bactericidal capacity. These leukocyte deficiencies are the cause of infection and improve with tight glycemic control, which leads to fewer POIs in critically ill surgical patients. Tight glycemic control, such as intensive insulin therapy, has a risk of hypoglycemia. In addition, the optimal targeted blood glucose range to reduce POI remains unknown. Since 2006, we have investigated tight perioperative blood glucose control using a closed-loop artificial endocrine pancreas system, to reduce POI and to avoid hypoglycemia. In this Topic Highlight, we review the relationship between perioperative glycemic control and POI, including the use of the artificial pancreas.

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Tight perioperative glycemic control using an artificial endocrine pancreas

Cited by 45 publications

References 39 publications

Pancreatogenic Diabetes after Pancreatic Resection

Pancreatogenic Diabetes after Pancreatic Resection

Preliminary Study on Glucose Control with an Artificial Pancreas in Postoperative Sepsis Patients

Relationship between perioperative glycemic control and postoperative infections

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