Dynamic changes in insulin requirements with post-operative time using bedside artificial pancreas to maintain normoglycemia without hypoglycemia after cardiac surgery
| Autor: | Motoharu Kawashima, Nobuhiko Mukohara, Yuki Nishimoto, Michinori Takabe, Shin Urai, Mitsuo Kuroda, Takeshi Ohara, Kazuki Doi, Tetsuya Oue, Hirohisa Murakami, Yu Yamane, Yuka Satake, Naoko Hashimoto |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Blood Glucose Male Pancreas Artificial medicine.medical_specialty medicine.medical_treatment Operative Time Biomedical Engineering Medicine (miscellaneous) Hypoglycemia Artificial pancreas law.invention Biomaterials law Diabetes mellitus medicine Cardiopulmonary bypass Humans Hypoglycemic Agents Insulin Cardiac Surgical Procedures Aged Retrospective Studies Glycemic Aged 80 and over business.industry Perioperative Middle Aged medicine.disease Cardiac surgery Anesthesia Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of Artificial Organs. 25:72-81 |
| ISSN: | 1619-0904 1434-7229 |
| Popis: | It is difficult to manage postoperative blood glucose levels without hyperglycemia and hypoglycemia in cardiac surgery patients even if continuous intravenous insulin infusion is used. Therefore, the insulin requirements for maintaining normoglycemia may be difficult to evaluate and need to be elucidated. In this single-center retrospective study, 30 adult patients (age 71.5 ± 9.0 years old, men 67%, BMI 22.0 ± 3.1 kg/m2, diabetes 33%) who underwent cardiac surgery and used bedside artificial pancreas (STG-55) as a perioperative glycemic control were included. We investigated the insulin and glucose requirements to maintain normoglycemia until the day after surgery. The bedside artificial pancreas achieved intensive glycemic control without hypoglycemia under fasting conditions for 15 h after surgery (mean blood glucose level was 103.3 ± 3.1 mg/dL and percentage of time in range (70—140 mg/dL) was 99.4 ± 2.0%). The total insulin requirement for maintaining normoglycemia differed among surgical procedures, including the use of cardiopulmonary bypass during surgery, while it was not affected by age, body mass index, or the capacity of insulin secretion. Moreover, the mean insulin requirement and the standard deviation of the insulin requirements were variable and high, especially during the first several hours after surgery. Treatment using the bedside artificial pancreas enabled intensive postoperative glycemic control without hypoglycemia. Furthermore, the insulin requirements for maintaining normoglycemia after cardiac surgery vary based on surgical strategies and change dynamically with postoperative time, even in the short term. |
| Databáze: | OpenAIRE |
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