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Utility of bedside artificial pancreas for postoperative glycemic control in cardiac surgery

  • Original Article
  • Artificial Liver, Pancreas
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Abstract

Perioperative hyperglycemia, hypoglycemia, and high glycemic variability are independent risk factors for mortality in critically ill patients. After cardiac surgery, intensive glycemic control without hypoglycemia may help to reduce the number of adverse events; however, postoperative glycemic control is difficult in many cases. In this study, we investigated whether the bedside artificial pancreas STG-55 is useful for postoperative glycemic control in cardiac surgery. Methods: In the present single-center retrospective study, we analyzed arterial blood glucose levels for 15 h after surgery in 69 patients treated using the bedside artificial pancreas and in 160 patients treated with continuous intravenous insulin infusion using a scale that adjusts for current blood glucose level, glycemic fluctuation, and insulin dose. Results: Hypoglycemia (arterial blood glucose level < 70 mg/dL) was not observed in any case. Patients in the group treated using the bedside artificial pancreas showed lower mean, maximum, and minimum blood glucose levels and glycemic variability and shorter treatment duration in the intensive care unit than patients treated with continuous intravenous insulin infusion. Notably, these results were not affected by diabetes status or differences in operative procedures. Analysis of patients undergoing isolated coronary artery bypass grafting surgery revealed that the incidence of surgical site complications composite with infection and dehiscence was lower. Conclusions: In cardiac surgery, postoperative treatment using bedside artificial pancreas is a novel therapy that improves hyperglycemia and glycemic variability, without hypoglycemia, and is, therefore, an attractive strategy for future surgeries.

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Acknowledgements

This study has received no specific grants from funding agencies.

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Authors and Affiliations

  1. Department of Diabetes and Endocrinology, Hyogo Brain and Heart Center, 520, Saisho-Kou, Himeji, Hyogo, 670-0981, Japan

    Urai Shin, Hashimoto Naoko, Takabe Michinori, Kashitani Yuya, Satake Yuka, Nishimoto Yuki & Ohara Takeshi

  2. Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan

    Urai Shin

  3. Department of Cardiovascular Surgery, Hyogo Brain and Heart Center, Himeji, Hyogo, Japan

    Kawashima Motoharu, Henmi Soichiro, Murakami Hirohisa & Mukohara Nobuhiko

  4. Department of Anesthesia, Hyogo Brain and Heart Center, Himeji, Hyogo, Japan

    Kuroda Mitsuo, Yamane Yu & Koga Tokito

  5. Department of Plastic Surgery, Hyogo Brain and Heart Center, Himeji, Hyogo, Japan

    Kajita Satoru

  6. Department of Clinical Engineering, Hyogo Brain and Heart Center, Himeji, Hyogo, Japan

    Doi Kazuki & Oue Tetsuya

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  1. Urai Shin
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  2. Hashimoto Naoko
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  3. Takabe Michinori
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  4. Kashitani Yuya
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  17. Ohara Takeshi
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Correspondence to Urai Shin or Ohara Takeshi.

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Shin, U., Naoko, H., Michinori, T. et al. Utility of bedside artificial pancreas for postoperative glycemic control in cardiac surgery. J Artif Organs 24, 225–233 (2021). https://doi.org/10.1007/s10047-020-01223-7

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  • DOI: https://doi.org/10.1007/s10047-020-01223-7

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