Surgery Today

, 40:1

Tight perioperative glycemic control using an artificial endocrine pancreas

Authors

  • Kazuhiro Hanazaki
    • Department of Surgery, Kochi Medical SchoolKochi University
  • Hiromichi Maeda
    • Department of Surgery, Kochi Medical SchoolKochi University
  • Takehiro Okabayashi
    • Department of Surgery, Kochi Medical SchoolKochi University
Review Article

DOI: 10.1007/s00595-009-4061-2

Cite this article as:
Hanazaki, K., Maeda, H. & Okabayashi, T. Surg Today (2010) 40: 1. doi:10.1007/s00595-009-4061-2

Abstract

Van den Berghe et al. reported in 2001 that tight glycemic control (maintaining blood glucose levels at 80–110 mg/dl) improved morbidity and mortality in the surgical intensive care unit. This method was termed intensive insulin therapy (IIT), and it is now being adopted worldwide for perioperative care. Recent evidence has suggested that perioperative hyperglycemia significantly contributes to the development of postoperative infection (POI). Many professional societies therefore now recommend IIT over conventional standard glycemic control measures for critically ill adult patients to minimize infectious complications. However, IIT carries a risk of inducing hypoglycemia, which is linked to serious neurological events. We recently demonstrated that achieving perioperative tight glycemic control using an artificial endocrine pancreas for surgical patients was a safe and effective method for decreasing the incidence of POI without increasing the risk of hypoglycemia. We herein review the benefits and requirements of tight glycemic control in surgery, with a focus on infection control. Strict perioperative glycemic control using a closed-loop artificial endocrine pancreas system is recommended for safe and effective performance of IIT.

Key words

Glycemic controlArtificial pancreasIntensive insulin therapySTG-22

Copyright information

© Springer 2010