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Strict blood glucose control by an artificial endocrine pancreas during hepatectomy may prevent postoperative acute kidney injury

  • Original Article
  • Artificial Liver, Pancreas
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Abstract

The aim of the present study was to evaluate the usefulness of a closed-loop system (STG-55; Nikkiso, Tokyo, Japan), a type of artificial endocrine pancreas for the continuous monitoring and control of intraoperative blood glucose, for preventing postoperative acute kidney injury (AKI) in patients undergoing hepatectomy. Thirty-eight patients were enrolled in this study. Glucose concentrations were controlled with either a manual injection of insulin based on a commonly used sliding scale (manual insulin group, n = 19) or the programmed infusion of insulin determined by the control algorithm of the artificial endocrine pancreas (programmed insulin group, n = 19). After the induction of anesthesia, a 20-G intravenous catheter was inserted into the peripheral forearm vein of patients in the programmed insulin group and connected to an artificial endocrine pancreas (STG-55). The target range for glucose concentrations was set to 100–150 mg/dL. The mean serum creatinine concentrations of preoperative, postoperative 24 and 48 h were 0.72, 0.78, and 0.79 mg/dL in the programmed insulin group, and 0.81, 0.95, and 1.03 mg/dL in the manual insulin group, respectively. Elevations in serum creatinine concentrations postoperative 48 h were significantly suppressed in the programmed insulin group. The STG-55 closed-loop system was effective for maintaining strict blood glucose control during hepatectomy with minimal variability in blood glucose concentrations and for suppressing elevations in serum creatinine concentrations. Strict blood glucose control by an artificial endocrine pancreas during hepatectomy may prevent postoperative AKI.

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Authors and Affiliations

  1. Department of Anesthesiology, Tokushima University Hospital, 3-18-15, Kuramoto, Tokushima, 770-8503, Japan

    Naoji Mita, Shinji Kawahito, Tomohiro Soga, Yasuo M. Tsutsumi & Katsuya Tanaka

  2. Department of Dental Anesthesiology, Tokushima University Hospital, Tokushima, Japan

    Kazumi Takaishi & Hiroshi Kitahata

  3. Diabetes Therapeutics and Research Center, University of Tokushima, Tokushima, Japan

    Munehide Matsuhisa

  4. Department of Digestive and Pediatric Surgery, Tokushima University Hospital, Tokushima, Japan

    Mitsuo Shimada

  5. Department of Anesthesiology, Aichi Medical University, Aichi, Japan

    Hiroyuki Kinoshita

Authors
  1. Naoji Mita
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  2. Shinji Kawahito
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  3. Tomohiro Soga
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  4. Kazumi Takaishi
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  5. Hiroshi Kitahata
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  6. Munehide Matsuhisa
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  7. Mitsuo Shimada
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  8. Hiroyuki Kinoshita
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  9. Yasuo M. Tsutsumi
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  10. Katsuya Tanaka
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Corresponding authors

Correspondence to Naoji Mita or Shinji Kawahito.

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The authors declare that they have no conflict of interest.

Financial support

This study was supported by intramural departmental funds.

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Mita, N., Kawahito, S., Soga, T. et al. Strict blood glucose control by an artificial endocrine pancreas during hepatectomy may prevent postoperative acute kidney injury. J Artif Organs 20, 76–83 (2017). https://doi.org/10.1007/s10047-016-0925-6

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  • DOI: https://doi.org/10.1007/s10047-016-0925-6

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