z-logo
open-access-imgOpen Access
Perioperative insulin therapy using a closed-loop artificial endocrine pancreas after hepatic resection
Author(s) -
Takehiro Okabayashi,
Hiromichi Maeda,
Zhao Li Sun,
Robert A. Montgomery,
Isao Nishimori,
Kazuhiro Hanazaki
Publication year - 2009
Publication title -
world journal of gastroenterology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.427
H-Index - 155
eISSN - 2219-2840
pISSN - 1007-9327
DOI - 10.3748/wjg.15.4116
Subject(s) - medicine , perioperative , glycemic , hypoglycemia , insulin , surgery , endocrine system , diabetes mellitus , intensive care medicine , anesthesia , endocrinology , hormone
Postoperative hyperglycemia is common in critically ill patients, even in those without a prior history of diabetes mellitus. It is well known that hyperglycemia induced by surgical stress often results in dysregulation of liver metabolism and immune function, impairing postoperative recovery. Current evidence suggests that maintaining normoglycemia postoperatively improves surgical outcome and reduces the mortality and morbidity of critically ill patients. On the basis of these observations, several large randomized controlled studies were designed to evaluate the benefit of postoperative tight glycemic control with intensive insulin therapy. However, intensive insulin therapy carries the risk of hypoglycemia, which is linked to serious neurological events. Recently, we demonstrated that perioperative tight glycemic control in surgical patients could be achieved safely using a closed-loop glycemic control system and that this decreased both the incidence of infection at the site of the surgical incision, without the appearance of hypoglycemia, and actual hospital costs. Here, we review the benefits and requirements of perioperative intensive insulin therapy using a closed-loop artificial endocrine pancreas system in hepatectomized patients. This novel intensive insulin therapy is safe and effectively improves surgical outcome after hepatic resection.

The content you want is available to Zendy users.

Already have an account? Click here to sign in.
Having issues? You can contact us here