Comparison between a novel and conventional artificial pancreas for perioperative glycemic control using a closed-loop system
Comparison between a novel and conventional artificial pancreas for perioperative glycemic control using a closed-loop system
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DOI：
10.1007/s10047-016-0926-5
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发表时间：
2017-03-01
影响因子：
1.3
通讯作者：
Hanazaki, Kazuhiro
中科院分区：
文献类型：
--
作者：
Namikawa, Tsutomu;Munekage, Masaya;Hanazaki, Kazuhiro
本临床研究旨在比较用于外科患者围手术期血糖控制的新型和传统人工胰腺（AP）的可用性、血糖测量和血糖控制特征。从2010年7月至2015年3月，177例患者使用新型AP进行围手术期血糖控制。其中，166例患者有资格入选本研究。在82例患者（49%）中实施了针对80-110 mg/dL血糖范围的强化胰岛素治疗（IIT），其余84例患者（51%）接受了强度较低的胰岛素治疗方案。前瞻性收集数据，并进行回顾性审查或分析。对324例使用新型AP（n = 82）或传统AP（n = 242）进行IIT血糖控制的患者进行了回顾性比较研究。所有患者均未发生低血糖。比较研究显示，新型AP组和传统AP组之间的围手术期平均血糖水平、目标血糖范围的实现率以及IIT实现的血糖水平变异性无显著差异。新型AP系统与传统AP系统之间的IIT血糖测量和血糖控制特性的可用性、性能相当。然而，新型AP比传统AP更容易操作，因为其尺寸更小，重量更轻，准备时间更短。在不久的将来，这种新型的AP系统可能会被全世界接受为用于围手术期血糖控制的安全和有用的器械。
This clinical study aimed to compare a novel and conventional artificial pancreas (AP) used in surgical patients for perioperative glycemic control, with respect to usability, blood glucose measurements, and glycemic control characteristics. From July in 2010 to March in 2015, 177 patients underwent perioperative glycemic control using a novel AP. Among them, 166 patients were eligible for inclusion in this study. Intensive insulin therapy (IIT) targeting a blood glucose range of 80-110 mg/dL was implemented in 82 patients (49 %), and the remaining 84 patients (51 %) received a less-intensive regime of insulin therapy. Data were collected prospectively and were reviewed or analyzed retrospectively. A comparison study of 324 patients undergoing IIT for glycemic control using a novel (n = 82) or conventional AP (n = 242) was conducted retrospectively. All patients had no hypoglycemia. The comparison study revealed no significant differences in perioperative mean blood glucose level, achievement rates for target blood glucose range, and variability in blood glucose level achieved with IIT between the novel AP and conventional AP groups. The usability, performance with respect to blood glucose measurement, and glycemic control characteristics of IIT were comparable between novel and conventional AP systems. However, the novel AP was easier to manipulate than the conventional AP due to its smaller size, lower weight, and shorter time for preparation. In the near future, this novel AP system might be accepted worldwide as a safe and useful device for use in perioperative glycemic control.