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World J Gastroenterol. Sep 7, 2009; 15(33): 4126-4131
Published online Sep 7, 2009. doi: 10.3748/wjg.15.4126
Intraoperative glycemic control procedures and the use of an artificial pancreas
Koichi Yamashita, Tomoaki Yatabe
Koichi Yamashita, Tomoaki Yatabe, Department of Anesthesiology and Critical Care Medicine, Kochi Medical School, Kohasu, Oko-cho, Nankoku, Kochi 781-8505, Japan
Author contributions: Yamashita K designed the study; Yamashita K and Yatabe T performed the search and data collection; Yamashita K performed the analysis and wrote the paper.
Correspondence to: Koichi Yamashita, MD, PhD, Department of Anesthesiology and Critical Care Medicine, Kochi Medical School, Kohasu, Oko-cho, Nankoku, Kochi 781-8505, Japan. koichiya@kochi-u.ac.jp
Telephone: +81-88-8802471 Fax: +81-88-8802475
Received: May 4, 2009
Revised: July 24, 2009
Accepted: July 31, 2009
Published online: September 7, 2009
Abstract

Strict intraoperative glycemic control can significantly decrease the incidence of postoperative infection; however, anesthesiologists must carefully control blood glucose levels as well as properly manage the respiratory and cardiovascular systems. However, standard blood glucose measurement systems and insulin dosing algorithms, which are necessary for achieving strict glycemic control, have not yet been developed. An artificial pancreas (STG-22TM; Nikkiso Co., Tokyo, Japan) is considered a highly accurate blood glucose monitoring system capable of closed-loop control of blood glucose. The device has, however, many problems to be addressed since it is a large and expensive system with little versatility, and it requires a large amount of blood to be collected. Therefore, the development of less invasive and inexpensive systems with future technological progress is greatly anticipated.

Keywords: Strict glycemic control; Artificial pancreas; Anesthesiologist; Sliding scale