Intensive insulin therapy during cardiovascular surgery

概要

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Recent evidence in the fields of surgery, emergency and critical care medicineindicates that strict glycemic control results in lower mortality. Hyperglycemia occursfrequently in patients with and without diabetes during cardiovascular surgery, especiallyduring cardiopulmonary bypass. However, strict glucose control is difficult toachieve during cardiovascular procedures. To establish effective intensive insulin therapyduring cardiovascular surgery, we conduct continuous blood glucose monitoring and employautomatic control by using an artificial endocrine pancreas (the STGR-22, Nikkiso,Tokyo, Japan). In this review, we will outline the present status and problems of conventionalglycemic control for perioperative cardiovascular surgery and introduce the newperioperative blood glucose management method that we are testing now. We will alsodiscuss the importance of perioperative glycemic control for cardiovascular surgery aswell as future prospects.