Effect of intensive insulin therapy using a closed-loop glycemic control system in hepatic resection patients: a prospective randomized clinical trial.
OBJECTIVE Intensive insulin therapy (IIT) reduces morbidity and mortality in patients in surgical intensive care units. The aim of this study is to assess the effect of IIT using a closed-loop system in hepatectomized patients. RESEARCH DESIGN AND METHODS Patients were randomly assigned to receive IIT using a closed-loop system: an artificial pancreas (AP group) or conventional insulin therapy using the sliding-scale method (SS group). RESULTS The incidence of surgical-site infection in the AP group was significantly lower than that in the SS group. The length of hospitalization required for patients in the AP group was significantly shorter than that in the SS group. CONCLUSIONS Total hospital costs for patients in the AP group were significantly lower than for patients in the SS group. IIT using a closed-loop system maintained near-normoglycemia and contributed to a reduction in the incidence of SSI and total hospital costs due to shortened hospitalization.
Department of Surgery, Kochi Medical School, Kochi, Japan. tokabaya@kochi-u.ac.jp
Takehiro
T
Okabayashi
Isao
I
Nishimori
Hiromichi
H
Maeda
Koichi
K
Yamashita
Tomoaki
T
Yatabe
Kazuhiro
K
Hanazaki
D001786:Blood Glucose / Q000378:metabolism*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use*; D007564:Japan; D007902:Length of Stay / Q000191:economics; D008113:Liver Neoplasms / Q000191:economics / Q000601:surgery*; D019397:Pancreas, Artificial / Q000009:adverse effects / Q000191:economics / Q000706:statistics & numerical data*; D011184:Postoperative Period; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000517:prevention & control
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin