The aim of the present study was to evaluate the usefulness of a closed-loop system (STG-55; Nikkiso, Tokyo, Japan), a type of
artificial endocrine pancreas for the continuous monitoring and control of intraoperative
blood glucose, for preventing postoperative
acute kidney injury (AKI) in patients undergoing
hepatectomy. Thirty-eight patients were enrolled in this study.
Glucose concentrations were controlled with either a manual injection of
insulin based on a commonly used sliding scale (manual
insulin group, n = 19) or the programmed infusion of
insulin determined by the control algorithm of the
artificial endocrine pancreas (programmed
insulin group, n = 19). After the induction of
anesthesia, a 20-G intravenous
catheter was inserted into the peripheral forearm vein of patients in the programmed
insulin group and connected to an
artificial endocrine pancreas (STG-55). The target range for
glucose concentrations was set to 100-150 mg/dL. The mean serum
creatinine concentrations of preoperative, postoperative 24 and 48 h were 0.72, 0.78, and 0.79 mg/dL in the programmed
insulin group, and 0.81, 0.95, and 1.03 mg/dL in the manual
insulin group, respectively. Elevations in serum
creatinine concentrations postoperative 48 h were significantly suppressed in the programmed
insulin group. The STG-55 closed-loop system was effective for maintaining strict
blood glucose control during
hepatectomy with minimal variability in
blood glucose concentrations and for suppressing elevations in serum
creatinine concentrations. Strict
blood glucose control by an
artificial endocrine pancreas during
hepatectomy may prevent postoperative AKI.