Kawahito Shinji, Mita Naoji, Soga Tomohiro, Yagi Shusuke, Kakuta Nami, Satomi Shiho, Kinoshita Hiroyuki, Takaishi Kazumi, Kitagawa Tetsuya, Kitahata Hiroshi
Department of Community Medicine and Human Resource Development, Tokushima University Graduate School of Biomedical Sciences, 3-18-15, Kuramoto, Tokushima, 770-8503, Japan.
Department of Anesthesiology, Tokushima University Hospital, Tokushima, Japan.
J Artif Organs. 2019 Dec;22(4):353-356. doi: 10.1007/s10047-019-01111-9. Epub 2019 Jun 24.
The purpose of this study was to assess the accuracy and reliability of a continuous blood glucose monitoring system (artificial endocrine pancreas; STG-55, Nikkiso, Tokyo, Japan) during pediatric cardiopulmonary bypass surgery. Twenty-five pediatric patients scheduled to undergo cardiovascular surgery with cardiopulmonary bypass (age 4 months to 11 years; body weight 5.6-59.7 kg) were enrolled. The glucose sensor line of the artificial endocrine pancreas was connected to the venous side of the cardiopulmonary bypass circuit and used for continuous blood glucose monitoring. We obtained 192 samples for blood gas assessment from the cardiopulmonary bypass circuit, and i-STAT (Abbott, East Windsor, NJ, USA) was used for conventional blood glucose assessment. The accuracies of continuous glucose measurements (STG-55) and conventional intermittent glucose measurements (i-STAT) during cardiopulmonary bypass were compared by means of Clarke error grid analysis. The results were divided into five zones, A, B, C, D, and E, and 78.6% of paired measurements were in zone A, while 21.4% were in zone B. We confirmed that the results of this continuous blood glucose monitoring system for cardiopulmonary bypass during pediatric cardiovascular surgery were highly reliable. An artificial endocrine pancreas may facilitate the safe use of intensive insulin therapy during pediatric cardiovascular surgery.
本研究的目的是评估一种连续血糖监测系统（人工内分泌胰腺；STG-55，日机装株式会社，东京，日本）在小儿体外循环心脏手术期间的准确性和可靠性。纳入了25例计划接受体外循环心脏手术的小儿患者（年龄4个月至11岁；体重5.6-59.7千克）。人工内分泌胰腺的葡萄糖传感器线连接到体外循环回路的静脉端，用于连续血糖监测。我们从体外循环回路获取了192份用于血气评估的样本，并使用i-STAT（美国雅培公司，东温莎，新泽西州）进行常规血糖评估。通过克拉克误差网格分析比较了体外循环期间连续血糖测量（STG-55）和常规间歇性血糖测量（i-STAT）的准确性。结果分为A、B、C、D和E五个区，78.6%的配对测量结果在A区，而21.4%在B区。我们证实，这种连续血糖监测系统在小儿心血管手术体外循环期间的结果高度可靠。人工内分泌胰腺可能有助于小儿心血管手术期间安全使用强化胰岛素治疗。
