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Accuracy and reliability of continuous blood glucose monitoring during pediatric cardiopulmonary bypass

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  • Artificial Liver, Pancreas
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Abstract

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.

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References

  1. Van den Berghe G, Wouters P, Weekers F, Verwaest C, Bruyninckx F, Schetz M, Vlasselaers D, Ferdinande P, Lauwers P, Bouillon R. Intensive insulin therapy in the critically ill patients. N Engl J Med. 2001;345:1359–67.

    Article  Google Scholar 

  2. Van den Berghe G, Wilmer A, Milants I, Wouters PJ, Bouckaert B, Bruyninckx F, Bouillon R, Schetz M. Intensive insulin therapy in mixed medical/surgical intensive care units: benefit versus harm. Diabetes. 2006;55:3151–9.

    Article  Google Scholar 

  3. Vlasselaers D, Milants I, Desmet L, Wouters PJ, Vanhorebeek I, van den Heuvel I, Mesotten D, Casaer MP, Meyfroidt G, Ingels C, Muller J, Van Cromphaut S, Schetz M, Van den Berghe G. Intensive insulin therapy for patients in paediatric intensive care: a prospective, randomized controlled study. Lancet. 2009;373:547–56.

    Article  CAS  Google Scholar 

  4. Tsukamoto Y, Kinoshita Y, Kitagawa H, Munekage M, Munekage E, Takezaki Y, Yatabe T, Yamashita K, Yamazaki R, Okabayashi T, Tarumi M, Kobayashi M, Mishina S, Hanazaki K. Evaluation of a novel artificial pancreas: closed loop glycemic control system with continuous blood glucose monitoring. Artif Organ. 2013;37:E67–73.

    Article  CAS  Google Scholar 

  5. Mita N, Kawahito S, Soga T, Takaishi K, Kitahata H, Matsuhisa M, Shimada M, Kinoshita H, Tsutsumi YM, Tanaka K. Strict blood glucose control by an artificial endocrine pancreas during hepatectomy may prevent postoperative acute kidney injury. J Artif Organ. 2017;20:76–83.

    Article  CAS  Google Scholar 

  6. Kawahito S, Higuchi S, Mita N, Kitagawa T, Kitahata H. Novel blood sampling method of an artificial endocrine pancreas via the cardiopulmonary bypass circuit. J Artif Organ. 2013;16:508–9.

    Article  Google Scholar 

  7. Clarke WL, Cox D, Gonder-Frederick LA, Carter W, Pohl SL. Evaluating clinical accuracy of systems for self-monitoring of blood glucose. Diabetes Care. 1987;10:622–8.

    Article  CAS  Google Scholar 

  8. Kawahito S, Kitahata H, Oshita S. Problems associated with glucose toxicity: role of hyperglycemia-induced oxidative stress. World J Gastroenterol. 2009;15:4137–42.

    Article  CAS  Google Scholar 

  9. Faustino EV, Apkon M. Persistent hyperglycemia in critically ill children. J Pediatr. 2005;146:30–4.

    Article  Google Scholar 

  10. Wintergerst KA, Buckingham B, Gandrud L, Wong BJ, Kache S, Wilson DM. Association of hypoglycemia, hyperglycemia, and glucose variability with morbidity and death in the pediatric intensive care unit. Pediatrics. 2006;118:173–9.

    Article  Google Scholar 

  11. Kawahito S, Kitahata H, Kitagawa T, Oshita S. Intensive insulin therapy during cardiovascular surgery. J Med Invest. 2010;57:191–204.

    Article  Google Scholar 

  12. Yates AR, Dyke PC 2nd, Taeed R, Hoffman TM, Hayes J, Feltes TF, Cua CL. Hyperglycemia is a marker for poor outcome in the postoperative pediatric cardiac patient. Pediatr Crit Care Med. 2006;7:351–5.

    Article  Google Scholar 

  13. Oyaert M, Van Maerken T, Bridts S, Van Loon S, Laverge H, Stove V. Analytical and pre-analytical performance characteristics of a novel cartridge-type blood gas analyzer for point-of care and laboratory testing. Clin Biochem. 2018;53:116–26.

    Article  CAS  Google Scholar 

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Funding

This study was supported by intramural departmental funds.

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Authors and Affiliations

  1. Department of Community Medicine and Human Resource Development, Tokushima University Graduate School of Biomedical Sciences, 3-18-15, Kuramoto, Tokushima, 770-8503, Japan

    Shinji Kawahito, Tomohiro Soga & Shusuke Yagi

  2. Department of Anesthesiology, Tokushima University Hospital, Tokushima, Japan

    Naoji Mita, Nami Kakuta & Shiho Satomi

  3. Department of Anesthesiology, IMS Fujimi General Hospital, Saitama, Japan

    Hiroyuki Kinoshita

  4. Department of Dental Anesthesiology, Tokushima University Hospital, Tokushima, Japan

    Kazumi Takaishi & Hiroshi Kitahata

  5. Department of Cardiovascular Surgery, Tokushima University Hospital, Tokushima, Japan

    Tetsuya Kitagawa

Authors
  1. Shinji Kawahito
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  2. Naoji Mita
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  3. Tomohiro Soga
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  4. Shusuke Yagi
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  5. Nami Kakuta
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  6. Shiho Satomi
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  7. Hiroyuki Kinoshita
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  8. Kazumi Takaishi
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  9. Tetsuya Kitagawa
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  10. Hiroshi Kitahata
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Correspondence to Shinji Kawahito.

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The authors declare that they have no conflict of interest.

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Kawahito, S., Mita, N., Soga, T. et al. Accuracy and reliability of continuous blood glucose monitoring during pediatric cardiopulmonary bypass. J Artif Organs 22, 353–356 (2019). https://doi.org/10.1007/s10047-019-01111-9

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  • DOI: https://doi.org/10.1007/s10047-019-01111-9

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