It is difficult to manage postoperative
blood glucose levels without
hyperglycemia and
hypoglycemia in cardiac surgery patients even if continuous intravenous
insulin infusion is used. Therefore, the
insulin requirements for maintaining normoglycemia may be difficult to evaluate and need to be elucidated. In this single-center retrospective study, 30 adult patients (age 71.5 ± 9.0 years old, men 67%, BMI 22.0 ± 3.1 kg/m2, diabetes 33%) who underwent cardiac surgery and used bedside
artificial pancreas (STG-55) as a perioperative
glycemic control were included. We investigated the
insulin and
glucose requirements to maintain normoglycemia until the day after surgery. The bedside
artificial pancreas achieved intensive
glycemic control without
hypoglycemia under fasting conditions for 15 h after surgery (mean
blood glucose level was 103.3 ± 3.1 mg/dL and percentage of time in range (70-140 mg/dL) was 99.4 ± 2.0%). The total
insulin requirement for maintaining normoglycemia differed among
surgical procedures, including the use of
cardiopulmonary bypass during surgery, while it was not affected by age, body mass index, or the capacity of insulin secretion. Moreover, the mean
insulin requirement and the standard deviation of the
insulin requirements were variable and high, especially during the first several hours after surgery. Treatment using the bedside
artificial pancreas enabled intensive postoperative
glycemic control without
hypoglycemia. Furthermore, the
insulin requirements for maintaining normoglycemia after cardiac surgery vary based on surgical strategies and change dynamically with postoperative time, even in the short term.