コンピュータ化された電子インスリン用量計算機を用いて,心臓手術患者の手術中の高血糖を制御する

Ahmed Zaky^1,2, Zdenek Novak³, Tinsley Roberson⁴

¹Department of Anesthesiology and Perioperative Medicine, University of Alabama at Birmingham, Birmingham, AL, USA. azaky@uabmc.edu.

Scientific reports

|August 29, 2025

まとめ

電子インスリン用量計算器 (EIC) は,心臓外科手術患者の手術中の高血糖症を効果的に軽減しました. この品質改善プロジェクトでは,EICの使用中に血糖値の低下と低血糖症の減少が示されました.

科学分野:

心臓病科
内分泌学
医療情報学

背景:

術後の高血糖症は,手術を受けた患者の罹病率と死亡率の増加の既知の危険因子です.
効果的な血糖管理は,特に心肺バイパス (CPB) を含む心臓手術のような複雑な手順では極めて重要です.

研究の目的:

CPB を受けている心臓外科の患者の間における手術中の高血糖症の軽減における電子インスリン投与計算器 (EIC) の有効性を評価する.
血糖値,低血糖症の発生率,およびインスリン使用量に対するEIC導入の影響を評価する.

主な方法:

品質改善プロジェクトでは,CPBを患っている成人心臓外科の患者に,パイロットと改造されたEICを順次実施した.
血糖 (BG) 値,EIC導入率,低血糖の発生率,およびインスリン用量をベースライン,パイロットEIC,および改変EICフェーズで比較した.

主要な成果:

CPBと処置終了時,ICUでの平均BG濃度は,ベースラインと比較してパイロットと改変されたEIC段階では著しく低かった.
低血糖症の発生率は,EICフェーズ (1%) でベースラインと比較して有意に減少した.
ベースライン期間と比較して,EICの実施期間中にインスリンが使用されました.

結論:

電子インスリン用量計算機 (EIC) は,CPBによる心臓手術を受けた患者の手術中の高血糖症の管理と軽減に有効なツールです.
低血糖症のリスクを高めることなく,EICの実施により,手術後のグルコース管理のより安全で効率的なアプローチが示唆されました.

キーワード:

心肺バイパスコンピュータ化されたインスリンプロトコル品質の向上ストレスによる高血糖症

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