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en: Intensive insulin therapy during cardiovascular surgery.

en: Recent evidence in the fields of surgery, emergency and critical care medicine indicates that strict glycemic control results in lower mortality. Hyperglycemia occurs frequently in patients with and without diabetes during cardiovascular surgery, especially during cardiopulmonary bypass. However, strict glucose control is difficult to achieve during cardiovascular procedures. To establish effective intensive insulin therapy during cardiovascular surgery, we conduct continuous blood glucose monitoring and employ automatic control by using an artificial endocrine pancreas (the STG-22, Nikkiso, Tokyo, Japan). In this review, we will outline the present status and problems of conventional glycemic control for perioperative cardiovascular surgery and introduce the new perioperative blood glucose management method that we are testing now. We will also discuss the importance of perioperative glycemic control for cardiovascular surgery as well as future prospects.

en: The Journal of Medical Investigation : JMI


en: Problems associated with glucose toxicity: Role of hyperglycemia-induced oxidative stress.

en: Glucose homeostasis deficiency leads to a chronic increase in blood glucose concentration. In contrast to physiological glucose concentration, chronic superphysiological glucose concentration negatively affects a large number of organs and tissues. Glucose toxicity means a decrease in insulin secretion and an increase in insulin resistance due to chronic hyperglycemia. It is now generally accepted that glucose toxicity is involved in the worsening of diabetes by affecting the secretion of beta-cells. Several mechanisms have been proposed to explain the adverse effects of hyperglycemia. It was found that persistent hyperglycemia caused the functional decline of neutrophils. Infection is thus the main problem resulting from glucose toxicity in the acute phase. In other words, continued hyperglycemia is a life-threatening risk factor, not only in the chronic but also the acute phase, and it becomes a risk factor for infection, particularly in the perioperative period.

en: World Journal of Gastroenterology : WJG

ja: World Journal of Gastroenterology : WJG


en: Cardiac Preconditioning by Volatile Anesthetics

ja: 揮発性吸入麻酔薬によるプレコンディショニング

en: 臨床麻酔

ja: 臨床麻酔


en: 手術中の不整脈 -原因，診断，治療-

ja: 手術中の不整脈 -原因，診断，治療-

en: 麻酔

ja: 麻酔