Endocrine Abstracts

Introduction: During the perioperative period, surgical operations put patients under a great deal of physical stress. The immune system produces cytokines and other immune mediators in response to this threat. Recent studies have shown that using insulin to regulate blood glucose can reduce systemic inflammation.

Objective: The objective of this research was examined how postoperative intensive insulin treatment (IIT) affects the inflammatory response in a synthetic pancreas during heart surgery with cardiopulmonary bypass.

Method: Two groups of patients undergoing cardiopulmonary bypass surgery were formed: the IIT group (n=15) and the conventional treatment (CT) group (n=15). At the start of surgery, an artificial pancreas was used to manage blood glucose in the IIT group. The blood sugar level was kept at 110 mg/dl for 20 hours after surgery. To track changes in serum cytokine levels over time, blood samples were taken. The mean±standard deviation was used to express all data. The nonparametric test (Mann-Whitney U-test) was used to assess the data for single comparisons. It was deemed statistically significant when P<0.04 was used.

Results: The characteristics of the patients were similar between groups. After surgery, blood glucose levels were much higher in the CT group. Interleukin-6, high-mobility group box 1, and tumor necrosis factor- serum levels were all greater in the CT group than in the IIT group.

Conclusion: During the postoperative period, IIT was safely performed during cardiac surgery with cardiopulmonary bypass utilizing an artificial pancreas. IIT also showed anti-inflammatory properties. An artificial pancreas used in conjunction with intensive insulin therapy has the potential to be a useful way to manage blood sugar during surgery, which would reduce the risk of both perioperative and postoperative problems. The inflammatory response was significantly reduced during the perioperative period when IIT was used in the artificial pancreas. Additionally, no signs of hypoglycemia was found in individuals receiving IIT. This shows that patients who are severely unwell may benefit from the safe and efficient use of IIT in a synthetic pancreas.