Continuous glucose monitoring and glucose control in critically ill patients.

• Project/Area Number: 18791079
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Single-year Grants
• Research Field: Anesthesiology/Resuscitation studies
• Research Institution: Okayama University
• Principal Investigator: EGI Moritoki Okayama University, 医学部・歯学部附属病院, 医員 (20423296)
• Project Period (FY): 2006 – 2008
• Project Status: Completed (Fiscal Year 2008)
• Budget Amount: ¥3,180,000 (Direct Cost: ¥3,000,000、Indirect Cost: ¥180,000); Fiscal Year 2008: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000); Fiscal Year 2007: ¥600,000 (Direct Cost: ¥600,000); Fiscal Year 2006: ¥1,800,000 (Direct Cost: ¥1,800,000)
• Keywords: 集中治療 / 急性期 / 重症患者 / 血糖 / インスリン / 持続血糖測定 / 人工膵臓

Research Abstract

本研究は、高度侵襲手術患者や集中治療成人患者における血糖管理に着目し、当該患者群で、1)持続血糖測定の安全性と信頼度を確認すること、2)持続血糖測定を用いた詳細な血糖測定を行うことで、血糖管理が予後に与えるメカニズムを検証すること、および3)安全な血糖管理法を持続血糖測定によって検証することを目的に行われた。
本研究期間中、高度侵襲手術患者や集中治療成人患者で、24-72時間の持続血糖測定を行い、1)持続血糖測定の信頼度試験、2)心臓手術中の血糖値と術後臓器障害および酸化ストレスの関係の観察研究、3)パラチノースを使用した血糖降下療法の無作為化試験を施行した。各研究結果は、国内・国際学会で報告し、国際雑誌に投稿中である。
現行の持続血糖測定機器では、新生児・小児での血糖測定は困難であるが、小型が進んだ際の研究を円滑にするために、小児患者の血糖管理に関しても、Pilot dataを集積した。この結果は、国際雑誌に投稿し採用され、2008年度日本集中治療医学会論文奨励賞を受賞した。

Research Products

• [Journal Article] Hyperglycemia and the outcome of pediatric cardiac surgery patients requiring peritoneal dialysis (2008)
  • Author(s): Egi M, Morimatsu H, Toda Y, Matsusaki T, Suzuki S, Shimizu K, Iwasaki T, TakeuchiM, Bellomo R, Morita K
  • Journal Title: Int J Artif Organs 31(4) Pages: 309-16
  • Peer Reviewed
• [Journal Article] 重症患者における血糖管理;糖尿病患者の血糖管理 (2008)
  • Author(s): 江木盛時
  • Journal Title: ICUとCCU 32(10) Pages: 795-803
• [Journal Article] Hyperglycemia and the outcome of pediatric cardiac surgery patients requiring peritoneal dialysis (2008)
  • Author(s): Egi M, Morimatsu H, Toda Y, Matsusaki T, Suzuki S, Shimizu K, Iwasaki T, Takeuchi M, Bellomo R, Morita K
  • Journal Title: Int J Artif Organs. 31(4) Pages: 309-316
  • Peer Reviewed
• [Journal Article] Blood glucose control in critical care (2008)
  • Author(s): Egi M, Bellomo R
  • Journal Title: Critical Care Nephrology second edition Pages: 11-15
• [Journal Article] 集中治療における血糖管理 ; 低血糖発生と患者予後 (2008)
  • Author(s): 江木盛時
  • Journal Title: 日本SHOCK学会雑誌 23 Pages: 32-38
• [Journal Article] 血糖コントロール (2008)
  • Author(s): 江木盛時、森田潔
  • Journal Title: 救急・集中治療 20 Pages: 1379-1384
• [Journal Article] 糖尿病患者の血糖管理 (2008)
  • Author(s): 江木盛時
  • Journal Title: ICUとCCU 32 Pages: 795-802
• [Journal Article] Effects of a Novel Palatinose Based Enteral Formula (MHN-01) Carbohydrate-adjusted Fluid Diet in Improving the Metabolism of Carbohydrates and Lipids in Patients with Esophageal Cancer Complicated by Diabetes Mellitus. (2007)
  • Author(s): Fujiwara T, Naomoto Y, Motoki T, Shigemitsu K, Shirakawa Y, Yamatsuji T, Kataoka M, Haisa M, Fujiwara T, Egi M,Morimatsu H, Hanazaki M, Katayama H,Morita K, Mizumoto K, Asou T, Arima H,Sasaki H, Matsuura M, Gunduz M, Tanaka N.
  • Journal Title: J Surg Res 138(2) Pages: 231-40
  • Peer Reviewed
• [Journal Article] ICUにおける代謝管理と長期予後 (2007)
  • Author(s): 江木盛時,森松博史,片山浩,森田潔
  • Journal Title: ICUとCCU 31(7) Pages: 527-534
• [Presentation] 周術期急性高血糖に対するパラチノース含有糖質調整流動食 ; Randomized Cross-over Trial (2009)
  • Author(s): 江木盛時, 鈴木聡, 松崎孝, 清水一好, 森松博史, 戸田雄一郎, 溝渕知司, 片山浩, 横山正尚, 森田潔
  • Organizer: 日本集中治療学術集会
  • Place of Presentation: 大阪
  • Year and Date: 2009-02-27
• [Presentation] Hyperglycemia and the outcome of pediatric cardiac surgery patients requiring peritoneal dialysis(日本集中治療医学会論文奨励賞) (2009)
  • Author(s): 江木盛時
  • Organizer: 日本集中治療学術集会
  • Place of Presentation: 大阪
  • Year and Date: 2009-02-27
• [Presentation] THE PALATINOSE-BASED ENTERAL FORMULA ON POST SURGICAL HYPERGLYCEMIA ; RANDOMIZED CROSS-OVER TRIAL (2009)
  • Author(s): Moritoki Egi, Hiroshi Morimatsu, Yuichiro Toda, Tomoki Yamatsuji, Naomoto Yoshio, Hiroshi Katayam aMasanao Yokoyama, Hidekazu Arai, Kiyoshi Morita
  • Place of Presentation: USA(ナッシュビル)
  • Year and Date: 2009-02-01
• [Presentation] Hyperglycemia and the outcome of pediatric cardiac surgery patients requiring peritoneal dialysis (2009)
  • Author(s): 江木盛時,森松博史,戸田雄一郎,松崎孝,鈴木聡,清水一好,岩崎達雄,竹内護,森田潔
  • Organizer: 日本集中治療学術集会学会論文奨励賞受賞講演
• [Presentation] 周術期急性高血糖に対するパラチノース含有糖質調整流動食;Randomized Cross-over Trial (2009)
  • Author(s): 江木盛時,鈴木聡,松崎孝,清水一好,森松博史,戸田雄一郎,溝渕知司,片山浩,横山正尚,森田潔
  • Organizer: 日本集中治療学術集会
• [Presentation] 重症患者の血糖管理 (2009)
  • Author(s): 江木盛時
  • Organizer: 徳島医学会学術集会
• [Presentation] The palatinose-based enteral formula on post surgical hyperglycemia;Randomized Cross over Trial (2009)
  • Author(s): Moritoki Egi, Hiroshi Morimatsu, Yuichiro Toda, Tomoki Yamatsuji, Naomoto Yoshio, Hiroshi Katayama, Masanao Yokoyama, Hidekazu Arai, Kiyoshi Morita
  • Organizer: Society of critical care medicine annual congress
  • Place of Presentation: USA, ナッシュビル
• [Presentation] Effect of Palatinose-Based Formula on Glycemia in Esphagectomy Patients ; Randomized Cross-Over Trial (2008)
  • Author(s): Moritoki Egi, Morimatsu Hiroshi Yuichiro Toda, SatoShi Suzuki, Kiyoshi Morita
  • Place of Presentation: USA(フロリダ)
  • Year and Date: 2008-10-21
• [Presentation] Continuous Glucose Measurement during Cardio-Pulmonary Bypass ; Association with Short Term Outcome (2008)
  • Author(s): Moritoki Egi, Kazuyoshi Shimizu, Yuichiro Toda, Tatsuo Iwasaki, Kiyoshi Morita
  • Place of Presentation: USA(フロリダ)
  • Year and Date: 2008-10-18
• [Presentation] Glucose control in the ICU (2008)
  • Author(s): Moritoki Egi
  • Organizer: Basic Concept in Intensive Care (BACIC) 2008
  • Place of Presentation: 韓国(ソウル)
  • Year and Date: 2008-07-19
• [Presentation] 人工心肺中の高血糖と患者短期予後 ; 持続血糖測定を用いた評価 (2008)
  • Author(s): 江木盛時, 森松博史, 戸田雄一郎, 清水一好, 岩崎達雄, 森田潔
  • Place of Presentation: 東京
  • Year and Date: 2008-06-14
• [Presentation] Glycemic Control in the Intensive Care Unit : Why We Should Wait for NICE-SUGAR (2008)
  • Author(s): 江木盛時
  • Place of Presentation: 東京
  • Year and Date: 2008-05-10
• [Presentation] Continuous Glucose Measurement during Cardio-Pulmonary Bypass; Association with Short Term Outcome (2008)
  • Author(s): Moritoki Egi, Kazuyoshi Shimizu, Yuichiro Toda, Tatsuo Iwasaki, Kiyoshi Morita
  • Organizer: American society of anesthesiology
  • Place of Presentation: USA, フロリダ
• [Presentation] Effect of Palatinose-Based Formula on Glycemia in Esphagectomy Patients; Randomized Cross-Over Trial (2008)
  • Author(s): Moritoki Egi, Morimatsu Hiroshi, Yuichiro Toda, Satoshi Suzuki, Kiyoshi Morita
  • Organizer: American society of anesthesiology
  • Place of Presentation: USA, フロリダ
• [Presentation] Blood glucose in intensive care (2008)
  • Author(s): Moritoki Egi
  • Organizer: BASIS
  • Place of Presentation: 韓国、ソウル
• [Presentation] 人工心肺中の高血糖と患者短期予後;持続血糖測定を用いた評価 (2008)
  • Author(s): 江木盛時
  • Organizer: 日本麻酔科学会学術集会
  • Place of Presentation: 横浜
• [Presentation] 本邦におけるSurviving sepsis campaign guidelineの現状と将来について;Glycemic Control in the Intensive Care Unit : Why We Should Wait for NICE-SUGAR (2008)
  • Author(s): 江木盛時
  • Organizer: 日本SHOCK 学会
  • Place of Presentation: 東京
• [Presentation] The reliability of continuous blood glucose measurements duringcardiac surgery. (2007)
  • Author(s): 江木 盛時、他4名
  • Organizer: 2007 American Society of Anesthesiologist annual meeting
  • Place of Presentation: San Francisco
  • Year and Date: 2007-10-14
• [Presentation] 人工心肺使用下開心衛における持続血糖測定は可能か? ;Quality Control Trial (2007)
  • Author(s): 江木 盛時、他5名
  • Organizer: 日本麻酔科学会第54回学術集会
  • Place of Presentation: 札幌
  • Year and Date: 2007-05-31
• [Presentation] The reliability of continuous blood glucose measurements during cardiac surgery (2007)
  • Author(s): Moritoki Egi, Kazuyoshi Shimizu, Yuichiro Toda, Hiroshi Morimatsu, Kiyoshi Morita
  • Organizer: American society of anesthesiology
  • Place of Presentation: USA, サンフランシスコ
• [Presentation] Intravenous glucose intake and outcome of pediatric cardiac patients requiring peritoneal dialysis (2007)
  • Author(s): Egi Moritoki, Hiroshi Morimatsu, Yuichiro Toda, Mamoru Takeuchi, Kiyoshi Morita
  • Organizer: American society of anesthesiology
  • Place of Presentation: USA, サンフランシスコ
• [Presentation] 人工心肺使用下開心術における持続血糖測定は可能か?; Quality Control Trial (2007)
  • Author(s): 江木盛時 清水一好、戸田雄一郎、森松博史、竹内護、森田潔
  • Organizer: 日本麻酔学会第51回大会
  • Place of Presentation: 札幌
• [Presentation] Blood Sugar Control in ICU (2007)
  • Author(s): Moritoki Egi
  • Organizer: 7th Joint Scientific Congress of the KSCCM and JSICM Symposium
  • Place of Presentation: 韓国、ソウル
• [Presentation] Reliability of Continuous glucose measurement in acute ill adults (2007)
  • Author(s): 江木盛時、森松博史、戸田雄一郎、鈴木聡、溝渕知司、竹内護、中塚秀樹、片山浩、横山正尚、森田潔
  • Organizer: 第34回日本集中治療医学会学術集会
  • Place of Presentation: 神戸
• [Presentation] Hyperglycemia in Pediatric Cardiac Surgery Patients Requiring Peritoneal Dialysis (2007)
  • Author(s): 江木盛時、森松博史、戸田雄一郎、岩崎達雄、清水一好、竹内護、松崎孝、鈴木聡、横山正尚、森田潔
  • Organizer: 第34回日本集中治療医学会学術集会
  • Place of Presentation: 神戸
• [Presentation] Reliability of Continuous Glucose Measurement Using STG-22 in Acute Ill Adults (2006)
  • Author(s): Moritoki Egi, Hiroshi Morimatsu, Hiroshi Katayama, Bellomo Rinaldo, Kiyoshi Morita
  • Organizer: American society of anesthesiology
  • Place of Presentation: USA, シカゴ
• [Presentation] Hyperglycemia in pediatric cardiac surgery patients requiring peritoneal dialysis (2006)
  • Author(s): Moritoki Egi, Hiroshi Morimatsu, Yuichiro Toda, Christoph Langenberg, Takashi Matsusaki, Tatsuo Iwasaki, Mamoru Takeuchi, Rinaldo Bellomo, Kiyoshi Morita.
  • Organizer: 10th International Congress of Cardiothorahic and Vascular Anesthesia
  • Place of Presentation: チェコ、プラハ
• [Book] 血糖コントロール(救急・集中治療20巻9・10号) (2008)
  • Author(s): 江木盛時、森田潔
  • Publisher: 総合医学社
• [Book] Blood glucose control in critical care Elsevier(chapter 146) (2008)
  • Author(s): Moritoki Egi, Bellomo Rinaldo
  • Publisher: Critical Care Nephrology second edition
• [Remarks] 2008年日韓合同コングレス最優秀演題賞Blood Glucose Concentration and Outcome in Critical Illness : The Impact of Diabetes
• [Remarks] 2008年度日本集中治療学会優秀論文奨励賞Hyperglycemia and the outcome of pediatric cardiac surgery patients requiring peritoneal dialysis
• [Remarks]
  • URL: http://www.okadaimasui.com/word_jp/index3.htm
• [Remarks]
  • URL: http://www.okadaimasui.com/word_jp/index3.html