使用闭环人工胰腺成功治疗一名儿童患者因暴发性 1 型糖尿病而引发的糖尿病酮症酸中毒。

IF 1.1 4区 医学 Q4 ENGINEERING, BIOMEDICAL
Journal of Artificial Organs Pub Date : 2024-03-01 Epub Date: 2022-12-13 DOI:10.1007/s10047-022-01378-5
Takahiko Tamura, Tsukasa Tadokoro, Hideki Iwata, Tsutomu Namikawa, Kazuhiro Hanazaki, Takashi Kawano
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引用次数: 0

摘要

糖尿病酮症酸中毒(DKA)是小儿糖尿病(DM)的一种危及生命的并发症。床旁闭环人工胰腺(AP)(STG-55;NIKKISO,日本东京)通过自动输注胰岛素和葡萄糖将血糖(BG)水平维持在目标范围内。我们报告了应用闭环 AP 安全控制 DKA 儿童患者血糖水平的情况。一名 12 岁的儿童病史不详,出现发热和烦躁不安。患者被诊断为继发于暴发性 1 型糖尿病的 DKA,并接受了胰岛素输注治疗。他的格拉斯哥昏迷量表为 E2V3M4。动脉血气分析显示他患有代谢性酸中毒,血糖水平为 489 mg/dL。他的尿检呈酮体阳性。入 ICU 后,除了输液治疗外,还开始使用闭环 AP 自动控制血糖。经过调整后,血糖水平保持在 100 mg/dL/6 小时以内。在重症监护室住院 24 小时后,患者恢复了意识,并从代谢性酸中毒中恢复过来。他的全身状况有所改善,并接受了饮食治疗。治疗改为持续输注胰岛素,并转入普通病房,于住院第 33 天出院。闭环 AP 防止了重复抽血,及时控制了血糖,并防止了一名 DKA 儿童患者出现脑水肿。这是首次报道使用床旁闭环 AP 成功治疗 DKA。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Successful treatment of diabetic ketoacidosis secondary to fulminant type 1 diabetes mellitus using a closed-loop artificial pancreas in a pediatric patient.

Successful treatment of diabetic ketoacidosis secondary to fulminant type 1 diabetes mellitus using a closed-loop artificial pancreas in a pediatric patient.

Diabetic ketoacidosis (DKA) is a life-threatening complication of pediatric diabetes mellitus (DM). A bedside closed-loop artificial pancreas (AP) (STG-55; NIKKISO, Tokyo, Japan) maintains the blood glucose (BG) levels within the target range via automatic infusion of insulin and glucose. We report the application of the closed-loop AP to safely control the BG levels of a pediatric patient with DKA. A 12-year-old child with an unremarkable medical history presented with fever and restlessness. The patient was diagnosed with DKA secondary to fulminant type 1 DM and was treated with insulin infusion. He presented with Glasgow Coma Scale of E2V3M4. Arterial blood gas analysis revealed metabolic acidosis and BG levels of 489 mg/dL. His urine test was positive for ketones. Along with infusion therapy, automatic BG control using a closed-loop AP was initiated after ICU admission. This was adjusted to maintain BG levels within 100 mg/dL/6 h or less. After 24 h in the ICU, the patient regained consciousness and recovered from the metabolic acidosis. His general condition improved, and he was prescribed a diet treatment. The treatment was shifted to continuous insulin infusion, and he was transferred to the general ward, and was discharged on the 33rd day of hospitalization. The closed-loop AP prevented repetitive blood extractions, achieved prompt glycemic control, and prevented cerebral edema in a pediatric patient with DKA. This is the first report of successful treatment of DKA using a bedside closed-loop AP.

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来源期刊
Journal of Artificial Organs
Journal of Artificial Organs 医学-工程:生物医学
CiteScore
2.80
自引率
15.40%
发文量
68
审稿时长
6-12 weeks
期刊介绍: The aim of the Journal of Artificial Organs is to introduce to colleagues worldwide a broad spectrum of important new achievements in the field of artificial organs, ranging from fundamental research to clinical applications. The scope of the Journal of Artificial Organs encompasses but is not restricted to blood purification, cardiovascular intervention, biomaterials, and artificial metabolic organs. Additionally, the journal will cover technical and industrial innovations. Membership in the Japanese Society for Artificial Organs is not a prerequisite for submission.
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