[Continuous Interstitial Subcutaneous Fluid Glucose (ISFG) Measurement during Pre- and Intraoperative Periods for Highly Invasive Surgery].

ABSTRACT

BACKGROUND: Recently ERAS protocol has become common, and patients in our hospital drink preoperative oral fluid with carbohydrate nutrition. The present study evaluates interstitial subcutaneous fluid glucose (ISFG) with CGMS-Gold and ISFG variability is relevant to oral fluid. METHODS: The data was ISFG measurement with CGMS-Gold from 29 patients undergoing esophagus operation, liver resection, and pancreaticoduodenectomy in September 2011 to September 2012. We divided them into two groups. One was "preoperative (from having oral fluid to entering room) high ISFG group (H group 11)" which showed preoperative peak ISFG over 200 mg x dl(-1). The other was "preoperative low ISFG group (N group 18)" which showed preoperative peak ISFG under 200 mg x dl(-1). We compared preoperative and intraoperative (from entering to leaving room) peak ISFG in these groups. RESULTS: Preoperative peak ISFG was 267 ± 55 mg x dl(-1) in H group and 161 ± 16 mg x dl(-1) in N group. Intraoperative peak ISFG was 231 ± 75 mg x dl(-1) in H group and intraoperative peak ISFG was over 180 mg x dl(-1) in 9 patients. Intraoperative peak ISFG was 177 ± 50 mg x dl(-1) in N group and intraoperative peak ISFG was over 180 mg x dl(-1) in 7 patients. Preoperative high ISFG patients tended to show intraoperative high ISFG (P = 0.052); 6 patients were with diabetes mellitus and all the patients had pre- and intraoperative high ISFG. Thirteen patients without diabetes mellitus didn't show intraoperative high ISFG. CONCLUSIONS: This study suggested preoperative high ISFG group tended to show intraoperative high ISFG.