Abstract
Forty-four patients received the nutritional treatment which utilizes the artficial pancreas. The mean duration of the treatment per patient was 5.3 days. Problems arising from longterm use are discussed. The majority of our patients (38 patients) were treated with STG-11A (Nikkiso), while five patients with STG-22 (Nikkiso) and one with Biostator (Miles). The first problem we encountered was insufficient blood sampling caused by obstruction of catheters due to blood clotting or catheter bending. This problem was solved by developing a new catheter of long length to beinserted in the central vein. This new catheter lasted for about a week when used in patients who were breathing spontaneously and able to move more or less freely. In contrast, long-term use of more than a week was possible in those who were on a respirator. The membrane utilized for blood glucose measurement was reliable for more than 15 days continuously. Another problem is the algorism of insulin injection, which must be adjusted to the condition of each patient. Most patients displayed the brittle type glucose fluctuation and the parameters needed to be changed, so that the artificial pancreas responded sensitively. Catheter infection and anemis from frequent bloodsampling are possible side effects. Two patients had positive bacterial culture from the catheter tip. Attention should be paid to patients with endotoxemia. One patient received blood transfusion for anemia, caused by blood sampling. [CONCLUSION] By modification in several points, artificial pancreas proved to be effective for long-term use.
