Anest. intenziv. Med. 2016;27(1):9-14

Perioperative monitoring of blood glucose levels in paediatric patientsAnaesthesiology - Original Paper

J. Žurek^1,*, M. Vavřina¹, M. Budíková², M. Forbelská², V. Bendová², M. Richtrová¹, A. Květoňová¹, M. Fedora¹

¹ Klinika dětské anesteziologie a resuscitace, Fakultní nemocnice Brno

² Ústav matematiky a statistiky, Přírodovědecká fakulta, Masarykova univerzita, Brno

Objective:
The aim was to study perioperative monitoring of blood glucose levels during anaesthesia in paediatric patients.

Design:
Prospective observational study.


Setting:
Department of Anaesthesiology and Intensive Care Medicine, University Hospital.

Materials and methods:
The study included 318 children aged 0-19 years (120 girls, 198 boys) undergoing elective surgery longer than 60 min. The patients were divided into age groups (newborns, infants, toddlers, age 3-6; age 7-12 and age > 12 years). During anaesthesia, blood glucose levels were monitored at the beginning of surgery and then hourly. Hypoglycaemia was defined as value of ≤2.8 mmol/l in neonates, ≤ 3.3 mmol/l in children under 15 and ≤ 3.9 mmol/l in children over 15.

Results:
The lowest and highest measured blood glucose levels were 1.6 mmol/l, and 15.6 mmol/l respectively. 75% of patients had preoperative blood glucose level equal or lower than 5.2 mmol/l. The highest variability in preoperative glycaemia was observed in the category of toddlers and infants and the lowest variability in the category of school age children. Patients who did not have carbohydrate drinks prior to surgery had higher average value of glycaemia (4.61 mmol/l) than patients who did (4.55 mmol/l); p = 0.486. Of the 284 patients who did not have preoperative hypoglycaemia, 250 patients (88%) did not and 34 patients (12%) did have carbohydrate drinks before surgery. Of the 34 patients who had preoperative hypoglycaemia, 27 patients (79.4%) did not and 7 patients (20.6%) did have carbohydrate drinks before surgery.

Conclusion:
Perioperative monitoring of blood glucose represents an essential part of fluid therapy optimization in children during surgical procedures.

Keywords: glycaemia; hypoglycaemia; children; fluid therapy

Received: June 8, 2015; Accepted: June 30, 2015; Published: February 1, 2016  Show citation