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Facteurs de risque d'hypoglycémie peropératoire chez l'enfant : une étude de cohorte observationnelle rétrospective. / Risk factors for intraoperative hypoglycemia in children: a retrospective observational cohort study.
Can J Anaesth ; 67(2): 225-234, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31529370
ABSTRACT

PURPOSE:

Intraoperative hypoglycemia can result in devastating neurologic injury if not promptly diagnosed and treated. Few studies have defined risk factors for intraoperative hypoglycemia. The authors sought to characterize children with intraoperative hypoglycemia and determine independent risk factors.

METHODS:

This retrospective observational single-institution study included all patients < 18 yr of age undergoing an anesthetic from January 1 2012 to December 31 2016. The primary outcome was blood glucose < 3.3 mmol·L-1 (60 mg·dl-1). Data collected included patient characteristics, comorbidities, and intraoperative factors. A multivariable logistic regression model was used to identify independent predictors of intraoperative hypoglycemia.

RESULTS:

Blood glucose was measured in 7,715 of 73,592 cases with 271 (3.5%) having a glucose < 3.3 mmol·L-1 (60 mg·dl-1). Young age, weight for age < 5th percentile, developmental delay, presence of a gastric or jejunal tube, and abdominal surgery were identified as independent predictors for intraoperative hypoglycemia. Eighty percent of hypoglycemia cases occurred in children < three years of age and in children < 15 kg.

CONCLUSION:

Young age, weight for age < 5th percentile, developmental delay, having a gastric or jejunal tube, and abdominal surgery were independent risk factors for intraoperative hypoglycemia in children. Frequent monitoring of blood glucose and judicious isotonic dextrose administration may be warranted in these children.

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Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE Aspecto clínico: Etiologia / Predição / Prognóstico Idioma: Inglês Revista: Can J Anaesth Assunto da revista: Anestesiologia Ano de publicação: 2020 Tipo de documento: Artigo País de afiliação: Estados Unidos