Sugar Low When NPO? Patient Variables Associated With Pediatric Preoperative Hypoglycemia

Abstract

Purpose

To identify the demographic variables and patient factors associated with pediatric patients treated for preoperative hypoglycemia at a large urban pediatric hospital.

Design

Retrospective chart review.

Methods

Chart reviews were completed for known cases of preoperative hypoglycemia. The study team evaluated each case of hypoglycemia for the presence or absence of 10 variables including age, gender, weight percentile, fasting duration for solids and clear liquids, time of day of hypoglycemic event, American Society of Anesthesiology status, surgical service, presence or absence of preoperative bowel cleanout, presence or absence of intraoperative complications, and prior history of diabetes or hypoglycemia. When comparison data were available, a comparison was made to the hospital’s general surgical population.

Findings

There were no statistically significant differences found between the frequency distributions of the general surgical population and the hypoglycemic population with regard to race (P = .211), gender (P = .3139), and incidence of intraoperative complications (P < .0813). However, the hypoglycemic population was different from the general population (P < .05) in the areas of age, American Society of Anesthesiology status, history of diabetes or hypoglycemia, frequency of gastrointestinal or pulmonary procedures, and time of day of the hypoglycemic event. In addition, trends were identified in the hypoglycemia population with regard to body weight, completion of preoperative bowel cleanout, and duration of fasting. These differences and trends could indicate risk factors for preoperative hypoglycemia.

Conclusions

This study identified several potential risk factors for pediatric preoperative hypoglycemia; however, the study was limited by its retrospective nature. More research is needed to confirm these risk factors and identify any others.