Riegger et al identified risk factors for hypoglycemia in pediatric patients undergoing surgery. These can help to identify a patient whose glucose should be monitored during surgery. The authors are from the University of Michigan.
Patient selection: age < 18 years
Outcome: intraoperative glucose concentration < 60 mg/dL
Risk factors for intraoperative hypoglycemia:
(1) age < 5 years (< 30 days aOR 4.2; aOR 30 days to 4.99 years aOR 2.7)
(2) weight for age less than 5th percentile (aOR 1.6)
(3) ASA status 3, 4 or 5 (aOR 1.3)
(4) presence of a gastric or jejunal tube (aOR 1.3)
(5) history of poor feeding (aOR 1.5)
(6) abdominal surgery (aOR 1.4)
where:
• The duration of preoperative fasting is not mentioned.
In addition. insulin or other drug associated with hypoglycemia might be contributory. Diuretics and heart failure medications are listed in Table 2 but not other drugs.
