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

Gretchen Rogers; Jenny Beitz; Shara Griffin; Melissa Neeplo; Candace Sturm; Jiwon Lee; Lili Ding; Kelly Dunn

doi:10.1016/j.jopan.2024.08.017

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

J Perianesth Nurs. 2024 Nov 26:S1089-9472(24)00445-3. doi: 10.1016/j.jopan.2024.08.017. Online ahead of print.

Authors

Gretchen Rogers¹, Jenny Beitz², Shara Griffin², Melissa Neeplo², Candace Sturm², Jiwon Lee³, Lili Ding⁴, Kelly Dunn²

Affiliations

¹ Department of Anesthesia, Cincinnati Children's Hospital Medical Center, Cincinnati, OH. Electronic address: gretchen.rogers@cchmc.org.
² Department of Anesthesia, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
³ Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
⁴ Department of Pediatrics, School of Medicine, University of Cincinnati, Cincinnati, OH.

PMID: 39601723
DOI: 10.1016/j.jopan.2024.08.017

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.

Keywords: hypoglycemia; pediatric; preoperative.