Perioperative Use of Glucose Containing Solutions in Infants Less Than 6 Months of Age: A Clinical Practice Survey Among US Academic Centers

Authors

Irim Salik, Department of Pediatric Anesthesiology at Westchester Medical Center, New York Medical College, Valhalla, New York, USA.
Tara Doherty, Department of Pediatric Anesthesiology at Westchester Medical Center, New York Medical College, Valhalla, New York, USA.
Ashley Kelley, Department of Pediatric Anesthesiology at Westchester Medical Center, New York Medical College, Valhalla, New York, USA.
Michael Jacoby, Department of Pediatric Anesthesiology at Westchester Medical Center, New York Medical College, Valhalla, New York, USA.
Bhupen Mehta, Department of Pediatric Anesthesiology at Westchester Medical Center, New York Medical College, Valhalla, New York, USA.
Olena Pryjdun, Department of Pediatric Anesthesiology at Westchester Medical Center, New York Medical College, Valhalla, New York, USA.
Maranatha Mclean, Department of Pediatric Anesthesiology at Westchester Medical Center, New York Medical College, Valhalla, New York, USA.
Samuel Barst, Department of Pediatric Anesthesiology at Westchester Medical Center, New York Medical College, Valhalla, New York, USA.

Author Type(s)

Faculty

Journal Title

Paediatric Anaesthesia

First Page

625

Last Page

630

Document Type

Article

Publication Date

5-1-2022

Department

Anesthesiology

Abstract

BACKGROUND: Although there is a wide breadth of literature on glucose homeostasis in infants, standardization of perioperative hypoglycemia diagnosis and management is lacking. AIMS: Survey of academic pediatric anesthesiology departments across the USA to evaluate institutional policies regarding the perioperative use of glucose containing solutions in infants less than 6 months of age. METHODS: A questionnaire was sent to 20 United States university affiliated academic pediatric anesthesiology departments. RESULTS: The responses suggest that, in the centers surveyed, glucose administration in infants is largely practitioner dependent. Two respondents (10%) claim to have a departmental policy regarding glucose administration in infants less than 6 months of age. In premature infants, 75% of respondents administer glucose. When administering glucose, 75% of physicians surveyed replete infants at their maintenance intravenous fluid rate. There was discrepancy among practitioners regarding initiation of hypoglycemia treatment, 35% treat infants at a blood glucose level of 70 mg/dl, 30% at BG 60 mg/dl, 25% at 50 mg/dl, and 10% are unsure. DISCUSSION: This survey highlights the lack of consensus, at least among pediatric anesthesiologists working in US academic centers, regarding blood glucose management in infants less than 6 months of age. There is a need to define the indications for using glucose containing solutions in infants during the perioperative period, their ideal content, the appropriate thresholds for hypo- and hyperglycemia as well as the optimal point-of care glucose monitoring intervals.

Recommended Citation

Salik, I., Doherty, T., Kelley, A., Jacoby, M., Mehta, B., Pryjdun, O., Mclean, M., & Barst, S. (2022). Perioperative Use of Glucose Containing Solutions in Infants Less Than 6 Months of Age: A Clinical Practice Survey Among US Academic Centers. Paediatric Anaesthesia, 32 (5), 625-630. https://doi.org/10.1111/pan.14420