Root causes of intraoperative hypoglycemia: a case series. J Clin Anesth 2012 Dec;24(8):625-30
Date
11/03/2012Pubmed ID
23116589DOI
10.1016/j.jclinane.2012.04.009Scopus ID
2-s2.0-84870873974 (requires institutional sign-in at Scopus site) 10 CitationsAbstract
STUDY OBJECTIVE: To describe the root causes of intraoperative hypoglycemic events.
DESIGN: Retrospective analysis.
SETTING: Large academic teaching hospital.
MEASUREMENTS: Data from 80,379 ASA physical status 1, 2, 3, 4, and 5 surgical patients were reviewed. Blood glucose values, insulin, oral hypoglycemic medication doses, and doses of glucose or other medications for hypoglycemia treatment were recorded.
MAIN RESULTS: Hypoglycemia in many patients had multiple etiologies, with many cases (8 of 17) involving preventable errors. The most common root causes of hypoglycemia were ineffective communication, circulatory shock, failure to monitor, and excessive insulin administration.
CONCLUSION: Intraoperative hypoglycemia was rare, but often preventable. Better communication among providers and between providers and patients may reduce the number of intraoperative hypoglycemic events. Many transient episodes of hypoglycemia did not result in any apparent complications, rendering their clinical importance uncertain. Critically ill patients in circulatory shock represent a group that may require close glucose monitoring.
Author List
Schwenk ES, Mraovic B, Maxwell RP, Kim GS, Ehrenfeld JM, Epstein RHAuthor
Jesse Ehrenfeld MD, MPH Sr Associate Dean, Director, Professor in the Advancing a Healthier Wisconsin Endowment department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultAged
Aged, 80 and over
Blood Glucose
Communication
Critical Illness
Female
Hospitals, Teaching
Humans
Hypoglycemia
Hypoglycemic Agents
Insulin
Intraoperative Period
Male
Medical Errors
Middle Aged
Monitoring, Intraoperative
Physician-Patient Relations
Retrospective Studies
Shock, Cardiogenic
Shock, Septic
