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This article has been peer reviewed. It is the authors' final version prior to publication in Journal of Clinical Anesthesia

Volume 24, Issue 8, December 2012, Pages 625-630.

The published version is available at DOI: 10.1016/j.jclinane.2012.04.009. Copyright © Elsevier Inc.


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.

Table 1 - JCA Revision.pdf (29 kB)
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Table 2 - JCA Revision.pdf (12 kB)
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