Perioperative Management of Pediatric Patients With Type 1 Diabetes Mellitus, Updated Recommendations for Anesthesiologists
| Autor: | Lizabeth D. Martin, Monica A. Hoagland, Erinn T. Rhodes, Joseph I. Wolfsdorf, Jennifer L. Hamrick, James Fehr, Ellen Kim, Kalie Tommerdahl, Stephen J. Gleich, Vikas O’Reilly-Shah, Steve Tosone, Kathrine Keech, Genevieve D’Souza, Anita Honkanen |
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| Rok vydání: | 2019 |
| Předmět: |
Blood Glucose
medicine.medical_specialty Adolescent medicine.medical_treatment MEDLINE Perioperative Care 03 medical and health sciences Intraoperative Period 0302 clinical medicine 030202 anesthesiology Diabetes mellitus medicine Humans Hypoglycemic Agents Insulin Intensive care medicine Child Glycemic Postoperative Care Type 1 diabetes business.industry Infant Newborn Infant Perioperative Guideline medicine.disease Anesthesiologists Anesthesiology and Pain Medicine Diabetes Mellitus Type 1 Child Preschool Pediatric anesthesia business 030217 neurology & neurosurgery |
| Zdroj: | Anesthesia and analgesia. 130(4) |
| ISSN: | 1526-7598 |
| Popis: | Approximately 1 of every 300 children in the United States has type 1 diabetes mellitus (T1D), and these patients may require anesthetics for a variety of procedures. Perioperative coordination is complex, and attention to perioperative fasting, appropriate insulin administration, and management of hypo- and hyperglycemia, as well as other metabolic abnormalities, is required. Management decisions may be impacted by the patient's baseline glycemic control and home insulin regimen, the type of procedure being performed, and expected postoperative recovery. If possible, preoperative planning with input from the patient's endocrinologist is considered best practice. A multi-institutional working group was formed by the Society for Pediatric Anesthesia Quality and Safety Committee to review current guidelines in the endocrinology and anesthesia literature and provide recommendations to anesthesiologists caring for pediatric patients with T1D in the perioperative setting. Recommendations for preoperative evaluation, glucose monitoring, insulin administration, fluid management, and postoperative management are discussed, with particular attention to increasingly prevalent insulin pumps and continuous glucose monitoring (CGM). |
| Databáze: | OpenAIRE |
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