INTRA-OPERATIVE NEED FOR GLUCOSE IN NEWBORNS

One ofthe important goals of intraoperativefluid therapy in neonates is to ensure normal glycemic status. However there is no definitive guidance on the issue of intraoperative administration solutions containing glucose.

a single-center study of intraoperative glycemic status in 60 newborns with congenital malformations was conducted. Age at the time of surgery amounted to Me 48 [24; 120] hours of life, the duration of surgery was 70 [60; 101] minutes. The children were divided into two groups: in group 1 (n = 30) intraoperative infusion therapy was only saline; in group 2 (n = 30) with salt solutions were simultaneously injected glucose in a dose of 2,3 mg/kg/ min. The glucose level in the blood was evaluated before operation, during operation every 30 minutes and at the end of surgical intervention, if it was necessary, was corrected.

the study revealed high incidence of hypoglycemic conditions in children in group 1, especially during tracheal intubation and skin incision (40 episodes in 20 children). However the blood glucose level subsequently normalized and remained within the reference values. In group 2, the average glucose level in these stages was significantly greater than 4,4 [3,3; 5,2] mmol/l (p = 0,03), and did not go beyond normal values, remaining stable in all phases of the operation. There was a decrease in 2 times the frequency of episodes of hypoglycemia in group 2 (19 episodes in 12 patients). At the same time, more often fixed hyperglycemia in group 2.

intraoperative blood glucose in newborns is unstable indicator and requires a precise dosing of glucose in the infusion to avoid Hypo- and hyperglycemia.