Learning Objective 1: The overall objective of this project is to determine both the prevalence of and risk factors for IONEE in preterm neonates.
Learning Objective 2: The long-term goal is to improve health outcomes for premature neonates experiencing a surgical procedure by developing intraoperative clinical guidelines for monitoring and treating IONEE.
This study examined the rates and risks of premature neonates <2500grams developing intraoperative non-euglycemia events (IONEE).
A retrospective chart review of 26 premature neonates <2500 grams who underwent surgical procedures between January 1 and December 31, 2009 was conducted. Statistical analysis was done using Chi square and t-tests.
Ten of the 26 subjects (38%) experienced an IONEE. Hyperglycemia was the primary IONEE that was noted in the neonates. (Mean: 143.19; sd: 56.041) Length of surgery was significantly longer in those premature neonates with IONEE than those with euglycemia (71.7 0± 27.03 vs. 45.62 ± 17.98 minutes). All IONEE subjects received general anesthesia (n=10) while none of those with only intravenous anesthesia had an IONEE (X2 (1) = 4.875, p=.027). Subjects with IONEE had a higher mean preoperative glucose level (127.11 gm/dL ± 31.66) than those who did not experienced IONEE (86.36 gm/dL ± 29.39; t(21) = 3.151, p=.005). A higher proportion of subjects who developed IONEE had the capillary heel (60%) as opposed to an arterial (40%) site for blood collection (X2 (1) = 6.518, p =.001). Also, subjects free of preoperative pulmonary complications were more prone to develop IONEE (X2 (1)= 8.60, p = .003). The presence of IONEE was associated with development of metabolic acidosis (X2 (1)= 5.426, p=.020) and lower postoperative pH values (7.19 ± 0.20 vs. 7.35 ± 0.11).
Anesthesia providers need to establish intraoperative guidelines for the monitoring and treatment of IONEE to protect these premature neonates from having complications such as developmental delay.
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