Effect of Hyperglycemia on Postoperative Outcome in Pediatric Surgical Unit

Abstract

In childhood, it is reported that hyperglycemia occurs in 4.7% of patients with acute illness aging 1 month to 6 years. Major surgery and urgent or emergent intervention without time enough for reparation and intraoperative complications as bleeding considered the main cornerstone for stress hyperglycemia. Surgical patients who undergo elective and urgent surgery may have un-recognized diabetes or develop stress hyperglycemia that contribute to increased postoperative complications. Patients with hospital induced stress hyperglycemia have a greater risk than those with pre-existing diabetes. The risk of postoperative infectious complications increase in stressed group than non-stressed group due to depressed immune function secondary to inhibition of IL-1 and impaired phagocytosis. Early intervention for control of hyperglycemia either by intravenous fluid or insulin therapy decrease the rate of postoperative complications.