How is hypoglycemic shock recognized and treated intraoperatively

How is hypoglycemic shock recognized and treated intraoperatively?

• ·       Hypoglycemia can lead to tissue energy failure and has been associated with hemodynamic collapse and brain injury.
• ·       Any patient receiving insulin, pramlintide, sitagliptin, or sulfonylureas is at risk for hypoglycemia.
• ·       Because risk is usually known beforehand, hourly or more frequent monitoring of serum glucose should detect hypoglycemia.
• ·       If glucose levels are low or decrease rapidly, the fastest treatment is a bolus of intravenous dextrose, 50% solution, administered slowly.
• ·       In an emergency, one full ampule is the starting dose.
• ·       In less urgent settings when the serum glucose level is low but not critical, smaller doses can be titrated to serum glucose values.