García-Domínguez AM, Ramírez-Mora JC

Language: Spanish
References: 16
Page: 196-200
PDF size: 50.66 Kb.

ABSTRACT

Childhood persistent hyperinsulinemic hypoglycemia is an abnormal proliferation of pancreatic bets cells that affects the gland in a diffuse form. It is an unusual pathology (1:50,000) that was associated with long-term severe neurological damage. This disease consists of a metabolic disorder characterized by hypoglycemia and persistent hyperinsulinemia, which can be present during the first three months of life. The disease is characterized by the presence of convulsions during the first hours of life and nonketotic hypoglycemia (NKH), which requires glucose infusions of glucose higher than 6.8 mg/kg/min. The initial management is directed to keep the normal values of glycemia, with the purpose of preventing hypoglycemia crisis and neurological damage through the proper pharmacological treatment (diazoxide, octreotide, somatostatin analogs, hydrocortisone). When the medical treatment fails, subtotal pancreatomy (pancreatectomy) is the elected treatment in order to keep euglycemia. In the anesthetic management, the therapeutic objective consists of keeping glucose homeostasis and the balance of fluids. In order to extend the information reported in the literature, in this occasion we present the report of the anesthetic management on seven patients who had been diagnosed childhood persistent hyperinsulinemic hypoglycemia and subjected to pancreatectomy.

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