Oral Dextrose Gel Reduces the Need for Intravenous Dextrose Therapy in Neonatal Hypoglycemia.
Oral Dextrose Gel Reduces the Need for Intravenous Dextrose Therapy in Neonatal Hypoglycemia.
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DOI：
10.1159/000448511
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发表时间：
2016-09
期刊：
影响因子：
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通讯作者：
Lakshminrusimha S
中科院分区：
文献类型：
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作者：
Rawat M;Chandrasekharan P;Turkovich S;Barclay N;Perry K;Schroeder E;Testa L;Lakshminrusimha S
有危险因素的新生儿可能需要静脉注射(IV)葡萄糖来治疗无症状低血糖。静脉注射葡萄糖和转移到新生儿重症监护病房(NICU)可能会干扰亲子关系。目的探讨晚期早产儿无症状性低血糖时补充葡萄糖凝胶对减少静脉注射葡萄糖治疗的影响。在使用葡萄糖凝胶前后分别进行了一项回顾性研究：2014年5月1日至2014年10月31日和2014年11月1日至2015年4月30日。新生儿托儿所(NBN)中的无症状低血糖(血糖水平为45 mg/dl)婴儿在喂养的同时给予最多3剂葡萄糖凝胶(200 mg/kg 40%葡萄糖)。转到NICU静脉注射葡萄糖被认为是治疗失败。添加饲料的葡萄糖凝胶可提高184/250名无症状低血糖婴儿的血糖水平(74%)，相比之下，只使用饲料的婴儿中有144/248名(58%)(p<；0.01)。从NBN转到NICU静脉注射葡萄糖的活产儿从35/1,000降至25/1,000(p<；0.01)。纯母乳喂养从19%提高到28%(p=0.03)。在饲料中使用葡萄糖凝胶减少了静脉输液的需要，避免了与母亲的分离，并促进了母乳喂养。葡萄糖凝胶治疗失败的新生儿更有可能大于胎龄，通过剖宫产分娩，并有较低的基线血糖水平。
Newborn infants with risk factors may require intravenous (IV) dextrose for asymptomatic hypoglycemia. Administration of IV dextrose and transfer to the neonatal intensive care unit (NICU) may interfere with parent-infant bonding. To study the effect of implementing dextrose gel supplement with feeds in late preterm/term infants affected by asymptomatic hypoglycemia on reducing IV dextrose therapy. A retrospective study was conducted before and after dextrose gel use: 05/01/2014 to 10/31/2014 and 11/01/2014 to 04/30/2015, respectively. Asymptomatic hypoglycemic (blood glucose level <45 mg/dl) infants in the newborn nursery (NBN) were given a maximum of 3 doses of dextrose gel (200 mg/kg of 40% dextrose) along with feeds. Transfer to the NICU for IV dextrose was considered treatment failure. Dextrose gel with feeds increased the blood glucose level in 184/250 (74%) of asymptomatic hypoglycemic infants compared to 144/248 (58%) with feeds only (p < 0.01). Transfer from the NBN to the NICU for IV dextrose decreased from 35/1,000 to 25/1,000 live births (p < 0.01). Exclusive breastfeeding improved from 19 to 28% (p = 0.03). Use of dextrose gel with feeds reduced the need for IV fluids, avoided separation from the mother and promoted breastfeeding. Neonates who failed dextrose gel therapy were more likely to be large for gestational age, delivered by cesarean section and had lower baseline blood glucose levels.