Insulin pump therapy in the very low birth weight infant.
Insulin pump therapy in the very low birth weight infant.
复制标题
极低出生体重婴儿的胰岛素泵治疗。
作者：
S. Ostertag;L. Jovanovič;B. Lewis;P. Auld
十名危重、出生体重低于 30 周的婴儿接受通过连续胰岛素输注泵（Betatron II，心脏起搏器，Inc）施用的外源胰岛素治疗。婴儿因葡萄糖输注超过 6 毫克/公斤/分钟而出现高血糖。所有婴儿的血糖浓度在两到四个小时内都恢复正常，对持续胰岛素治疗的要求各不相同。伴随糖尿，静脉注射葡萄糖的耐受性从平均 7.4 mg/kg/min 增加至 11.2 mg/kg/min。能量摄入量从胰岛素泵治疗前的 49.5 卡路里/公斤/天增加到治疗后的 70.4 卡路里/公斤/天（P 小于 0.01），体重增加从 -23 克/天变为 +13 克/天（P 小于 0.01）。一项意想不到的观察结果是，一些婴儿仅接受三到六小时的胰岛素治疗后，服用较高剂量的葡萄糖后，血糖稳态就明显正常化。连续胰岛素输注泵是一种灵活的工具，可以根据血糖值改变胰岛素输注速率，而无需改变其他肠外输注。
Ten critically ill, very low birth weight infants less than 30 weeks' gestation were treated with exogenous insulin administered through a continuous insulin infusion pump (Betatron II, Cardiac Pacemaker, Inc). Infants were hyperglycemic to dextrose infusions greater than 6 mg/kg/min. The blood glucose concentration became normal in all infants within two to four hours, with varying requirements for continued insulin treatment. Tolerance to intravenous dextrose increased from a mean of 7.4 mg/kg/min to 11.2 mg/kg/min with glycosuria. Energy intake increased from 49.5 calories/kg/d prior to insulin pump therapy to 70.4 calories/kg/d afterward (P less than .01) with weight gain changed from -23 g/d to +13 g/d (P less than .01). One unexpected observation was the apparent normalization of blood glucose homeostasis on higher dextrose doses among some infants after only one three- to six-hour treatment with insulin. The continuous insulin infusion pump is a flexible tool that allows insulin infusion rates to be changed as dictated by blood glucose values without altering other parenteral infusions.