Newborn Intensive Care Unit, Waikato District Health Board, Hamilton, New Zealand.
J Pediatr. 2010 Aug;157(2):198-202.e1. doi: 10.1016/j.jpeds.2010.02.003. Epub 2010 Mar 24.
To determine the usefulness of continuous glucose monitoring in babies at risk of neonatal hypoglycemia.
Babies >/=32 weeks old who were at risk of hypoglycemia and admitted to newborn intensive care received routine treatment, including intermittent blood glucose measurement using the glucose oxidase method, and blinded continuous interstitial glucose monitoring.
Continuous glucose monitoring was well tolerated in 102 infants. There was good agreement between blood and interstitial glucose concentrations (mean difference, 0.0 mmol/L; 95% CI, -1.1-1.1). Low glucose concentrations (<2.6 mmol/L) were detected in 32 babies (32%) with blood sampling and in 45 babies (44%) with continuous monitoring. There were 265 episodes of low interstitial glucose concentrations, 215 (81%) of which were not detected with blood glucose measurement. One hundred seven episodes in 34 babies lasted >30 minutes, 78 (73%) of which were not detected with blood glucose measurement.
Continuous interstitial glucose monitoring detects many more episodes of low glucose concentrations than blood glucose measurement. The physiological significance of these previously undetected episodes is unknown.
确定连续血糖监测在有新生儿低血糖风险的婴儿中的应用价值。
对有低血糖风险且入住新生儿重症监护病房的≥32 周大的婴儿,给予常规治疗,包括使用葡萄糖氧化酶法进行间歇性血糖测量和盲法连续间质血糖监测。
102 名婴儿均能很好地耐受连续血糖监测。血糖和间质葡萄糖浓度之间具有良好的一致性(平均差值为 0.0mmol/L;95%CI,-1.1-1.1)。有 32 名婴儿(32%)通过采血和 45 名婴儿(44%)通过连续监测发现血糖浓度较低(<2.6mmol/L)。有 265 次出现低间质葡萄糖浓度的情况,其中 215 次(81%)未通过血糖测量检测到。在 34 名婴儿中,有 107 次低血糖持续时间超过 30 分钟,其中 78 次(73%)未通过血糖测量检测到。
连续间质血糖监测比血糖测量检测到更多的低血糖浓度发作。这些先前未检测到的发作的生理意义尚不清楚。