Rozance Paul J, Wolfsdorf Joseph I
Perinatal Research Center, Department of Pediatrics, Colorado Children's Hospital, University of Colorado School of Medicine, 13243 E 23rd Avenue, Aurora, CO 80045, USA.
Division of Endocrinology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA.
Pediatr Clin North Am. 2019 Apr;66(2):333-342. doi: 10.1016/j.pcl.2018.12.004. Epub 2019 Feb 1.
This article covers several aspects of the clinical management of neonatal hypoglycemia that have recently evolved, reviewing the evidence informing these recommended changes in practice. Topics covered include use of buccal dextrose gel, rationale for avoiding the traditional "mini dextrose bolus," and benefits of direct breastfeeding for the treatment of asymptomatic hypoglycemia in at-risk newborns. The reasons for increasing use of more accurate point-of-care devices for measuring neonatal glucose concentrations are discussed, as well as the implications of different published opinions regarding the determination of readiness for discharge and the most important considerations when making this determination.
本文涵盖了新生儿低血糖临床管理中最近出现变化的几个方面,回顾了为这些推荐的实践变化提供依据的证据。涵盖的主题包括颊部葡萄糖凝胶的使用、避免传统“小剂量葡萄糖推注”的理由,以及直接母乳喂养对高危新生儿无症状低血糖治疗的益处。文中讨论了越来越多地使用更精确的即时检测设备来测量新生儿血糖浓度的原因,以及关于确定出院准备情况的不同已发表观点的影响,以及做出这一决定时最重要的考虑因素。