Austie Femke M C, van Unen Hans J, Smit-Wu Mei-Nga, Bekhof Jolita
Isala Ziekenhuis Zwolle, afd. Kindergeneeskunde, Zwolle.
Contact: Femke M.C. Austie (
Ned Tijdschr Geneeskd. 2021 Mar 4;165:D5466.
Evaluate the effectiveness and safety of application of oral glucose to neonates with an increased risk of neonatal hypoglycaemia.
Neonatal hypoglycaemia is a common problem in neonates with potential permanent neurological damage. Recent studies show that the use of oral glucose to prevent and treat neonatal hypoglycaemia leads to a decrease in intravenous glucose administration and fewer clinical admissions. However, oral glucose administration is still rarely used. In 2019 Isala hospital implemented the use of oral glucose in neonates with an increased risk of neonatal hypoglycaemia.
Retrospective evaluation study in Isala hospital between November 1, 2018 and December 31. Neonates with one of the following risk factors for neonatal hypoglycaemia: prematurity (gestational age between 34+0-37+0), maternal diabetes requiring medication, asphyxia with an Apgar score <7 at five minutes and/or a birthweight <2500 grams. The frequency of glucose infusions, the lowest glucose value and the type of food were compared between neonates treated before and after the use of oral glucose.
The number of glucose infusions decreased after introduction of oral glucose (14.0% versus 5.9%, -8.1% [-14.1, -2.1]). The lowest measured glucose value (2.2 mmol/l versus 2.5 mmol/l, 0.3 mmol/l [0.15, 0.47]) was significantly higher after introduction of oral glucose. Mild complications (vomiting and food refusal) occurred in 3.8% of neonates receiving oral glucose, all without clinical consequence.
The use of oral glucose administration in neonates with an increased risk of hypoglycaemia reduces the number of intravenous glucose by half and is safe to use.
评估口服葡萄糖应用于新生儿低血糖风险增加患儿的有效性和安全性。
新生儿低血糖是新生儿中常见的问题，具有潜在的永久性神经损伤风险。近期研究表明，使用口服葡萄糖预防和治疗新生儿低血糖可减少静脉输注葡萄糖的次数，并减少临床住院人数。然而，口服葡萄糖给药仍很少使用。2019年，伊萨拉医院开始对新生儿低血糖风险增加的患儿使用口服葡萄糖。
对伊萨拉医院2018年11月1日至12月31日期间进行回顾性评估研究。纳入具有以下新生儿低血糖风险因素之一的新生儿：早产（胎龄34+0 - 37+0周）、需要药物治疗的母亲糖尿病、5分钟时阿氏评分<7分的窒息和/或出生体重<2500克。比较口服葡萄糖使用前后治疗的新生儿的葡萄糖输注频率、最低血糖值和食物类型。
引入口服葡萄糖后，葡萄糖输注次数减少（14.0%对5.9%，-8.1%[-14.1，-2.1]）。引入口服葡萄糖后，测得的最低血糖值显著更高（2.2毫摩尔/升对2.5毫摩尔/升，0.3毫摩尔/升[0.15，0.47]）。接受口服葡萄糖的新生儿中有3.8%出现轻度并发症（呕吐和拒食），均无临床后果。
对低血糖风险增加的新生儿使用口服葡萄糖给药可使静脉输注葡萄糖次数减半，且使用安全。
