Desenfants Aurelie, Soleirol Marion, Salet Randa, Benito Castro Fernando, Le Guillou Caroline, Di Maio Massimo, Tran Tu Anh
Department of Neonatology, CHU Nimes, Univ Montpellier, Nimes, France.
Department of Pediatrics, CHU Nimes, Univ Montpellier, Nimes, France.
Neonatology. 2022;119(2):260-263. doi: 10.1159/000521695. Epub 2022 Feb 7.
Neonatal hyperglycaemia is common in extremely low birth weight (ELBW, <1,000 g) infants, associated with a number of adverse clinical outcomes, and usually treated with continuous intravenous insulin infusion (CIVII). We report a case of continuous subcutaneous insulin infusion (CSII) in an ELBW neonate (730 g, 25 weeks GA) requiring insulin infusion for transient idiopathic hyperglycaemia. After presenting hyperglycaemia on day 4, the patient was treated with CIVII. From day 12 to 34, CSII was used to replace central venous catheter. Insulin requirements were lower and glycaemia more stable under CSII. No side effect was noticed. CSII was also beneficial for developmental care, allowing parents to be more easily involved in their baby's care. Thus, CSII appeared to be a safe and reliable alternative for insulin administration in ELBW infants. However, indication and management requires training of the NICU team by paediatric diabetes specialists.
新生儿高血糖在极低出生体重（ELBW，<1000克）婴儿中很常见，与许多不良临床结局相关，通常采用持续静脉输注胰岛素（CIVII）进行治疗。我们报告了一例ELBW新生儿（730克，孕25周）因短暂特发性高血糖需要胰岛素输注而采用持续皮下胰岛素输注（CSII）的病例。该患儿在出生第4天出现高血糖后接受了CIVII治疗。从第12天到第34天，使用CSII替代中心静脉导管。在CSII治疗下，胰岛素需求量更低，血糖更稳定。未观察到副作用。CSII对促进发育护理也有益，使父母能更轻松地参与到婴儿护理中。因此，CSII似乎是ELBW婴儿胰岛素给药的一种安全可靠的替代方法。然而，适应症和管理需要儿科糖尿病专家对新生儿重症监护病房团队进行培训。
