Management of asymptomatic hypoglycemia with 40% oral dextrose gel in near term at-risk infants to reduce intensive care need and promote breastfeeding
| Autor: | Francesco Cavigioli, Gianluca Lista, Francesca Castoldi, Miriam Acunzo, Martina Manzalini, Fabio Meneghin, Petrina Bastrenta, Irene Daniele, Gian Vincenzo Zuccotti |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Neonatal intensive care unit Population Breastfeeding Administration Oral Hypoglycemia Asymptomatic 40% oral dextrose gel RJ1-570 At-risk newborns Patient Admission Intensive Care Units Neonatal Intensive care medicine Humans Prospective Studies Infusions Intravenous education NICU admission education.field_of_study business.industry Research Neonatal hypoglycemia Infant Newborn Historically Controlled Study General Medicine medicine.disease Breast Feeding Glucose Intravenous glucose Sweetening Agents Asymptomatic Diseases Female medicine.symptom business Gels |
| Zdroj: | Italian Journal of Pediatrics, Vol 47, Iss 1, Pp 1-8 (2021) Italian Journal of Pediatrics |
| ISSN: | 1824-7288 |
| Popis: | BackgroundNeonatal hypoglycemia is a common disorder especially in at-risk infants and it can be associated with poor long-term neurological outcomes. Several therapeutic interventions are suggested, from the implementation of breastfeeding to the glucose intravenous administration. Oral dextrose gel massaged into the infant’s inner cheek is a recent treatment option of asymptomatic hypoglycemia, after which oral feeding is encouraged. This approach seems to reduce the admission of infants to neonatal intensive care unit (NICU) so favouring maternal bonding and breastfeeding success at discharge.MethodsIn our ward, we prospectively compared a group of near-term neonates, (Gr2,n = 308) at risk for hypoglycemia, treated with an innovative protocol based on the addition of 40% oral dextrose gel (Destrogel, Orsana®,Italy) administered by massaging gums and cheek with historical matching newborns (Gr1,n = 389) treated with a formerly used protocol, as control group. The primary outcome was occurrence of NICU admission and the requirement of intravenous glucose administration; while discharge with full breastfeeding was the secondary outcome.ResultsIn Gr1, 39/389 (10%) infants presented with asymptomatic hypoglycemia, 19/39 were transferred to the NICU, and 14/39 required intravenous glucose treatment. In Gr2, among the 30/308 infants with asymptomatic hypoglycemia managed according to the new protocol, 3/30 were transferred to the NICU and received intravenous glucose infusion. The mean duration of hospitalization respectively was 6.43 (± 6.36) and 3.73 ± 1.53 days (p p = 0.02). Considering Gr1 vs Gr2, the number of patients that were transferred to NICU was 19 (48.7%) vs 3 (10%) (p = 0.001) and the number of infants that needed intravenous glucose infusion was 14 (35.9%) vs 3 (10%) (p = 0.01), respectively.ConclusionsIn our population of near term infants, the introduction of 40% oral dextrose gel to the protocol, helped in the safe management of asymptomatic hypoglycemia and, at the same time, implemented breastfeeding. |
| Databáze: | OpenAIRE |
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