Deborah L Harris1, Philip J Weston2, Jane E Harding3. 1. Newborn Intensive Care Unit, Waikato District Health Board, Hamilton, New Zealand Liggins Institute, University of Auckland, Auckland, New Zealand. 2. Newborn Intensive Care Unit, Waikato District Health Board, Hamilton, New Zealand. 3. Liggins Institute, University of Auckland, Auckland, New Zealand.
Abstract
OBJECTIVE: Alternative cerebral fuels are reputed to provide neuroprotection during hypoglycaemia, particularly in breastfed babies. We measured concentrations of alternative cerebral fuels in hypoglycaemic babies in the first 48 h. PATIENT AND METHODS: Babies were ≥35 weeks, ≤48 h old and at risk of hypoglycaemia (infant of diabetic, preterm, small or large). Plasma glucose, β-hydroxybutyrate, lactate and insulin concentrations were measured in babies who had been hypoglycaemic (<2.6 mM) for >1 h. RESULTS: Samples were taken from 35 hypoglycaemic babies at 3.7; 1.8-39.6 (median; range) hours after birth. Concentrations of glucose and β-hydroxybutyrate were low (2.03; 0.19-3.39 mM and 0.06; 0.00-1.20 mM), but lactate concentrations varied widely (3.06; 0.02-7.96 mM). Infants of diabetics had lower β-hydroxybutyrate and higher insulin concentrations, but mode of feeding did not influence plasma concentrations of alternative cerebral fuels. CONCLUSIONS:Hypoglycaemic babies within the first 48 h after birth are unlikely to receive neuroprotection from ketones. However, lactate may provide an alternative cerebral fuel for many. Lactate, rather than ketones, may provide alternative cerebral fuel in hypoglycaemic newborns. TRIAL REGISTRATION NUMBER: ACTRN12608000623392. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
RCT Entities:
OBJECTIVE: Alternative cerebral fuels are reputed to provide neuroprotection during hypoglycaemia, particularly in breastfed babies. We measured concentrations of alternative cerebral fuels in hypoglycaemic babies in the first 48 h. PATIENT AND METHODS: Babies were ≥35 weeks, ≤48 h old and at risk of hypoglycaemia (infant of diabetic, preterm, small or large). Plasma glucose, β-hydroxybutyrate, lactate and insulin concentrations were measured in babies who had been hypoglycaemic (<2.6 mM) for >1 h. RESULTS: Samples were taken from 35 hypoglycaemic babies at 3.7; 1.8-39.6 (median; range) hours after birth. Concentrations of glucose and β-hydroxybutyrate were low (2.03; 0.19-3.39 mM and 0.06; 0.00-1.20 mM), but lactate concentrations varied widely (3.06; 0.02-7.96 mM). Infants of diabetics had lower β-hydroxybutyrate and higher insulin concentrations, but mode of feeding did not influence plasma concentrations of alternative cerebral fuels. CONCLUSIONS:Hypoglycaemic babies within the first 48 h after birth are unlikely to receive neuroprotection from ketones. However, lactate may provide an alternative cerebral fuel for many. Lactate, rather than ketones, may provide alternative cerebral fuel in hypoglycaemic newborns. TRIAL REGISTRATION NUMBER: ACTRN12608000623392. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Authors: Jane E Harding; Deborah L Harris; Joanne E Hegarty; Jane M Alsweiler; Christopher Jd McKinlay Journal: Early Hum Dev Date: 2016-12-15 Impact factor: 2.079
Authors: Christopher J D McKinlay; Jane M Alsweiler; Judith M Ansell; Nicola S Anstice; J Geoffrey Chase; Gregory D Gamble; Deborah L Harris; Robert J Jacobs; Yannan Jiang; Nabin Paudel; Matthew Signal; Benjamin Thompson; Trecia A Wouldes; Tzu-Ying Yu; Jane E Harding Journal: N Engl J Med Date: 2015-10-15 Impact factor: 91.245
Authors: Nataliia Burakevych; Christopher J D McKinlay; Deborah L Harris; Jane M Alsweiler; Jane E Harding Journal: Sci Rep Date: 2019-05-31 Impact factor: 4.379