Alejandra Barrero-Castillero1,2,3, Wenyang Mao4, Ann R Stark4,5, David Miedema4, DeWayne M Pursley6,4,5, Heather H Burris4,5,7,8. 1. Division of Newborn Medicine, Children's Hospital Boston, Boston, MA, USA. abcastil@bidmc.harvard.edu. 2. Department of Neonatology, Beth Israel Deaconess Medical Center (BIDMC), Boston, MA, USA. abcastil@bidmc.harvard.edu. 3. Department of Pediatrics, Harvard Medical School, Boston, MA, USA. abcastil@bidmc.harvard.edu. 4. Department of Neonatology, Beth Israel Deaconess Medical Center (BIDMC), Boston, MA, USA. 5. Department of Pediatrics, Harvard Medical School, Boston, MA, USA. 6. Division of Newborn Medicine, Children's Hospital Boston, Boston, MA, USA. 7. Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA. 8. Division of Neonatology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Abstract
OBJECTIVES: Determine the prevalence of glucose concentrations below the Pediatric Endocrine Society (PES) term and late preterm-focused guideline target for mean glucose concentrations (≥70 mg/dL) among preterm NICU infants on full enteral nutrition and assess the impact on monitoring practices. STUDY DESIGN: Retrospective cohort study. RESULTS: We analyzed 1717 infants who were at least 2 days old and 48 hours after parenteral fluids were discontinued. Glucose concentrations were ≥70, 60-69, 50-59, and <50 mg/dL in 76.6, 16.2, 5.9, and 1.3% of measurements, respectively. In multivariate models, concentrations <60 mg/dL were common among male infants at lower postnatal age, small-for-gestational age, and born to women with hypertension (p < 0.05). After PES guideline, infants were more likely to have >3 glucose measurements (p < 0.05). CONCLUSIONS: Glucose concentrations <70 mg/dL are not uncommon among preterm infants receiving full enteral nutrition. Monitoring increased after guideline publication. Applying PES threshold to well-appearing preterm infants may promote increased monitoring and intervention without clear long-term benefit.
OBJECTIVES: Determine the prevalence of glucose concentrations below the Pediatric Endocrine Society (PES) term and late preterm-focused guideline target for mean glucose concentrations (≥70 mg/dL) among preterm NICU infants on full enteral nutrition and assess the impact on monitoring practices. STUDY DESIGN: Retrospective cohort study. RESULTS: We analyzed 1717 infants who were at least 2 days old and 48 hours after parenteral fluids were discontinued. Glucose concentrations were ≥70, 60-69, 50-59, and <50 mg/dL in 76.6, 16.2, 5.9, and 1.3% of measurements, respectively. In multivariate models, concentrations <60 mg/dL were common among male infants at lower postnatal age, small-for-gestational age, and born to women with hypertension (p < 0.05). After PES guideline, infants were more likely to have >3 glucose measurements (p < 0.05). CONCLUSIONS:Glucose concentrations <70 mg/dL are not uncommon among preterm infants receiving full enteral nutrition. Monitoring increased after guideline publication. Applying PES threshold to well-appearing preterm infants may promote increased monitoring and intervention without clear long-term benefit.
Authors: Charles A Stanley; Paul J Rozance; Paul S Thornton; Diva D De Leon; Deborah Harris; Morey W Haymond; Khalid Hussain; Lynne L Levitsky; Mohammad H Murad; Rebecca A Simmons; Mark A Sperling; David A Weinstein; Neil H White; Joseph I Wolfsdorf Journal: J Pediatr Date: 2015-03-25 Impact factor: 4.406
Authors: Barbara J Stoll; Nellie I Hansen; Edward F Bell; Seetha Shankaran; Abbot R Laptook; Michele C Walsh; Ellen C Hale; Nancy S Newman; Kurt Schibler; Waldemar A Carlo; Kathleen A Kennedy; Brenda B Poindexter; Neil N Finer; Richard A Ehrenkranz; Shahnaz Duara; Pablo J Sánchez; T Michael O'Shea; Ronald N Goldberg; Krisa P Van Meurs; Roger G Faix; Dale L Phelps; Ivan D Frantz; Kristi L Watterberg; Shampa Saha; Abhik Das; Rosemary D Higgins Journal: Pediatrics Date: 2010-08-23 Impact factor: 7.124