Yair Kasirer1,2, Ophir Dotan3, Francis B Mimouni4,5, Netanel Wasserteil4, Cathy Hammerman4,3, Alona Bin-Nun4,3. 1. Department of Neonatology, Shaare Zedek Medical Center, Jerusalem, Israel. yairkasir@szmc.org.il. 2. Faculty of Medicine, the Hebrew University, Jerusalem, Israel. yairkasir@szmc.org.il. 3. Faculty of Medicine, the Hebrew University, Jerusalem, Israel. 4. Department of Neonatology, Shaare Zedek Medical Center, Jerusalem, Israel. 5. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Abstract
OBJECTIVE: To investigate the success rate of intramuscular (IM) glucagon in preventing need for IV glucose and describe its glycemic effect. METHODS: Retrospective study of 158 consecutive term neonates with feeding-resistant hypoglycemia treated with glucagon. RESULTS: After glucagon, blood glucose (BG) increased in all but 1 infant by 25.9 ± 17.1, 42.1 ± 21.1, and 39.2 ± 28.3 mg/dL (1.4 ± 0.9, 2.3 ± 1.2, 2.2 ± 1.6 mmol/L) at 30, 60 and 120 mins respectively. In multivariable logistic regression, glucagon success was dependent upon gender (increased male risk) (P = 0.021), meeting American Academy of Pediatrics (AAP) criteria for immediate IV glucose (P = 0.004), birth weight, (P = 0.018) and delta glucose concentration at 60 min (P = 0.013). After IM glucagon, 24 out of 49 infants that met AAP criteria for immediate IV glucose (49%) ended up not requiring any additional intervention. CONCLUSIONS: Glucagon increases BG nearly universally in hypoglycemic infants and allowed reducing the number of infants that needed immediate IV glucose infusion therapy by ≈half.
OBJECTIVE: To investigate the success rate of intramuscular (IM) glucagon in preventing need for IV glucose and describe its glycemic effect. METHODS: Retrospective study of 158 consecutive term neonates with feeding-resistant hypoglycemia treated with glucagon. RESULTS: After glucagon, blood glucose (BG) increased in all but 1 infant by 25.9 ± 17.1, 42.1 ± 21.1, and 39.2 ± 28.3 mg/dL (1.4 ± 0.9, 2.3 ± 1.2, 2.2 ± 1.6 mmol/L) at 30, 60 and 120 mins respectively. In multivariable logistic regression, glucagon success was dependent upon gender (increased male risk) (P = 0.021), meeting American Academy of Pediatrics (AAP) criteria for immediate IV glucose (P = 0.004), birth weight, (P = 0.018) and delta glucose concentration at 60 min (P = 0.013). After IM glucagon, 24 out of 49 infants that met AAP criteria for immediate IV glucose (49%) ended up not requiring any additional intervention. CONCLUSIONS: Glucagon increases BG nearly universally in hypoglycemic infants and allowed reducing the number of infants that needed immediate IV glucose infusion therapy by ≈half.
Authors: M Cornblath; J M Hawdon; A F Williams; A Aynsley-Green; M P Ward-Platt; R Schwartz; S C Kalhan Journal: Pediatrics Date: 2000-05 Impact factor: 7.124
Authors: Jeffrey R Kaiser; Shasha Bai; Neal Gibson; Greg Holland; Tsai Mei Lin; Christopher J Swearingen; Jennifer K Mehl; Nahed O ElHassan Journal: JAMA Pediatr Date: 2015-10 Impact factor: 16.193