Abstract
The metabolic responses of 75 LBWI subjected to “routine nursery regimes” were studied prospectively for the 1st 5 days of life. Glucose (10%) was given via infusion pumps at a mean (±S.E.) rate of 4.4±.2mg/kg/min (range 3-7) for the 1st 2 days and was weaned slowly. Oral feedings were started as tolerated. The mean birth wt. was 1394±47g (range, 567-2000g); there were 60AGA, 11SGA and 4LGA infants. Blood glucose values were significantly higher on days 1 and 2 (125±19 and 94±13mg% respectively) than on days 3 and 5 (65±5 and 66±5mg%) reflecting the decreased use of I.V. fluids after day 2. Hypoglycemia (blood glucose <20mg%) occured in 2 SGA and 1 AGA before I.V. fluids were started (<3 hrs. of age). On the other hand, hyperglycemia (>150mg%, range 152-875mg%) was found in 27 of 75 infants. Moreover, hyperglycemia was seen in a significantly (p<0.001) greater proportion of IBWI who died (18/24) than in those who lived (9/51). Plasma insulin values were significantly higher on days 1 and 2 (15±3 and 18±4uU/ml) than on days 3 and 4-5 (6±1 and 7±2uU/ml) indicating the ability of the LBWI's pancreas to respond to hypertonic glucose. Plasma growth hormone values were significantly lower after the 3rd day when glucose values were low than during the 1st 3 days when glucose values were high. Although a direct causal relationship between I.V. glucose, hyperglycemia and mortality cannot be made, careful monitoring of blood glucose in LBWI is indicated even if the amounts of glucose infused are relatively small.
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Pildes, R., Zarif, M. & Vidyasagar, D. HYPERGLYCEMIA IN LOW BIRTH WEIGHT INFANTS (IBMI). Pediatr Res 8, 437 (1974). https://doi.org/10.1203/00006450-197404000-00584
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DOI: https://doi.org/10.1203/00006450-197404000-00584