Abstract
The metabolic responses to a constant glucose infusion (4.3±.2 mg/kg/min) were measured in 30 prematures, 700-1559g. The study included 18 stressed infants who needed assisted ventilation (Grp A) and 12 controls (Grp B). Plasma samples for glucose, insulin, cortisol, and glycerol were obtained from cord blood, just prior to glucose infusion at 2.1±.2 hr (mean ± S.E.) and 5.5±.4 and 25.6±1.0 hr after start of glucose infusion. Metabolic responses were similar in both groups in the cord and preinfusion samples. In the first post-infusion sample, glucose (p<.01), cortisol (p<.05), and glycerol (p<.01) were higher in A than in B. Insulin values correlated with glucose values (p<.001) and I/G were not significantly different between A and B. Hyperglycemia (plasma glucose >145mg/dl) was seen in 10 of A and 1 of B infants (p<.025). Infants in A who became hyperglycemic in the first post-infusion sample (Grp A1) were then compared with stressed euglycemic infants (Grp A2). Insulin levels were higher (42.2±13.9 VS 9.4±2.5μU/ml, p<.05), glycerol levels similar (8.6±1.6 VS 8.8±1.4mg/dl), but cortisol levels lower (15.3±4.2 VS 28.0±2.4μg/dl, p<.05) in A1 than A2 infants. There was no difference in mortality between A1 and A2 infants; stress, rather than hyperglycemia was related to mortality. In summary, cortisol and glycerol responses were higher in stressed neonates. However, hyperglycemia in stressed infants could not be attributed to any of the metabolic factors evaluated.
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Lilien, L., Rosenfield, R., Baccaro, M. et al. 990 HYPERGLYCEMIA IN STRESSED SMALL PREMATURES. Pediatr Res 12 (Suppl 4), 529 (1978). https://doi.org/10.1203/00006450-197804001-00996
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DOI: https://doi.org/10.1203/00006450-197804001-00996