Abstract 1209

Intolerance to glucose is well recognized in very low birth weight infants (≤1250 gms). However, little is known regarding the incidence and significance of hyperglycemia in the increasingly viable group of extremely low birth weight infants (ELBW≤750 gms). We reviewed the charts of 31 ELBW infants admitted to our NICU during the first 10 months of 1998. All glucose values during the first 72 hours were reviewed; values ≥180 mg/dl were considered as hyperglycemia. Of the 31 infants, 10 were hyperglycemic; the hyperglycemic and non-hyperglycemic groups of infants are compared in the table:

Table 1 No caption
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Of the ten hyperglycemic infants, four required insulin therapy; only two reached glucose values usually associated with symptoms of hyperosmolarity (≥300 mg/dl); the maximum values were 330 mg/dl in one and 440 mg/dl in the other. Hyperglycemia occurred in 7 of 9 infants weighing ≤600gms (78%); 3 of 13 between 601 - 700gms (23%); and in none of the 9 infants ≥700 gms. Only two of the 31 infants required treatment had hypoglycemia; both had a BW ≥700 gms.

All hyperglycemic infants had severe intraventricular hemorrhage; whereas, only 29% of non-hyperglycemic infants had severe intraventricular hemorrhage. All 31 study infants received surfactant at birth and required ventilatory assistance; none were given postnatal steroids during the study period.

Conclusion: Despite increasing use of antenatal steroids, early and frequent monitoring of glucose values, and careful attention to glucose intake, the incidence of hyperglycemia remains high in the ELBW infants; especially those ≤600 gms at birth. Hyperglycemia in ELBW infants was associated with a high incidence of mortality and morbidity.