Hypoglycemia in the newborn period - New Born Baby

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AIIMS- NICU protocols updated 2007 10 None of the studies provided a valid estimate of the effect of neonatal hypoglycemia on neurodevelopment. 17 Though these studies have major limitations, it would seem prudent to follow up all infants who had confirmed hypoglycemia in the high-risk category, till a future optimal study is performed. 17 . The outcome of hypoglycemia is determined by factors like, duration, degree of hypoglycemia, rate of cerebral blood flow and cerebral utilization of glucose. Special attention should be paid to neuro-developmental outcome, overall IQ, reading ability, arithmetic proficiency and motor performance. The babies can be assessed at one month corrected age for vision / eye evaluation. At 3, 6, 9, 12 and 18 months corrected age they can be followed up for growth, neurodevelopment, vision and hearing loss. Vision can be assessed with Teller acuity card and hearing should be assessed by Brainstem evoked auditory responses. Neurodevelopment will be assessed by the clinical psychologist using DASII 2. REFERENCES: 1. Cornblath M. Neonatal hypoglycemia 30 years later: does it injure the brain? Historical summary and present challenges. Acta Paediatr Jpn 1997;39:S7-11. 2. Wilker RE. Hypoglycemia and hyperglycemia. In Cloherty JP and Stark AR (Eds) Manual of Neonatal Care, 6 th ed. Philadelphia: Lippincott-Raven, 1998 pp 540-49. 3. Cornblath M, Hawdon JM, Williams AF, Aynsley-Green A, Ward-Platt MP, Schwartz R, Kalhan SC. Controversies regarding definition of neonatal hypoglycemia: suggested operational thresholds. Pediatrics 2000;105:1141-5 4. TH Koh, JA Eyre,A Aynsley.Green Neonatal hypoglycaemia --the controversy regarding definition. Arch Dis Child 1988; 63: 1386-1388 5. Hypoglycemia of the newborn: A review of literature. WHO/CHD/ 97.1; 1997:1-55 6. Cornblath M, Ichord R. Hypoglycemia in the neonate. Semin Perinatol 2000;24:136-49 Downloaded from www.newbornwhocc.org
AIIMS- NICU protocols updated 2007 11 7. Cornblath M, Schwartz R. Outcome of neonatal hypoglycemia Br Med J. 1999;318:194 8. Kalhan S, Parimi P . Gluconeogenesis in the fetus and neonate. Semin Perinatal 2000;24:94-106 9. Cowett RM, Damico LB. Capillary (heelstick) versus venous blood sampling for determination of glucose concentration in neonate. Biol Neonate 1992;62:32-6 10. Lucas A, Morley R . Outcome of neonatal hypoglycemia. Br Med J 1999;318:194 11. Lucas A, Morley R, Cole TJ. Adverse neuro-developmental outcome of moderate neonatal hypoglycemia. Br Med J 1988;297:1304 –8. 12. Holtrop PC. The frequency of hypoglycemia in full term and small for gestational age newborns. Am J Perinatol 1993;10:150-4. 13. Singhal PK, Singh M, Paul VK . Prevention of hypoglycemia: A controlled evaluation of sugar fortified milk feeding in small- for- date infants..Indian Pediatr 1992;29:1365-9 14. Singhal PK, Singh M, Paul VK, Malhotra AK, Deorari AK, Ghorpade MD. Acontrolled study of sugar fortified milk feeding in prevention of neonatal hypoglycemia. Indian J Med Res 1991;94:342-5 15. Lilien LD, Pildes RS, Srinivasan G. Treatment of neonatal hypoglycemia with minibolus and intravenous glucose infusion. J Pediatr. 1980;97:295-98 16. Duvanel CB, Fawer CL, Cotting J, Hothfield P, Matthieu JM. Long term effects of neonatal hypoglycemia on brain growth and psychomotor development in small-for- gestational age preterm infants. J Pediatr. 1999;134:492-8 17. Nicole Boluyt, Anne van Kempen, Martin offringa. Neurodevelopment after neonatal hypoglycemia: A systematic review and design of an optimal future study. Pediatrics 2006 ; 117: 2231-43 Downloaded from www.newbornwhocc.org
Page 1 and 2: Hypoglycemia in the Newborn AIIMS-
Page 3 and 4: Introduction AIIMS- NICU protocols
Page 5 and 6: Clinical signs associated with hypo
Page 7 and 8: AIIMS- NICU protocols updated 2007
Page 9: (1) Hydrocortisone 5mg/kg/day IV or

Hypoglycemia in the newborn period - New Born Baby

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