Please enable JavaScript.
Coggle requires JavaScript to display documents.
Neonatal Hypoglycaemia - Coggle Diagram
Neonatal Hypoglycaemia
Risk factors
IUGR (poor glycogen stores)
Preterm (poor glycogen stores)
Mothers with DM
islet hyperplasia, high insulin
baby @ increased risk of other things...
congenital malformations
CHD
sacral agenesis (caudal regression syndrome)
hypoplastic left colon
not increased in GDM
IUGR (microvasc disease)
macrosomia (hence CPD, birth asphyxia, SD, brachial plexus injury)
RDS (lung maturation delayed)
hypertrophic CM
polycythaemia
infant looks plethoric
tx = partial exchange transfusion
Meticulous control pre-conceptually + in pregnancy NB
Large for dates
hypothermia
polycythaemia
unwell for any reason
Sx
jittery
irritability
apnoea
lethargy / drowsiness
seizures
Tx
IV dextrose infusion
high conc may be needed (up to 20%)
if high conc give via CVC to avoid skin necrosis
aim to get level > 2.6
2nd line options: glucagon, hydrocortisone
Prolonged can cause permanent neuro disability
Prevention
monitoring @ risk infants
early + frequent milk feeding
No agreed definition - so when to tx?
if any sx
2 low values (<2.6)
1 v low value (<1.6)