Hypoglycemia policy

[mmmorgan58]

We are in the process of revising our policy regarding monitoring of those newborns at risk for hypoglycemia i.e.- LGA, IDM,IUGR, SGA, post dates, near term, etc. Trying to get a feel for policies at other hospitals.

[Stefan Johansson]

We screen the following groups of "high-risk" infants, cared for in the maternity:

- infants to diabetic mothers

- near-term infants (35-36 week)

- LGA

- SGA

- infants Apgar<4 at 5 min's, metabolic acidosis BE<-15 in cord blood or hypothermic postpartum

B-glucose are checked twice the first 24 hours. If supplementary feeding is started (generally done in the first four groups above), we check b-glucose after the 2nd and the 4th feeds.

This is the outlined management in our units depending on b-glucose levels (mmol/L)

>2.6 - unchanged strategy and no further controls

1.8-2.6 - increased feeding

<1.8 - consider iv glucose infusion

< 1.1 - NICU admission, glucose bolus and infusion

[dr mir]

risks groups are quite the same along with others having signs and symptoms kindly inform tha since we do nt have pharmacy or comercially availabla solutions between 10./. and 25./.dextrose, we make dilutions from 25./. dextrose when reqrmnts abv 8mg/kg also because we arent familiar wth central lines plz guide