hello every one 

 

regarding the initiative from AAP , STABLE program ,  i know its designed mainly for (pre-transportation/ post resuscitation) of sick infant .. 

 

S point for sugar ..  so if newly delivered baby was sick and resuscitated , its not uncommon  to have low blood sugar in the first hour of life 

, and usualy we dont intervene to correct sugar immediatly after birth as long as its above 25mg/dl .

 

so anyone have idea about at what level i should manage ? is i go strictly with STABLE program??? 

 

 

thanks

 

My opinion - I would def react and treat hypoglycemia after resuscitation. My experience is rather that sick infants often have elevated blood glucose initially, due to high stress, and then go low when the stress response diminishes.

 

If the level of hypoglycemia is not defined in the STABLE programme, my suggestion is to go with your regular definition. We consider levels below 2.6 mmol/L (i.e. ≈45 mg/dl) as hypoglycemia (the 1st day of life).

We consider hypoglycemia below 2.6 mmol/L and the mode of action depends on the condition of the child (seizures,excitation, ability to receive oral feedings etc).

There is a physiological dip in glucose immediately after birth but this should be normal by 1 hour. So if the dextrose is low at one hour you should manage it. The practice appears to be treating hypoglycaemia earlier. Some centres are even suggesting 3.0mmol/l. If I remember correctly STABLE is teaching 2.8? Currently we still treat less than 2.5mmol/l