Neonatal Hypoglycaemia, a Literature Review. Essay

1371 Words Mar 25th, 2014 6 Pages
Neonatal Hypoglycaemia, a Literature Review.
The key words used when researching this review: Neonatal hypoglycaemia/hypoglycemia, New-born hypoglycaemia, Low plasma glucose level, New-born/Infant low blood sugar, Hypoglycaemia in preterm/high risk neonates, Hypoglycaemia/breastfeeding, gluconeogenesis/ketone bodies. The databases and search engines used: Google scholar, CINHAL and Medline.
Hypoglycaemia is common among neonates, therefore Healthcare professionals must be aware of the risk factors that predispose infants, allowing for early screening so that asymptomatic hypoglycaemia can be detected and treated early preventing more severe or symptomatic hypoglycaemia. This essay will examine the physiology behind neonatal
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By 19:30 the baby had taken 12mls of formula by cup. At 22:00 the 2nd TBG result was 1.72mmol/l Lactate 1.1mmol/l, with the baby’s temperature being 36.2C. With possible hypothermia compounding the problem of depleting neonatal energy stores, he was placed in a hot cot at 37C to maintain his temperature for the night. The SHO was informed and a plan put in place to increase feeds to 60mls/kg/day, equal to 18mls per feed via cup every 2-3 hours. The baby’s 3rd TBG was repeated at 01:45 with a result of 1.60mmol/l and Lactate 1.83mmol/l. The SHO was informed, with a plan to do a septic screen, begin IV Benzylpenicillin and Amikasin and increase feeds to 90/mls/kg/day, 27mls per cup feed and transfer to Transitional Care. Temperature was 36.7 whilst out of hot cot for more than half an hour and he was taking 27mls by cup every 2-3hours.
The next TBG was 2.33mmol/l at 03:33, 40 minutes post feed. According to trust guidelines the blood glucose levels must remain between 2.0-2.50mmol/l on 2 consecutive occasions, with an assessment by an experienced DR before discontinuing blood glucose monitoring. The next two were 2.7mmol/l and 3.2mmol/l and the baby had passed meconium by 11:00 and was alert and rooting. No more TBG’s were now needed until weaning commenced from cup feeding formula to fully breastfeeding.
With close observation, blood glucose tests and regular feeding this baby managed to pull through an episode of asymptomatic

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