Abstract Ref Number = APCP1044
CLINICAL PROFILE OF BLOOD GLUCOSE USING PARENTERAL NUTRITION
Loysa Ladydi,Mahendra Tri Arif,Kartika Darma,Dina Angelika,Martono Tri Utomo,Risa Etika,Agus Harianto
DEPARTMENT OF CHILD HEALTH FACULTY OF MEDICINE UNIVERSITAS AIRLANGGA DR SOETOMO HOSPITAL SURABAYA INDONESIA
Background : Parenteral nutrition (PN) should be started as soon as possible to achieve glucose level and to enhance positive protein balance. Hyperglycemia and hypoglycemia in neonates are the most complications that considered to receive PN and it is important to be monitored. The aim of this study is to evaluate neonates blood glucose receiving PN.
Material : A prospective study was undertaken all neonates receiving PN admitted in Neonatal Intensive Care Unit (NICU) Dr. Soetomo Hospital from March to May 2018. Random blood glucose (BG) were measured daily until reached full enteral feeding with glucose stick test. The neonate who died before reaching full enteral feeding were excluded. Hyperglycemia (BG >150 mg/dL) is when a neonate got more than two times hyperglycemia episodes. Hypoglycemia (BG <45 mg/dL) is when a patient got more than two times hypoglycemia episodes. The data were analyzed including numbers of hyperglycemia and hypoglycemia, PN duration, Glucose Infusion Rate (GIR), BG level, and outcome (sepsis, Necrotizing Enterocolitis (NEC), and Respiratory Distress Syndrome (RDS)). Statistical analysis was carried out using chi square with 95% confidence interval (P<0.05 was considered significant).
Results : A total of 101 neonates were included, 82 (82%) preterm and 19 (19%) term. Twenty one (21%) neonates were hyperglycemia and 25 (25%) were hypoglycemia. Hyperglycemia occurred in mean gestational age 33 (SD 3.2) weeks, mean birth weight 1700 (SD 727.7) grams, and mean GIR 7.8 (SD 1.65) mg/kg/min. Hypoglycemia occurred in mean gestational age 32 (SD 2.9) weeks, mean birth weight 1500 (SD 520.2) grams, mean GIR 7.4 (SD 1.69) mg/kg/min. There were significant differences between hypoglycemia and gestational age (P=0.016), birth weight (P=0.021), RDS (P=0.02). There were no significant differences between hyperglycemia and gestational age, birth weight, NEC, sepsis and RDS.
Conclusions : Hypoglycemia in neonate receiving PN related with smaller gestational age, low birth weight and RDS.
Keywords: Parenteral nutrition neonate glucose infusion rate hyperglycemia