دورية أكاديمية
أعرض في EDS

Continuous glucose monitoring profile during therapeutic hypothermia in encephalopathic infants with unfavorable outcome.

التفاصيل البيبلوغرافية
العنوان: Continuous glucose monitoring profile during therapeutic hypothermia in encephalopathic infants with unfavorable outcome.
المؤلفون: Montaldo P; Department of Neonatal Intensive Care, University of Campania 'Luigi Vanvitelli', Naples, Italy. p.montaldo@imperial.ac.uk.; Centre for Perinatal Neuroscience, Imperial College London, London, UK. p.montaldo@imperial.ac.uk., Caredda E; Department of Neonatal Intensive Care, University of Campania 'Luigi Vanvitelli', Naples, Italy., Pugliese U; Department of Neonatal Intensive Care, University of Campania 'Luigi Vanvitelli', Naples, Italy., Zanfardino A; Regional Centre for Pediatric Diabetes, Department of Pediatrics, University of Campania 'Luigi Vanvitelli', Naples, Italy., Delehaye C; Department of Neonatal Intensive Care, University of Campania 'Luigi Vanvitelli', Naples, Italy., Inserra E; Department of Neonatal Intensive Care, University of Campania 'Luigi Vanvitelli', Naples, Italy., Capozzi L; Department of Neonatal Intensive Care, Monaldi Hospital, Naples, Italy., Chello G; Department of Neonatal Intensive Care, Monaldi Hospital, Naples, Italy., Capristo C; Department of Neonatal Intensive Care, University of Campania 'Luigi Vanvitelli', Naples, Italy., Miraglia Del Giudice E; Department of Neonatal Intensive Care, University of Campania 'Luigi Vanvitelli', Naples, Italy., Iafusco D; Regional Centre for Pediatric Diabetes, Department of Pediatrics, University of Campania 'Luigi Vanvitelli', Naples, Italy.
المصدر: Pediatric research [Pediatr Res] 2020 Aug; Vol. 88 (2), pp. 218-224. Date of Electronic Publication: 2020 Mar 02.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Nature Publishing Group Country of Publication: United States NLM ID: 0100714 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1530-0447 (Electronic) Linking ISSN: 00313998 NLM ISO Abbreviation: Pediatr Res Subsets: MEDLINE
أسماء مطبوعة: Publication: 2012- : New York : Nature Publishing Group
Original Publication: Basel ; New York : Karger.
مواضيع طبية MeSH: Blood Glucose/*analysis , Blood Glucose Self-Monitoring/*methods , Brain Diseases/*metabolism , Hypothermia, Induced/*methods, Biosensing Techniques ; Child, Preschool ; Female ; Homeostasis ; Humans ; Hydrogen-Ion Concentration ; Hyperglycemia/metabolism ; Hypoglycemia/metabolism ; Hypoxia-Ischemia, Brain/therapy ; Infant ; Infant, Newborn ; Longitudinal Studies ; Male ; Prospective Studies ; Treatment Outcome
مستخلص: Background: The relation between glucose homeostasis and outcome in hypoxic-ischemic encephalopathy (HIE) is unclear. To investigate whether glucose abnormalities assessed by using continuous interstitial glucose monitoring (CGM) correlate with later neurological outcomes in HIE.
Methods: Prospective cohort study recruiting full-term neonates who received therapeutic hypothermia for HIE. CGM devices were placed soon after birth and recorded glucose profile for 3 days. The association between hypoglycemia (≤50 mg/dL), hyperglycemia (>144 mg/dL) and primary outcome defined as death or moderate or severe disability was examined with generalized estimating equations adjusted for Apgar scores, umbilical artery pH and base deficit. Neurodevelopmental outcome was assessed between 18 and 24 months.
Results: Fifty-four neonates had outcome data available for the analysis; 19 of them (35%) had adverse outcome. Longer duration of hypoglycemia (OR 7.1, 95% CI 1.8-20.3, P < 0.001) and hyperglycemia (OR 5.4, 95% CI 1.6-15.7, P < 0.001), a greater area under the hypoglycemic (OR 2.6, 95% CI 1.4-4.6, P = 0.04) and hyperglycemic (OR 6.4, 95% CI 1.9-16.3, P < 0.001) curve were significantly associated with adverse outcomes.
Conclusion: Both hyper and hypoglycemia may be associated with adverse outcome in neonates with HIE. Future studies are needed to assess their prognostic association with neurological outcome.
Impact: Glucose abnormalities during therapeutic hypothermia are associated with later neurological outcomes.Increased glucose variability correlates to the neurological outcome between 18 and 24 months.This study provides the first data on the continuous glucose profile in a group of HIE infants followed up to 2 years of age.Glucose homeostasis represents a key point in the management of HIE patients.Further research is needed to find the appropriate glycemic target in this population.
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المشرفين على المادة: 0 (Blood Glucose)
تواريخ الأحداث: Date Created: 20200303 Date Completed: 20210823 Latest Revision: 20210823
رمز التحديث: 20240628
DOI: 10.1038/s41390-020-0827-4
PMID: 32120381
قاعدة البيانات: MEDLINE
الوصف
تدمد:1530-0447
DOI:10.1038/s41390-020-0827-4