Category Archives: Metabolic

Tip 56: hyperglycaemia in prematurity

Hyperglycaemia has been estimated to occur in 45% to 80% of premature infants. The underlying mechanisms causing hyperglycaemia are multifactorial and may be the result of high glucose concentrations in the infusion fluids or low glucose uptake rate. Other causes … Continue reading

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Tip 21b: maternal diabetes

The rates of all of the following are significantly higher in women with diabetes or their babies compared to matched controls: Preterm birth (31% vs. 10%) Macrosomia (41% vs. 16%) Hypoglycaemia (14% vs. 1%) Jaundice (46% vs. 23%) Respiratory distress (12% vs. 1%). … Continue reading

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Tip 16: metabolic bone disease of prematurity

Premature babies are at risk of osteopenia due to lack of minerals normally accumulated in the last trimester. This increases the risk of fractures in the short-term and short stature in the long-term. All enterally fed very preterm babies should … Continue reading

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Tip 11: congenital adrenal hyperplasia

Incidence is 1:18,000 (girls=boys) ~90% have 21-hydroxylase deficiency ~50% present as a neonate (girls mainly with virilised genitalia, boys mainly with salt-wasting crisis) External links: Khalid, JM., et al. Incidence and clinical features of congenital adrenal hyperplasia in Great Britain. Arch … Continue reading

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Tip 8: jaundice

According to the NICE guidelines: ~60% of term and 80% of preterm babies develop jaundice in the first week of life ~10% of breastfed babies are still jaundiced at 1 month of age Reference: NICE. Jaundice in newborn babies under … Continue reading

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Tip 249: hypoglycaemia 4

Ward based blood gas analysers should be used to guide the management of neonatal hypoglycaemia, as most handheld glucometers are not sufficiently accurate in the range of 0 – 2.0 mmol/l. Reference: British Association of Perinatal Medicine. (2017). Identification and … Continue reading

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Tip 243: neonatal hypoglycaemia 3

The definition of neonatal hypoglycaemia is capillary plasma glucose <2.6 mmol/L. The threshold for invasive treatment (nasogastric feeds or IV Dextrose) is glucose <2.0 mmol/L on two consecutive readings despite maximal support for feeding, or if the baby is not … Continue reading

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