REDUCING NEONATAL ICU ADMISSIONS DUE TO HYPOGLYCEMIA THROUGH THE USE OF GLUCOSE GEL
M. Pearce MD¹, M. Connolly MD¹, A. Waldeck PharmD BCPS¹, S. Sridhar MD¹
¹Department of Pediatrics, Division of Neonatology. Stony Brook Children's,
Renaissance School of Medicine at Stony Brook University, Stony Brook, NY
Introduction: Hypoglycemia is a common problem in the immediate neonatal period with an incidence of 15-25% in late preterm/term infants. Severe/persistent hypoglycemia is associated with neurodevelopmental deficits while mild/transient hypoglycemia associated risks are less known. The definition and optimal management strategies continue to be debated. The AAP Committee on Fetus and Newborn provides guidelines for management at risk infants. Oral glucose gel offers the possibility to reduce NICU admissions and separation of the maternal-infant dyad. The study aim was to reduce NICU admissions for hypoglycemia by 25% using glucose gel.
Methods: EPOCH 1 of this study collected data on 36 to 42 week infants admitted to the NICU for hypoglycemia. A one-year pre and post intervention timeframe was studied.
Results: There were 75 and 51 infants in the pre and post intervention groups, comprising 10.8% and 7.3% of NICU admissions, respectively. There was no significant difference in risk factors (IDM, beta blocker exposure, gestational age, LGA, SGA). In the post intervention group more infants were breastfed [33% vs 19%, p 0.07], male [76% vs 60%, p 0.06] and SGA [27% vs 16%, p 0.13]. There was no difference in the duration of IV fluids [46.4 vs 46.9 hours] or NICU length of stay [138.8 vs 134.3 hours]
Conclusion: The use of glucose gel reduced NICU admissions by 33%. There was less maternal-infant separation and improved breastfeeding rates. Our study is continued in EPOCH 2 which compared the clinical effectiveness of glucose gel use in nearly 400 infants treated in labor and delivery & newborn nursery based on identified risk factors.
