This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (3)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Pathology & Laboratory Medicine  • Neonatology and Infant Care  • Hematology/ Hematologic Malignancies  • Alert me on articles by topic  Social Bookmarking   What's this?

Robin E. Miralles, MB, BCh, MRCPCH; Abhay Lodha, MD, DM; Max Perlman, MB, FRCPC; Aideen M. Moore, MD, FRCPC

Arch Pediatr Adolesc Med. 2002;156:999-1004.

Background  Based on limited anecdotal evidence, glucagon is used for the management of intractable neonatal hypoglycemia persisting in the face of high glucose administration rates.

Objective  To evaluate the short-term response of blood glucose levels to an intravenous infusion of glucagon.

Design  A retrospective observational study in which all newborns who received glucagon infusions (usual dose, 0.5-1 mg/d) during a 5-year period were identified (N = 55). The common causes of hypoglycemia were perinatal stress, intrauterine growth restriction, prematurity, and maternal diabetes mellitus. Laboratory blood glucose measurements made between 24 hours before and 72 hours after the start of the glucagon infusion and the rates of glucose administration during the same period were analyzed. The effects of glucagon on sodium and platelet levels were also examined.

Setting  University referral hospital.

Results  A statistically and clinically significant rise in blood glucose concentration, from a mean of 36.3 to 93.0 mg/dL (2.02-5.17 mmol/L), was observed within 4 hours of starting glucagon administration. The change was unrelated to the cause of the hypoglycemia. The frequency of hypoglycemic episodes was significantly reduced, and no further episodes of severe hypoglycemia (glucose level, <20 mg/dL [<1.1 mmol/L]) occurred. Five patients, 4 of whom were preterm newborns with intrauterine growth restriction, required additional glycemic treatment. Seventy-five percent of newborns were thrombocytopenic before starting glucagon infusion, and in 9 newborns platelet counts decreased following glucagon infusion. There was no hyponatremia attributable to glucagon.

Conclusion  Glucagon infusions appear to be beneficial for problematic neonatal hypoglycemia of different causes.

From the Division of Neonatology, Hospital for Sick Children and University of Toronto, Toronto, Ontario.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Occipital Lobe Injury and Cortical Visual Outcomes After Neonatal Hypoglycemia
Tam et al.
Pediatrics 2008;122:507-512.
ABSTRACT | FULL TEXT