Back to Search
Start Over
Continuous glucose monitoring profile during therapeutic hypothermia in encephalopathic infants with unfavorable outcome
- Source :
- Pediatric Research. 88:218-224
- Publication Year :
- 2020
- Publisher :
- Springer Science and Business Media LLC, 2020.
-
Abstract
- 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.
- Subjects :
- Blood Glucose
Male
medicine.medical_specialty
Encephalopathy
Longitudinal Studie
Biosensing Techniques
Hypoglycemia
Biosensing Technique
03 medical and health sciences
0302 clinical medicine
Hypothermia, Induced
030225 pediatrics
medicine.artery
Internal medicine
Homeostasi
medicine
Homeostasis
Humans
Glucose homeostasis
Longitudinal Studies
Prospective Studies
Prospective cohort study
Generalized estimating equation
Brain Diseases
Continuous glucose monitoring
business.industry
Blood Glucose Self-Monitoring
Brain Disease
Infant, Newborn
Infant
Umbilical artery
Hydrogen-Ion Concentration
Hypothermia
medicine.disease
Prospective Studie
Treatment Outcome
Child, Preschool
Hyperglycemia
Hypoxia-Ischemia, Brain
Pediatrics, Perinatology and Child Health
Female
medicine.symptom
business
030217 neurology & neurosurgery
Human
Subjects
Details
- ISSN :
- 15300447 and 00313998
- Volume :
- 88
- Database :
- OpenAIRE
- Journal :
- Pediatric Research
- Accession number :
- edsair.doi.dedup.....d07dec679b4863bd97a7ec0db5185e27