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Hyperglycemia in Extremely Preterm Infants Insulin Treatment, Mortality and Nutrient Intakes

Zamir, Itay (författare)
Umeå University,Umeå universitet,Pediatrik,Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden. Electronic address itay.zamir@umu.se,Umea Univ, Dept Clin Sci, Pediat, SE-90187 Umea, Sweden
Tornevi, Andreas (författare)
Umeå University,Umeå universitet,Yrkes- och miljömedicin,Department of Public Health and Clinical Medicine, Division of Occupational and Environmental Medicine, Umeå University, Umeå, Sweden,Umea Univ, Div Occupat & Environm Med, Dept Publ Hlth & Clin Med, Umea, Sweden
Abrahamsson, Thomas, 1968- (författare)
Linköping University,Linköpings universitet,Avdelningen för barns och kvinnors hälsa,Medicinska fakulteten,Region Östergötland, H.K.H. Kronprinsessan Victorias barn- och ungdomssjukhus,Linkoping Univ, Div Pediat, Dept Clin & Expt Med, Linkoping, Sweden
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Ahlsson, Fredrik, 1967- (författare)
Uppsala University,Uppsala universitet,Perinatal, neonatal och barnkardiologisk forskning
Engström, Eva (författare)
Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för pediatrik,Institute of Clinical Sciences, Department of Pediatrics,Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden,Univ Gothenburg, Sahlgrenska Acad, Inst Clin Sci, Dept Pediat, Gothenburg, Sweden
Hallberg, B. (författare)
Karolinska Institutet
Hansen-Pupp, Ingrid (författare)
Lund University,Lunds universitet,Pediatrik, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Paediatrics (Lund),Section V,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital
Stoltz Sjöström, Elisabeth (författare)
Umeå University,Umeå universitet,Institutionen för kostvetenskap,Department of Food and Nutrition, Umeå University, Umeå, Sweden,Umea Univ, Dept Food & Nutr, Umea, Sweden
Domellöf, Magnus (författare)
Umeå University,Umeå universitet,Pediatrik,Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden,Umea Univ, Dept Clin Sci, Pediat, SE-90187 Umea, Sweden
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 (creator_code:org_t)
Elsevier BV, 2018
2018
Engelska.
Ingår i: Journal of Pediatrics. - : Elsevier BV. - 0022-3476 .- 1097-6833. ; 200
  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
Stäng  
  • Objective To explore the prevalence of hyperglycemia and the associations between nutritional intakes, hyperglycemia, insulin treatment, and mortality in extremely preterm infants. Study design Prospectively collected data from the Extremely Preterm Infants in Sweden Study (EXPRESS) was used in this study and included 580 infants born <27 gestational weeks during 2004-2007. Available glucose measurements (n = 9850) as well as insulin treatment and nutritional data were obtained retrospectively from hospital records for the first 28 postnatal days as well as 28- and 70-day mortality data. Results Daily prevalence of hyperglycemia >180 mg/dL (10 mmol/L) of up to 30% was observed during the first 2 postnatal weeks, followed by a slow decrease in its occurrence thereafter. Generalized additive model analysis showed that increasing parenteral carbohydrate supply with 1 g/kg/day was associated with a 1.6% increase in glucose concentration (P < .001). Hyperglycemia was associated with more than double the 28-day mortality risk (P< .01). In a logistic regression model, insulin treatment was associated with lower 28- and 70-day mortality when given to infants with hyperglycemia irrespective of the duration of the hyperglycemic episode (P< .05). Conclusions Hyperglycemia is common in extremely preterm infants throughout the first postnatal month. Glucose infusions seem to have only a minimal impact on glucose concentrations. In the EXPRESS cohort, insulin treatment was associated with lower mortality in infants with hyperglycemia. Current practices of hyperglycemia treatment in extremely preterm infants should be reevaluated and assessed in randomized controlled clinical trials.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Endokrinologi och diabetes (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Endocrinology and Diabetes (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Pediatrik (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Pediatrics (hsv//eng)

Nyckelord

neonatal hyperglycemia
risk-factor
growth
death
retinopathy
management
Pediatrics
neonatology
Pediatrics
neonatology
nutrition

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