Glucose instability and outcomes of neonates with hypoxic ischemic encephalopathy undergoing therapeutic hypothermia

IF 1.4 4区医学 Q4 CLINICAL NEUROLOGY

Brain & Development Pub Date : 2024-05-22 DOI:10.1016/j.braindev.2024.05.003

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引用次数: 0

Abstract

Background

To investigate the prevalence and associated outcomes of glucose abnormalities in infants with hypoxic ischemic encephalopathy (HIE) undergoing therapeutic hypothermia (TH).

Methods

Glucose values were reviewed in all HIE infants. Pearson’s correlation was used to assess the association of hypo- and hyperglycemic episodes with neonatal brain MRI and neurodevelopmental outcomes (NDO) at 12 & 24 months.

Results

Of 153 infants included, 31, 56 and 43 had episodes of hypo-, hyperglycemia and combined, respectively. Hyperglycemia and combined hypo/hyper had higher mortality (p = 0.035), seizures (p = 0.009), and longer hospitalization (p = 0.023). Hypo- and hyperglycemia were associated with parenchymal hemorrhages (p = 0.028 & p = 0.027, respectively). Hypoglycemia was associated with restricted diffusion (p = 0.014), while hyperglycemia was associated with cortical injuries (p = 0.045). Each hour of hyper- or hypoglycemia was associated with 5.2–5.8 times unfavorable outcomes (p < 0.001).

Conclusion

Blood glucose aberrations were detrimental in HIE infants treated with TH. Optimizing glucose management is crucial in this setting.

查看原文本刊更多论文

接受治疗性低温的缺氧缺血性脑病新生儿的血糖不稳定性和预后。

背景：研究接受治疗性低温（TH）的缺氧缺血性脑病（HIE）婴儿血糖异常的发生率和相关结果：研究接受治疗性低温（TH）的缺氧缺血性脑病（HIE）婴儿血糖异常的发生率和相关结果：方法：对所有 HIE 婴儿的血糖值进行复查。方法：对所有 HIE 婴儿的血糖值进行复查，采用皮尔逊相关性评估低血糖和高血糖发作与新生儿脑磁共振成像及 12 个月和 24 个月的神经发育结果（NDO）之间的关联：在纳入的 153 名婴儿中，分别有 31、56 和 43 名婴儿出现低血糖、高血糖和合并低血糖。高血糖和合并低血糖/高血糖的婴儿死亡率较高（p = 0.035），癫痫发作率较高（p = 0.009），住院时间较长（p = 0.023）。低血糖和高血糖与脑实质出血有关（分别为 p = 0.028 和 p = 0.027）。低血糖与扩散受限有关（p = 0.014），而高血糖与皮质损伤有关（p = 0.045）。每一个小时的高血糖或低血糖都会导致5.2-5.8倍的不良后果（p 结论：血糖畸变对人体有害：血糖异常对接受 TH 治疗的 HIE 婴儿不利。在这种情况下，优化血糖管理至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Brain & Development 医学-临床神经学

CiteScore

3.60

自引率

0.00%

发文量

153

审稿时长

50 days

期刊介绍： Brain and Development (ISSN 0387-7604) is the Official Journal of the Japanese Society of Child Neurology, and is aimed to promote clinical child neurology and developmental neuroscience. The journal is devoted to publishing Review Articles, Full Length Original Papers, Case Reports and Letters to the Editor in the field of Child Neurology and related sciences. Proceedings of meetings, and professional announcements will be published at the Editor''s discretion. Letters concerning articles published in Brain and Development and other relevant issues are also welcome.