三比二好：葡萄糖凝胶治疗高危新生儿低血糖的剂量相关疗效，质量改进倡议。

IF 2.4 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Journal of Perinatology Pub Date : 2025-04-12 DOI:10.1038/s41372-025-02298-x

Melanie Gao, Jenny Jin, Jillian Schon, Erin Kelly, Snezana Nena Osorio, Rae-Jean Hemway, Abie Iyare, Jeffrey Perlman, Priyanka Tiwari

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引用次数: 0

摘要

目的：采用质量改进（QI）框架，我们旨在使用葡萄糖凝胶（DG）减少20%的新生儿低血糖入院率和10%的静脉注射葡萄糖液体需求。方法：这是一项前瞻性QI研究，使用改进模型和计划顺序实验，通过三个计划-执行-研究-行动（PDSA）周期：途径创建，EMR实施和剂量增加。数据分析采用Shewhart p图和卡方检验。结果：我们的干预措施使接受DG治疗的低血糖高危婴儿比例从67%增加到98%。实施三剂量的DG引起了特殊原因的变化，将新生儿低血糖入院率从3.7%降低到2.0%，静脉注射葡萄糖液率从2.7%降低到1.7%（分别降低46%和37%）。结论：给高危新生儿低血糖患者服用三剂量葡萄糖凝胶可减少额外干预的需要，提示葡萄糖凝胶在减轻新生儿低血糖后果方面具有剂量相关的功效。

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Three is Better Than Two: Dose-related Efficacy of Dextrose Gel for Neonatal Hypoglycemia in At-Risk Infants, a Quality Improvement Initiative.

Objective: Using a quality improvement (QI) framework, we aimed to use dextrose gel (DG) to reduce admissions for neonatal hypoglycemia by 20% and IV dextrose fluid needs by 10% in at-risk infants.

Methods: This is a prospective QI study using the Model for Improvement and planned sequential experimentation through three Plan-Do-Study-Act (PDSA) cycles: pathway creation, EMR implementation, and dose increase. Data were analyzed using Shewhart P-charts and chi-square tests.

Results: Our interventions increased the percentage of at-risk infants with hypoglycemia who received DG from 67% to 98%. Implementing three doses of DG caused a special cause variation, reducing neonatal hypoglycemia admissions from 3.7% to 2.0% and IV dextrose fluid rates from 2.7% to 1.7% (46% and 37% reduction, respectively).

Conclusion: Three doses of dextrose gel administered to at-risk infants with neonatal hypoglycemia reduced the need for additional intervention, suggesting the dose-related efficacy of dextrose gel in mitigating the consequences of neonatal hypoglycemia.

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来源期刊

Journal of Perinatology 医学-妇产科学

CiteScore

5.40

自引率

6.90%

发文量

284

审稿时长

3-8 weeks

期刊介绍： The Journal of Perinatology provides members of the perinatal/neonatal healthcare team with original information pertinent to improving maternal/fetal and neonatal care. We publish peer-reviewed clinical research articles, state-of-the art reviews, comments, quality improvement reports, and letters to the editor. Articles published in the Journal of Perinatology embrace the full scope of the specialty, including clinical, professional, political, administrative and educational aspects. The Journal also explores legal and ethical issues, neonatal technology and product development. The Journal’s audience includes all those that participate in perinatal/neonatal care, including, but not limited to neonatologists, perinatologists, perinatal epidemiologists, pediatricians and pediatric subspecialists, surgeons, neonatal and perinatal nurses, respiratory therapists, pharmacists, social workers, dieticians, speech and hearing experts, other allied health professionals, as well as subspecialists who participate in patient care including radiologists, laboratory medicine and pathologists.