1379 RATES AND ASSOCIATED RISK FACTORS FOR DLOW INDUCED HYPERGLYCEMIA (HG) IN NEONATES

Abstract

We have identified rates and associated risk factors for D10W-induced HG among 636 newborns exposed to IV D10W in 2 neonatal ICU's monitored by an intensive Pediatric Drug Surveillance (PeDS) Program. DIOW-induced HG (range 110-774 mg %) was observed in 23 exposed infants (3.6%). There was a highly significant trend (X2=52.5) toward an increasing risk of HG with decreasing admission weight:Infants ≥ 1000 gm who were under stress (ie., asphyxia, sepsis, RDS and/or pneumonia) were 7 times more likely to have HG than non-stressed infants of similar weight (2.7% vs 0.4% respectively); however, stress did not appear to increase the risk of HG among infants ≥ 1000 gm. Similarly, among infants ≥ 1000 gm, increases in the average daily dextrose dose/kg of all dextrose-containing infusions increased the risk of HG, but this effect was not observed among the smaller (< 1000 gm) infants. Since HG may alter fluid balance and cerebral blood flow, it may also affect the risk of CNS bleeding or infarct. Admission weight and stress are risk factors for HG which cannot be altered; to reduce the risk of HG in very low birth weight infants or in larger infants who are under stress, physicians should carefully consider the total amount of dextrose administered (independent of fluids and electrolytes) and carefully monitor the neonate's blood glucose.