Hyperglycemia and glucosuria in preterm infants receiving parenteral glucose: influence of birth weight, gestational age and infusion rate

Abstract

OBJECTIVE: Morbidity and mortality of premature infants have decreased considerably over the last decades, therefore, adequate nutrition of the premature is a major concern. Enteral feeding is the route of choice, but when it is not possible the parenteral route, which contains glucose as one of its main components, is used. Glucose infusions are not devoid of risk as they facilitate the development of hyperglycemia leading to intracranial hemorrhage, glucosuria and dehydration. The aim of this paper is to relate hyperglycemia and glucosuria to birth weight, gestational age and glucose infusion rate.METHODS: The study was developed at the Nursery of Santa Catarina Hospital (São Paulo). The authors developed a prospective study; 511 concurrent determinations of glycemia and qualitative glucosuria were performed in 40 preterm newborn infants receiving parenteral glucose (mean of 12.8 dosages per newborn).RESULTS: Fifty-nine (11.5%) episodes of hyperglycemia were detected, and their frequency was higher at lower gestational ages (</=34 weeks), lower birth weights (< 1500g) and higher glucose infusion rates (>/= 6 mg/kg/min). Thirty-one (6.1%) episodes of glucosuria were detected, and were more frequent in lower gestational ages (</= 34 weeks), lower birth weights (< 1500g) and higher glucose infusion rates (>/= 6 mg/kg/min).CONCLUSIONS: The frequency of hyperglycemia and glucosuria in preterm newborn infants receiving glucose infusion was higher in lower gestational ages, lower birth weights and higher glucose infusion rates. In preterm newborn infants it is necessary to observe the glucose infusion rate and its respective glycemia, in order to avoid the complications of hyperglycemia.