TY - JOUR
T1 - High glucose variability is associated with poor neurodevelopmental outcomes in neonatal hypoxic ischemic encephalopathy
AU - Al Shafouri, N.
AU - Narvey, M.
AU - Srinivasan, G.
AU - Vallance, J.
AU - Hansen, G.
N1 - Publisher Copyright:
© 2015 IOS Press and the authors. All rights reserved.
PY - 2015/7/31
Y1 - 2015/7/31
N2 - BACKGROUND: In neonatal hypoxic ischemic encephalopathy (HIE), hypo-and hyperglycemia have been associated with poor outcomes. However, glucose variability has not been reported in this population. OBJECTIVE: To examine the association between serum glucose variability within the first 24 hours and two-year neurodevelopmental outcomes in neonates cooled for HIE. STUDY DESIGN: In this retrospective cohort study, glucose, clinical and demographic data were documented from 23 term newborns treated with whole body therapeutic hypothermia. Severe neurodevelopmental outcomes from planned two-year assessments were defined as the presence of any one of the following: Gross Motor Function Classification System levels 3 to 5, Bayley III Motor Standard Score <70, Bayley III Language Score <70 and Bayley III Cognitive Standard Score <70. RESULTS: The neurodevelopmental outcomes from 8 of 23 patients were considered severe, and this group demonstrated a significant increase of mean absolute glucose (MAG) change (-0.28 to-0.03, 95% CI, p = 0.032). There were no significant differences between outcome groups with regards to number of patients with hyperglycemic means, one or multiple hypo-or hyperglycemic measurement(s). There were also no differences between both groups with mean glucose, although mean glucose standard deviation was approaching significance. CONCLUSIONS: Poor neurodevelopmental outcomes in whole body cooled HIE neonates are significantly associated with MAG changes. This information may be relevant for prognostication and potential management strategies.
AB - BACKGROUND: In neonatal hypoxic ischemic encephalopathy (HIE), hypo-and hyperglycemia have been associated with poor outcomes. However, glucose variability has not been reported in this population. OBJECTIVE: To examine the association between serum glucose variability within the first 24 hours and two-year neurodevelopmental outcomes in neonates cooled for HIE. STUDY DESIGN: In this retrospective cohort study, glucose, clinical and demographic data were documented from 23 term newborns treated with whole body therapeutic hypothermia. Severe neurodevelopmental outcomes from planned two-year assessments were defined as the presence of any one of the following: Gross Motor Function Classification System levels 3 to 5, Bayley III Motor Standard Score <70, Bayley III Language Score <70 and Bayley III Cognitive Standard Score <70. RESULTS: The neurodevelopmental outcomes from 8 of 23 patients were considered severe, and this group demonstrated a significant increase of mean absolute glucose (MAG) change (-0.28 to-0.03, 95% CI, p = 0.032). There were no significant differences between outcome groups with regards to number of patients with hyperglycemic means, one or multiple hypo-or hyperglycemic measurement(s). There were also no differences between both groups with mean glucose, although mean glucose standard deviation was approaching significance. CONCLUSIONS: Poor neurodevelopmental outcomes in whole body cooled HIE neonates are significantly associated with MAG changes. This information may be relevant for prognostication and potential management strategies.
KW - Neonatal
KW - glucose
KW - hypothermia
KW - hypoxic ischemic encephalopathy
KW - treatment outcomes
UR - http://www.scopus.com/inward/record.url?scp=84938864575&partnerID=8YFLogxK
U2 - 10.3233/NPM-15814107
DO - 10.3233/NPM-15814107
M3 - Journal Article
C2 - 26410435
AN - SCOPUS:84938864575
SN - 1934-5798
VL - 8
SP - 119
EP - 124
JO - Journal of Neonatal-Perinatal Medicine
JF - Journal of Neonatal-Perinatal Medicine
IS - 2
ER -