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Stable glucose balance in premature infants with fluid restriction and early enteral feeding
Insights
Fluid restriction and early enteral feeding in premature infants effectively managed glucose homeostasis, reducing hyperglycemia risk. Both 5% and 10% intravenous glucose infusions were well-tolerated in this study.
Area of Science:
- Neonatalogy
- Pediatric Endocrinology
- Metabolic Research
Background:
- Premature infants often experience hyperglycemia during intravenous glucose administration.
- Maintaining glucose homeostasis is critical for the well-being of premature infants.
Purpose of the Study:
- To assess glucose homeostasis in premature infants receiving intravenous glucose and early enteral feeding.
- To compare the tolerance of 5% and 10% glucose infusions in this population.
Main Methods:
- 24 infants (27-34 weeks gestational age) were randomly assigned to receive either 5% or 10% glucose intravenously.
- Infants received increasing amounts of human milk from day one, with fluid intake restricted.
- High air humidity incubators were used to minimize insensible water loss.
Main Results:
- Fluid restriction and early enteral feeding reduced parenteral glucose administration and the risk of hyperglycemia.
- Glucose homeostasis was efficiently maintained in both treatment groups.
- Intravenous infusion of 5% and 10% glucose were equally well tolerated.
Conclusions:
- Fluid restriction combined with early enteral feeding is an effective strategy for managing glucose in premature infants.
- Both 5% and 10% intravenous glucose solutions are safe and well-tolerated for hydration in premature infants under these conditions.
Abstract:
Hyperglycemia readily develops during intravenous glucose administration in premature infants. In this study glucose homeostasis was measured in 24 infants appropriate-for-gestational age with a gestational age between 27 and 34 weeks and a birthweight between 1,150 and 2,610 g. The infants were randomly assigned to one of two treatment groups. Fluid intake consisted of intravenous infusion of 5% glucose in Group 1 and 10% glucose in Group 2, and increasing amounts of human milk from the first day of life. The infants were treated in incubators with high air humidity in order to minimize insensible water loss and total fluid intake was restricted. The fluid restriction and early enteral feeding decreased the total amount of glucose given parenterally and thereby the risk of hyperglycemia. Glucose homeostasis was efficiently maintained in both groups and under the conditions described hydration by intravenous infusion of 5% and 10% glucose appear equally well tolerated.