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Admission High Anion Gap is Associated with Increased Odds of Hospitalization in Obstetric Patients Presenting with 1 st Trimester Bleeding to ED
Author(s) -
ED,
Garima,
KP Gatman,
JA Dawson,
DA Blank,
Kamlin,
COF,
BJ Manley
Publication year - 2018
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1111/jpc.13882_199
Subject(s) - medicine , odds , second trimester , odds ratio , first trimester , pregnancy , obstetrics , pediatrics , gestation , logistic regression , biology , genetics
Background: There is currently no international consensus on the optimal management of neonatal hyperglycaemia in premature neonates. The aim of this study was to identify areas of variability in the clinical management of neonatal hyperglycaemia in neonatal intensive care units (NICUs) in Australia and New Zealand. Methods: Treatment protocols for tertiary NICUs in Australia and New Zealand were retrieved and analysed. Protocols were compared and contrasted. Results: Treatment protocols for 25 out of 29 Australasian NICUs were available for analysis. In 52% of protocols, treatment was indicated when a random blood glucose level (BGL) was above 10 – 15 mmol/L. The first-line treatment option was intravenous infusion of insulin in 52% of NICUs, whereas 36% recommended a reduction in glucose-containing infusions. An insulin dose range of 0.01 – 0.1 units/kg/hour was recommended in 64% of protocols. Only 24% of protocols reported a method for insulin dose titration and 60% of protocols reported a BGL monitoring frequency. Conclusions: Most NICUs have protocols for how to manage neonatal hyperglycaemia, but the level of detail is variable. This analysis shows considerable differences in clinical practice which likely reflect the lack of published consensus on the optimal management of this condition.