44 Management of Neonatal Hypoglycemia using Dextrose 40% Oral Gel in Term and Late Preterm Neonates
Bibliographic record
Abstract
Abstract Introduction/Background Oral dextrose gel has been shown to be an effective first-line treatment for neonatal hypoglycemia (NH) in full term and late preterm neonates in New Zealand (Harris et al., 2013). The use of dextrose gel in NH has not been evaluated in a Canadian setting. Dextrose gel preparations in Canada are not designed for neonates, and significant variations in dextrose concentration have been reported (Solimano et al., 2019). In October 2018, we instituted a new clinical guideline for the use of dextrose gel to treat NH. Objectives Primary Objective: To determine if the use of dextrose gel is effective in treating infants with NH, and if it leads to higher rates of breastfeeding and lower rates of formula supplementation at discharge. Secondary Objective: To determine if the use of dextrose gel leads to a decrease in NICU admissions due to NH. Design/Methods We performed a retrospective cohort study of all neonates treated for hypoglycemia during a six month period before and after implementation of a clinical guideline involving dextrose gel (January 1 – June 30, 2018 and 2019). Equivalent timeframes were used with a two month washout period during guideline implementation. Results A total of 269 neonates were treated for hypoglycemia - 109 in the formula group and 160 in the dextrose group. The two study cohorts shared similar baseline characteristics. The timing and severity of the first episode of hypoglycemia were similar in both groups, but the median blood glucose following treatment was higher in the formula group (median 3.3 mmol/L, p<0.05). The proportion of neonates who experienced a second episode of hypoglycemia and the rate of NICU admission for IV dextrose appeared to be higher in the dextrose group, although the differences were not statistically significant. There was no statistical difference in the average volume of formula used per feed at discharge, the rates of exclusive breastfeeding at discharge, or the average quality of breastfeeding as measured by the LATCH score. Conclusion This is the first study evaluating dextrose gel in the management of NH in Canada, and it did not identify any significant advantage over formula-based treatment, with some parameters demonstrating an inferior response. With the latest Canadian Paediatric Society hypoglycemia guidelines recommending the routine use of dextrose gel, further studies are urgently needed to evaluate the efficacy of Canadian preparations, and advocacy is needed at a national level to create a paediatric-specific formulation.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".