Dokument: Neonatal hypoglycemia: lack of evidence for a safe management

Titel:Neonatal hypoglycemia: lack of evidence for a safe management
URL für Lesezeichen:https://docserv.uni-duesseldorf.de/servlets/DocumentServlet?id=67094
URN (NBN):urn:nbn:de:hbz:061-20241017-140630-8
Kollektion:Publikationen
Sprache:Englisch
Dokumententyp:Wissenschaftliche Texte » Artikel, Aufsatz
Medientyp:Text
Autoren: Roeper, Marcia [Autor]
Hoermann, Henrike [Autor]
Kummer, Sebastian [Autor]
Meißner, Thomas [Autor]
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Dateien vom 17.10.2024 / geändert 17.10.2024
Stichwörter:treatment guideline, at-risk neonates, brain damage, treatment threshold, neonatal hypoglycemia
Beschreibung:Neonatal hypoglycemia affects up to 15% of all newborns. Despite the high prevalence there is no uniform definition of neonatal hypoglycemia, and existing guidelines differ significantly in terms of when and whom to screen for hypoglycemia, and where to set interventional thresholds and treatment goals. In this review, we discuss the difficulties to define hypoglycemia in neonates. Existing knowledge on different strategies to approach this problem will be reviewed with a focus on long-term neurodevelopmental outcome studies and results of interventional trials. Furthermore, we compare existing guidelines on the screening and management of neonatal hypoglycemia. We summarize that evidence-based knowledge about whom to screen, how to screen, and how to manage neonatal hypoglycemia is limited – particularly regarding operational thresholds (single values at which to intervene) and treatment goals (what blood glucose to aim for) to reliably prevent neurodevelopmental sequelae. These research gaps need to be addressed in future studies, systematically comparing different management strategies to progressively optimize the balance between prevention of neurodevelopmental sequelae and the burden of diagnostic or therapeutic procedures. Unfortunately, such studies are exceptionally challenging because they require large numbers of participants to be followed for years, as mild but relevant neurological consequences may not become apparent until mid-childhood or even later. Until there is clear, reproducible evidence on what blood glucose levels may be tolerated without negative impact, the operational threshold needs to include some safety margin to prevent potential long-term neurocognitive impairment from outweighing the short-term burden of hypoglycemia prevention during neonatal period.
Rechtliche Vermerke:Originalveröffentlichung:
Röper, M., Hörmann, H., Kummer, S., & Meißner, T. (2023). Neonatal hypoglycemia: lack of evidence for a safe management [OnlineRessource]. Frontiers in Endocrinology, 14, Article 1179102. https://doi.org/10.3389/fendo.2023.1179102
Lizenz:Creative Commons Lizenzvertrag
Dieses Werk ist lizenziert unter einer Creative Commons Namensnennung 4.0 International Lizenz
Fachbereich / Einrichtung:Medizinische Fakultät
Dokument erstellt am:17.10.2024
Dateien geändert am:17.10.2024
english
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