Contemporary research is elucidating both the molecular mechanisms of hypoglycemiainduced neuronal injury and its corresponding clinical manifestations. Recognizing and screening those neonates at highest risk of hypoglycemia-induced injury is an important skill for all physicians responsible for the care of newborns. Appropriate therapy, consisting of either oral or intravenous glucose, should never be delayed while one is awaiting laboratory confirmation of a “low” glucose level.
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References
1.
1. Halamek LP, Benaron DA, Stevenson DK. The value of neurophysiologic approaches in the anticipation and evaluation of neonatal hypoglycemia. Acta Paediatrica Japonica. 1997;39 (Suppl. 1):33-43.
2.
2. Hawdon JM, Ward Platt MP, Aynsley-Green A. Patterns of metabolic adaptation for preterm and term infants in the first neonatal week. Arch Dis Child. 1992;67:357-365.
3.
3. Banker BQ. The neuropathological effects of anoxia and hypoglycemia in the newborn. Develop Med Child Neurol. 1967;9:544-550.
7. Rothman SM, Olney JW. Excitotoxicity and the NMDA receptor. Trends Neurosci. 1987;10:299-302.
8.
8. Kemp JA, Foster AC, Wong EHF. Noncompetitive antagonists of excitatory amino acid receptors. Trends Neurosci. 1987;10:294-298.
9.
9. McGowan JE, Haynes-Laing AG, Mishra OP, Delivoria-Papadopoulos M. The effect of acute hypoglycemia on the cerebral NMDA receptor in newborn piglets. Brain Res. 1995; 670:283-288.
10.
10. Pryds O, Greisen G, Friis-Hansen B. Compensatory increase of CBF in preterm infants during hypoglycaemia. Acta Paediatr Scand. 1988; 77:632-637.
11.
11. Creery RDG. Hypoglycemia in the newborn: diagnosis, treatment and prognosis. Develop Med Child Neurol. 1966;8:746-754.
12.
12. Koivisto M, Blanco-Sequeiros M, Krause U. Neonatal symptomatic and asymptomatic hypoglycemia: a follow-up study of 151 children. Develop Med Child Neurol. 1972;14:603-614.
13.
13. Fluge G. Neurological findings at follow-up in neonatal hypoglycemia. Acta Paediatr Scand. 1975;64:629-634.
14.
14. Griffiths AD, Bryant GM. Assessment of effects of neonatal hypoglycemia. Arch Dis Child. 1971;46:819-827.
15.
15. Pildes RS, Cornblath M, Warren I, et al. A prospective controlled study of neonatal hypoglycemia. Pediatrics. 1974;54:5-14.
16.
16. Lucas A, Morley R, Cole TJ. Adverse neurodevelopmental outcome of moderate neonatal hypoglycaemia. Br Med J1988;297:1304-1308.
17.
17. Koh THHG, Aynsley-Green A, Tarbit M, Eyre JA. Neural dysfunction during hypoglycaemia. Arch Dis Child. 1988; 63:1353-1358.
18.
18. Jones TW, McCarthy G, Tamborlane WV, et al. Mild hypoglycemia and impairment of brain stem and cortical evoked potentials in healthy subjects. Diabetes. 1990;39:1550-1555.
19.
19. Holtrop PC. The frequency of hypoglycemia in full-term large and small for gestational age newborns. Am J Perinatol. 1993;10:150-154.
20.
20. Committee on the Fetus and Newborn. Routine evaluation of blood pressure, hematocrit, and glucose in newborns. Pediatrics. 1993;92:474-476.
21.
21. Cohen RS, Stevenson DK. Hypoglycemia and brain injury. In: Stevenson DK, Sunshine P, eds. Fetal and Neonatal Brain Injury: Mechanisms, Management, and the Risks of Practice, 1st ed.Philadelphia: BC Decker, Inc; 1987: 141-146.
22.
22. Cornblath M, Schwartz R. Hypoglycemia in the neonate. In: Stevenson DK, Sunshine P, eds. Fetal and Neonatal Brain Injury: Mechanisms, Management, and the Risks of Practice, 2nd ed.New York: Oxford University Press; 1996.
23.
23. De Feo P, Gallai V, Mazzotta G, et al. Modest decrements in plasma glucose concentration cause early impairment in cognitive function and later activation of glucose counterregulation in the absence of hypoglycemic symptoms in normal man. J Clin Invest. 1988;82:436-444.
24.
24. Ogata ES. Carbohydrate metabolism in the fetus and neonate and altered neonatal glucoregulation. Pediatr Clin North Am. 1986;33:25-45.
25.
25. Marconi AM, Paolini C, Cetin I, et al. The impact of gestational age and of intrauterine growth upon maternalfetal glucose concentration differences determined at cordocentesis. Pediatr Res. 1995;37:1319A-1319A.
26.
26. Chameides L, Hazinski F, eds. Textbook of Pediatric Advanced Life Support, 2nd ed.Dallas, TX: American Heart Association, 1994.
27.
27. Lilien LD, Pildes RS, Srinivasan G, et al. Treatment of neonatal hypoglycemia with minibolus and intravenous glucose infusion. J Pediatr. 1980;97:295-298.
28.
28. Schwartz SS, Rich BH, Lucky AW, et al. Familial nesidioblastosis: severe neonatal hypoglycemia in two families. J Pediatr. 1979;95:44-53.
29.
29. Gregory JW, Aynsley-Green A. The definition of hypoglycaemia. Bailliere's Clin Endocrinol Metab. 1993;7:587-590.