title: Preventive management of hypoglycemia in very low-birthweight infants following indomethacin therapy for patent ductus arteriosus.
abstract: BACKGROUND
  To evaluate the effects of an increase in glucose infusion rate of 2 mg/kg per min from the basal infusion rate on the prevention of hypoglycemia in very low-birthweight (VLBW) infants, following indomethacin therapy for patent ductus arteriosus (PDA).
  
  
  METHODS
  Forty VLBW infants with PDA were given indomethacin 0.2 mg/kg intravenously up to three doses. In 15 of the 40 infants (supplemented group: between April 1995 and March 1996) the glucose infusion rate was increased in 2 mg/kg per min increments from the basal rate just before the initial indomethacin administration, compared with 25 historical control infants who received a fixed glucose infusion rate during the first 12 h after the initial dose. We evaluated the changes in blood glucose levels and glucose infusion rates in both groups.
  
  
  RESULTS
  In the control group 11 of 25 (44%) infants had a blood glucose value below 40 mg/dL between 12 and 60 h (mean 32.7 h). In contrast only two out of 15 infants in the supplemented group reached the glucose level below 40 mg/dL between 72 and 96 h but both two were light-for-dates infants (defined as birthweight below the 10th percentile for gestational age on the standard intrauterine growth curve). Blood glucose values in the supplemented group were significantly higher than those in the control group between 12 and 96 h. However, glucose infusion rates were similar before and between 72 and 96 h.
  
  
  CONCLUSIONS
  This retrospective study shows that an increase in glucose infusion rate of 2 mg/kg per min, in addition to the pre-existing stable maintenance glucose intake, might prevent against the occurrence of unexpected hypoglycemia in VLBW infants following indomethacin therapy.
authors.affiliation: Division of Neonatology, Saitama Children's Medical Center, Saitama, Japan. hosonos@med.nihon-u.ac.jp
authors.forename: S
authors.initials: S
authors.lastname: Hosono
authors.forename: T
authors.initials: T
authors.lastname: Ohono
authors.forename: H
authors.initials: H
authors.lastname: Kimoto
authors.forename: R
authors.initials: R
authors.lastname: Nagoshi
authors.forename: M
authors.initials: M
authors.lastname: Shimizu
authors.forename: M
authors.initials: M
authors.lastname: Nozawa
mesh_terms: D001786:Blood Glucose; D004374:Ductus Arteriosus, Patent / Q000188:drug therapy*; D005260:Female; D005865:Gestational Age; D005947:Glucose / Q000008:administration & dosage* / Q000627:therapeutic use; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced / Q000517:prevention & control*; D007213:Indomethacin / Q000009:adverse effects* / Q000627:therapeutic use; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight / Q000378:metabolism; D007262:Infusions, Intravenous; D008297:Male; D011247:Pregnancy; D012189:Retrospective Studies
chemical_list: D001786:Blood Glucose; D005947:Glucose; D007213:Indomethacin