title: Hyperglycemia is associated with poor outcome in newborn infants undergoing therapeutic hypothermia for hypoxic ischemic encephalopathy.
abstract: BACKGROUND
  Therapeutic hypothermia (TH) improves survival and neurodevelopmental outcome in neonatal hypoxic ischemic encephalopathy (HIE). Both, hypoglycemia and hyperglycemia are common in infants with HIE. The relationship between hypoglycemia and hyperglycemia, and immediate outcome has not been well described.
  
  
  METHODS
  A retrospective analysis of newborn infants with HIE (N = 56) was conducted. Blood glucose concentrations recorded during the first 96 hours were noted. Glucose levels of infants who underwent TH (TH group, N = 20) were compared with those that did not undergo TH (No-TH group, N = 36). The relationship between blood glucose and mortality and/or moderate/severe disability was determined.
  
  
  RESULTS
  Mean ± SD blood glucose concentration during the first 24 hours of age was significantly higher in the TH group (148 ± 65 mg/dl), compared with the No-TH group (113 ± 50 mg/dl; p = 0.02), despite a lower glucose infusion rate in the former (4.05 ± 1.77 mg/kg/hr vs. 5.36 ± 2.51 mg/kg/hr; p = 0.04). One hundred percent of infants (n = 9) in the TH group with blood glucose levels >200 mg/dl during the first 24 hours of age died or had moderate/severe disability, compared with 54.5% of those with blood glucose <200 mg/dl in this group (p = 0.03). A similar effect was not present in the No-TH group.
  
  
  CONCLUSIONS
  Hyperglycemia on the first day portends poor outcome in newborn infants undergoing TH for HIE.
authors.affiliation: Division of Neonatal Perinatal Medicine, Department of Pediatrics, Wayne State University, Detroit, MI, USA.
authors.forename: Nitin S
authors.initials: NS
authors.lastname: Chouthai
authors.affiliation: Division of Neonatal Perinatal Medicine, Department of Pediatrics, Wayne State University, Detroit, MI, USA.
authors.forename: Holly
authors.initials: H
authors.lastname: Sobczak
authors.affiliation: Division of Neonatal Perinatal Medicine, Department of Pediatrics, Wayne State University, Detroit, MI, USA.
authors.forename: Reshma
authors.initials: R
authors.lastname: Khan
authors.affiliation: Division of Neonatal Perinatal Medicine, Department of Pediatrics, Wayne State University, Detroit, MI, USA.
authors.forename: Divya
authors.initials: D
authors.lastname: Subramanian
authors.affiliation: Division of Neonatal Perinatal Medicine, Department of Pediatrics, Wayne State University, Detroit, MI, USA.
authors.forename: Sim
authors.initials: S
authors.lastname: Raman
authors.affiliation: Division of Neonatology, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA.
authors.forename: Raghavendra
authors.initials: R
authors.lastname: Rao
mesh_terms: D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism*; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000097:blood* / Q000150:complications / Q000503:physiopathology; D007036:Hypothermia, Induced / Q000379:methods*; D020925:Hypoxia-Ischemia, Brain / Q000097:blood / Q000150:complications / Q000503:physiopathology*; D007231:Infant, Newborn; D008297:Male; D065886:Neurodevelopmental Disorders / Q000097:blood / Q000209:etiology / Q000503:physiopathology*; D011379:Prognosis; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D001786:Blood Glucose
keywords: Hypoxic ischemic encephalopathy; hyperglycemia; therapeutic hypothermia