title: Implementation of dextrose gel in the management of neonatal hypoglycaemia.
abstract: OBJECTIVE
  The aim of this study was to evaluate dextrose gel in the management of neonatal hypoglycaemia in the postnatal wards at an Australian tertiary level perinatal centre.
  
  
  METHODS
  An audit was performed before and after implementation of dextrose gel. Pre-implementation, neonatal hypoglycaemia was managed with feed supplementation alone, and dextrose gel was used in addition to feed supplementation in the post-implementation phase. Outcomes included admission to neonatal intensive care unit (NICU) for management of hypoglycaemia, proportion of neonates who achieved normoglycaemia (defined as blood glucose ≥2.6 mmol/L, with no clinical signs after one or two treatment attempts) and proportion of neonates with hypoglycaemia recurrence after normoglycaemia and one or two treatment attempts.
  
  
  RESULTS
  NICU admission for treatment of hypoglycaemia reduced significantly post-implementation of dextrose gel (29/100 (29%) vs. 14/100 (14%), P = 0.01). No significant difference was seen in the proportion of neonates achieving normoglycaemia (71/100 (71%) vs. 75/100 (75%), P = 0.52), but hypoglycaemia recurrence was higher in the post-implementation group (22/71 (31%) vs. 37/75 (49%), P = 0.02).
  
  
  CONCLUSIONS
  Dextrose gel is effective in the management of neonatal hypoglycaemia in the postnatal ward setting, reducing admission to NICU and mother-infant separation.
authors.affiliation: Department of Pharmacy, and, Royal Women's Hospital, Melbourne, Victoria, Australia.
authors.forename: Marene
authors.initials: M
authors.lastname: Ter
authors.affiliation: Neonatal Services, Royal Women's Hospital, Melbourne, Victoria, Australia.
authors.forename: Ikhwan
authors.initials: I
authors.lastname: Halibullah
authors.affiliation: Department of Pharmacy, and, Royal Women's Hospital, Melbourne, Victoria, Australia.
authors.forename: Laura
authors.initials: L
authors.lastname: Leung
authors.affiliation: Neonatal Services, Royal Women's Hospital, Melbourne, Victoria, Australia.|Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.|Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Susan
authors.initials: S
authors.lastname: Jacobs
mesh_terms: D001786:Blood Glucose / Q000032:analysis; D005260:Female; D005947:Glucose / Q000008:administration & dosage*; D006801:Humans; D007003:Hypoglycemia / Q000175:diagnosis / Q000188:drug therapy*; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases; D008297:Male; D008485:Medical Audit; D015997:Neonatal Screening; D017063:Outcome Assessment, Health Care
chemical_list: D001786:Blood Glucose; D005947:Glucose
keywords: glucose; guideline; hypoglycaemia; infant; newborn