METABOLIC DISORDERS:
HYPOGLYCEMIA:
defined as blood glucose level
<1.4mmol/L(25mg/dl) in the first 24 hours
of life
and< 2mmol/L(40mg/dl) thereafter.
90% of glucose is consumed by the
brain.
Blood
glucose
is maintained by:
1. Adequate fetal glycogen stores.
2. Effective glycogenolysis & gluconeogenesis.
3. Good intake.
CLINICAL FEATURES:
Tachycardia, lethargy, poor feeding, apnea,
cyanosis, seizure. -Some are
asymptomatic & treated by early feeding.
CAUSES OF HYPOGLYCEMIA:
1. I.U.G.R.
2. Prematurity.
3. Birth asphyxia.
4. Neonatal sepsis.
5. Delayed or poor feeding.
6. IDM(infant of diabetic mother).
TREATMENT OF HYPOGLYCEMIA:
10%Dextrose i.v.as 4ml/kg stat then
8mg/kg/min.is given if blood glucose is
<25mg/dl. If blood glucose
remains low for more than 7days
(persistent hypoglycemia): increase the dose
of dextrose to 16-20mg/kg/min.& investigate
for causes e.g.hyperinsulinism & inborn error of
metabolism.