February 2017

Does dextrose gel prevent treatment failure in infants with neonatal hypoglycemia?

HYPOGLYCEMIA Neonatal hypoglycemia remains a challenging condition requiring admission to the NICU; significant improvements to intravenous dextrose treatment can be made. This randomized controlled trial assessed the efficacy of oral dextrose gel to treat neonatal hypoglycemia, obviating the need for NICU admisson and IV dextrose treatment. The study revealed that among breastfeeding infants at 35-42 weeks’ gestational age, oral dextrose gel safely reduced neonatal hypoglycemia and prevented NICU admissions. Thus, oral dextrose gel represents a potentially useful therapeutic option for neonatal hypoglycemia.

Admission hypo- and hyperthermia are associated with increased mortality and morbidity in very preterm infants

ADMISSION TEMPERATURE Both hypo- and hyperthermia have been associated with poor neonatal outcomes. This retrospective study assessed the relationship between admission temperature and outcome in extremely preterm infants (<33 weeks' gestation). The study revealed that hypo- and hyperthermia were very common among neonates being admitted, and that both were significantly associated with poor outcomes, indicating that continuous, accurate temperature monitoring during admission may be a useful predictive tool at the bedside.

Probiotics for prevention of suspected sepsis in low birthweight infants

SEPSIS Early- and late-onset sepsis are common among low birthweight infants. This randomized controlled trial assessed the effectiveness of probiotics to prevent sepsis, and identified a reduction in sepsis risk among infants 1500-1999 g; however, additional study is required before probiotics can be considered an effective preventative measure against sepsis.

Oxygen-Saturation Targets in Extremely Preterm Infants

OXYGEN SATURATION Significant difficulties exist in answering the essential question of ideal oxygen saturation targets in extremely preterm infants. This report describes the two-year findings of the BOOST-II Australia and BOOST-II UK randomized controlled trials targeting low- and high-range oxygen saturations, and confirms previous findings that although targeting lower oxygen saturation ranges does not increase risk of disability, rates of death are increased. Thus, although oxygen saturation targeting remains a complex and important issue, targeting high oxygen saturation ranges is recommended in extremely preterm infants.

Predictors for Referral-Warranted ROP

RETINOPATHY OF PREMATURITY Serial opthalmologic examination is considered necessary to prevent ROP in preterm neonates. This observational study assessed demographic, medical, and ocular factors predicting referral-warranted ROP among ELBW neonates. While several significant factors predicting RW-ROP were identified, additional studies are necessary to confirm these findings before modifying opthalmological surveillance practices in ELBW neonates.