Persistent hyperglycemia in a neonate: Is it a complication of therapeutic hypothermia?

Abstract

The aim of this report is to present a newborn with persistent hyperglycemia requiring insulin therapy as a possible complication of therapeutic hypothermia. A term appropriate for gestational age (AGA) female infant, was born by emergency cesarean section due to abruption of placenta and was resuscitated and intubated in the delivery room. Whole body cooling was initiated according to standard cooling criteria. The patient's blood glucose increased up to 250 mg/dl on a glucose perfusion rate of 6 mg/kg/min after the second day of cooling. Insulin therapy was started due to persistent hyperglycemia and continued for 17 days. As it has been reported in adults after therapeutic cooling, persistent hyperglycemia attributed to hypothermia can also complicate therapeutic hypothermia in neonates.

Randomized comparison between a forced air system and warm water bath for resuscitation of neonatal hypothermic calves with or without oral administration of caffeine

“…Hyperglycemia is a common physiologic response to cold stress in animals 49 and humans 50 alike, particularly during acute cold exposure; in contrast, prolonged hypothermia typically results in whole body energy depletion and hypoglycemia 6,51 . Although the change rate of glucose was faster during the rewarming period, there was no difference among groups.…”

Yenidoğan döneminde geçici endokrin sorunlar

“…In very preterm babies, the proinsulin level is higher and the levels of insulin-like growth factor (IGF-1), which increases peripheral glucose use, are low. Sepsis, necrotizing enterocolitis, cerebral bleeding, convulsion, hypernatremia, therapeutic premature delivery, and surgical interventions, which cause stress, increase the blood glucose level (3, 4). Fungal infections occur more commonly, if hyperglycemia is present.…”