Hypothwaymicemia in babies: Signs and treatment

Not only occurs in adults, babies and young children are also at risk of hypotensis. This condition can cause dangerous complications that affect the health of the child, can even cause brain damage if not diagnosed and treated in a timely manner.

Hypothwayemia is a common disease for babies and can be transient in the early stages after birth. However, persistent hypoth glucose can cause brain damage and leave long-term consequences for the child.

According to the American Association of Pediatrics, infant hypoglycemia is determined when a child's glucose levels are < 2.6mmol/l.

There are many causes of hypotensive conditions in babies such as:

2.1 Hypotensive due to increased Insulin

Due to mage metabolism changes: Diabetes , water infusionor medication in pregnancy chewing.

Congenital factors: Genetic mutations that encode the insulin secretion of pancreatic island Beta cells such as Kir6.2 gene, KCNJ11, ABCC8, SUR1,…

Second-rate insulin increase: Asphyxiated, the mother during treatment for the drug Terbutaline, suffers from Beckwith-Wiedemann syndrome. Besides, increasing Insulin also has to mention a number of causes as follows:

• Abruptly stop high levels of Glucose
• Catheter umbilical artery in the wrong place
• Blood replacement with high glucose levels
• Tumors that produce insulin, increase Beta cells

2.2 Infants due to being older than gestational age

Besides the cause of the mother's diabetes, it is impossible to confirm other causes. This is a high-risk group so the mother is screened for hypoth glucose.

2.3 Decreased glucose production or reserves

For this cause will occur for some cases as follows:

• Premature babies;
• Delayed development in the uterus;
• Insufficient nutrition;
• Late feeding;

2.4 Increased use/ reduction of Glucose production

• Birth stress: Infection, shock, hypothermia, respiratory failure, the period after resuscitation.
• Congenital conversion disorders.
• End noisic disorders.
• Polyeths.
• Adrenaline.
• The mother is in the period of using beta blockers.

In newborns, hypotensive symptoms usually appear 3-48 hours after birth, including the following signs:

• Rapidly decreasing body temperature, pale chestnut skin, cyanosis, cold limbs
• Digestive symptoms such as abdominal pain, vomiting, alcohol hunger, discomfort
• Fast, folded, strong breathing
• Severe cases may convulsions, coma

41% of cases of hypoglycemia in newborns usually occur in premature babies, weighing less than 2.5 kg. According to experts, the disease can have a serious impact on the child's nerves later on. Therefore, babies need to be diagnosed and treated in a timely manner.

4.1. Immediately handle emergency conditions

Emergency is required as soon as there are symptoms such as seizures, cyanosis, respiratory failure …

4.2. Blood glucose adjustment

The goal is to maintain serum glucose ≥ 2.6 mmol/L on the first day after birth and ≥ 2.8 mmol/L in the following days.

Blood glucose adjustment is carried out step by step depending on the degree of hypoth glucose, with or without symptoms as follows:

4.2.1 Diet adjustments

• Applied to serum glucose levels of 2 – 2.6 mmol/L and asymptomatous.
• Breastfeed early after birth. In some cases, the child is at risk of being fed early in the first hour after birth and screened for Blood Glucose 30 minutes later.
• If the baby cannot breastfeed, milk and feed the baby by alternative methods, sufficient amount of food according to the needs of the day.
• Meals can be increased 12 meals per day.
• Monitor blood glucose before eating.

4.2.2 Infusions

In dinhcemia cases:

• The child has symptoms.
• Blood glucose < 1,4 mmol/L
• Blood glucose < 2,2 mmol/L (40mg/dL) khi đã điều chỉnh bằng chế độ ăn.
• The child cannot eat.

With Glucose Levels < 1,4 mmol/L cần tiêm tĩnh mạch dịch glucose 10%, 2ml/kg trong 1 phút, sau đó truyền dịch.

The transmission rate (GIR) is between 6 – 8 mg/kg/min, the solution infusion has a glucose concentration of 10% at a sustained dose of 80-120 ml/Kg/day. Two peripheral sugar concentrations of 10% and 12% should be used.

The infusion rate for a 10% Glucose solution is 0.6 x CN x GIR and the 12% Glucose solution is 0.5 x CN x GIR

Blood glucose monitoring every 3 hours until blood glucose is > 2.6 mmol/L in 2 consecutive tests.

If Glucosse is low, gradually increase the amount of solution or glucose levels. The epidemic has a glucose concentration of less than 12.5% that allows peripheral TM infusion, the infusion with glucose concentration above 12.5% needs a central TM infusion

4.2.3 Persistent hypothlycemia

• If it lasts more than 2 days with a transmission rate of up to 12 mg/kg/min, diazoxide or Hydrocortisone medications may be required and cause should be sought for treatment (Insulin and cortisol blood tests prior to Glucocorticoid treatment).
• Hydrocortisone dose is 5 mg/kg daily, in 2 divided doses, TM injections or orally.
• The use of Diazoxide or Glucagon should be consulted with an endo noisyist .

4.2.4 Monitoring when blood glucose is normal

If serum glucose is stable with intravenous infusion treatment:

• Start feeding 20ml/Kg/day
• Gradually increase the amount of food and gradually reduce the infusion until completely eaten.

Check your glucose after each change in treatment, be aware of preeginal blood glucose checks.

4.3. Treatment by cause

In case of persistent hypotension with the need for a transmission rate of more than 8 mg/kg/min lasting more than 1 week, it is necessary to consult with an endo noising specialist for appropriate treatment for cases of hypotension due to some unusual causes.

Infant hypothmemia is an extremely dangerous disease, so when children have abnormal symptoms, parents need to immediately take the child to medical facilities to be consulted, diagnosed and treated by doctors in a timely manner.

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