Review of Neonatal hypoglycemia - Sugar them up
Management of Neonatal Hypoglycemia
Detailing every aspect of neonatal hypoglycemia, Here is Queensland Maternity and Neonatal Clinical Guideline on Newborn hypoglycaemia.
Here is the link
Detailed charts on prevention and detection, management, hypoglycaemic screen and other investigations along with their interpretation. Pharmacological interventions for resistant and persistent hypoglycemia given in detail along with doses of drugs and finally discharge and follow up. Highly recommended for indepth read.
Both NNF and AIIMS protocol are good and almost same
This is the most recent article , try to get a copy of NEOREVIEW 2014 , Here
All this simple stuff is based on this mother equation
|GIR =||IV Rate (mL/hr) * Dextrose Conc (g/dL) * 1000 (mg/g)|
|Weight (kg) * 60 (min/hr) * 100 (mL/dL)|
Now while calculating GIR in babies on both IV fluid and Breast feed or any other feed
Term formula sugar content 7.1 g / 100 ml
Pre-term formula sugar content 8.5 g / 100 ml
Here is a nomogram to quickly see what Dextrose infusion rate you giving at % glucose fluid at perticular fluid rate or just know what is the desired % dextrose needed to achieve target GIR
(Interconversion of glucose infusion units. from Klaus MH, Fanaroff. AA, eds: Care of the High-Risk Neonate. 2nd edition. Philadelphia:WB Saunders, 1979:, 430.
After deciding what dextrose % you need in fluid, to target your DIR, you can use following simple formula to achieve that % dextrose by mixing two fluid of different dextrose concentration.
Desired conc - lowest conc X 100
Highest conc - lowest conc
This gives you volume of highest conc fliud in 100 ml rest will be the volume of lowest concentration fluid
Some ready made stuff
You can use following link to calculate GIR but "practising" will always be better for learning than shortcuts. The best thing is we can calculate the GIR of IVF along with Breast milk or Top milk, all together.
Glucomix is a android software, easy to use to calculate the combination of two fluids with different dextrose concentration right on your mobile, find details here