Yenidoğan döneminde hipoglisemiye yaklaşım
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Date
2012-07-26
Authors
Sangün, Özlem
Dündar, Bumin
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Yenidoğanların enerji gereksinimi fazla, birçok enzim sistemleri ve substratları ise sıklıkla yetersizdir. Bu yüzden yenidoğan döneminde hipoglisemiye yatkınlık fazladır. Bu dönemde gözlenen hipoglisemiler, sıklıkla geçici karakterde olup, spesifi k klinik bulgu vermezler. Yenidoğanın keton ve laktat gibi alternatif enerji kaynakları düşüktür ve glukoz yenidoğanın başlıca enerji kaynağı olup, temel olarak beyin tarafından kullanılır. Günümüzde hipogliseminin nörogelişimsel gerilik ve kalıcı nörolojik hasarla ilişkili olduğu bilinmekte ve riskli bebeklerin korunması için hipoglisemi sınırları, izlem gerektiren durumlar ve tedavi protokolleri konusunda yaklaşımlar geliştirilmeye çalışılmaktadır. Hipoglisemi tedavisi özellikle de hasta semptomatikse acildir ve nedene yönelik araştırmalar devam ederken başlatılmalıdır. Postnatal erken dönemde ve özellikle anne sütü ile beslenme yenidoğanı hipoglisemiden korumakta oldukça etkilidir. Dirençli ve uzun süren hipoglisemilerde ileri araştırmalar yapılmalı ve nedene yönelik tedaviler uygulanmalıdır.
Although neonates have high energy requirement, most of their enzyme systems are immature and substrates are inadequate. Therefore they have a predisposition for hypoglycemia. There are no specifi c clinic symptoms and signs for hypoglycemia in neonatal period and it is usually transient. Alternative energy sources of the neonate like ketones and lactate are low and glucose is the major source of energy which is mainly used by the brain. Due to well known relation of hypoglycemia with neurodevelopemental delay and neurologic impairment, levels of hypoglycemia for at risk babies, conditions which require monitoring and treatment protocols are studied on. Treatment of hypoglycemia is an emergency especially when the patient is symptomatic and must be initiated together with the etiologic investigation. Early postnatal feeding particularly with human milk is quite effective in preventing from neonatal hypoglycemia. Further investigation must be performed in prolonged or resistant hypoglycemia which requires etiology-oriented approach.
Although neonates have high energy requirement, most of their enzyme systems are immature and substrates are inadequate. Therefore they have a predisposition for hypoglycemia. There are no specifi c clinic symptoms and signs for hypoglycemia in neonatal period and it is usually transient. Alternative energy sources of the neonate like ketones and lactate are low and glucose is the major source of energy which is mainly used by the brain. Due to well known relation of hypoglycemia with neurodevelopemental delay and neurologic impairment, levels of hypoglycemia for at risk babies, conditions which require monitoring and treatment protocols are studied on. Treatment of hypoglycemia is an emergency especially when the patient is symptomatic and must be initiated together with the etiologic investigation. Early postnatal feeding particularly with human milk is quite effective in preventing from neonatal hypoglycemia. Further investigation must be performed in prolonged or resistant hypoglycemia which requires etiology-oriented approach.
Description
Keywords
Yenidoğan, Hipoglisemi, Tedavi, Neonata, Hypoglycemia, Management
Citation
Sangün, Ö. ve Dündar, B. (2013). "Yenidoğan döneminde hipoglisemiye yaklaşım". Güncel Pediatri, 11(1), 31-38.