Bold Voices - March 2013 - (Page 9)

AT THE BEDSIDE Recurrent Hypoglycemia May Not Impair Long-Term Development of Preterm Infants Contrary to the influential results of an earlier study, recurrent hypoglycemia does not seem to impair long-term development in premature infants, finds “15-Year Follow-Up of Recurrent ‘Hypoglycemia’ in Preterm Infants,” a study in Pediatrics. Modern neonatal care has been influenced by the findings of a previous study 15-year follow-up study that found premature babies with recurrent asymptomatic hypoglycemia experienced impaired motor and cognitive development by the age of 18 months, says shows hypoglycemia Win Tin, a consultant neonatologist from the Department of Neonatal Medicine at danger threshold The James Cook University Hospital in Middlesbrough, U.K. “Many have doubted whether low levels are even damaging when there are no associated clinical must be lower than signs,” he says in previously thought. the article. Tin and his colleagues tested the findings by evaluating all children in the north of England who were born at less than 32 weeks of gestation. Blood glucose levels were measured daily for the first 10 days of life. he 32-mg single intra“It would be unwise to assume that low blood venous (IV) dose of glucose levels cannot be damaging in the preterm ondansetron — an antiinfant even in the absence of overt recognizable nausea drug that’s marketed as signs, simply because this study has failed to repliZofran — has been pulled from cate the earlier study from Cambridge. All that the market because of concerns the current study can do is show that the danger about potentially serious cardiac threshold must be lower than many had come to problems, announced the U.S. think it was,” the authors write. Food and Drug Administration Of the 566 children who survived to 2 years old, (FDA), Silver Spring, Md. 47 had a blood glucose level of 2.5 mmol/L (45 mg/ The decision was based on dl) or less on three or more days. No difference in initial results from a clinical developmental progress or physical ability was study that suggests the 32-mg observed between the test and control groups — IV dose of Zofran may affect the electrical activity of even when 45 families were revisited when the the heart, which could predispose patients to develop children were 15 years old and psychometrically an abnormal and potentially fatal arrhythmia known assessed. as torsades de pointes. “I hope the findings from our study will help Patients found to the professionals to rationalize their approach in Patients who be at the highest risk otherwise healthy and asymptomatic babies, and receive high-dose include those with to realize the gaps in our knowledge on the subject an underlying heart of neonatal hypoglycemia,” Tin says in a related ondansetron may condition, those article in Modern Medicine. develop torsade predisposed to low levels of potassium de pointes. and magnesium in the blood and those taking other medications that lead to QT prolongation, a specific type of irregular heart rhythm. Although the FDA does not yet have an alternative recommendation for the Zofran single IV dose regimen, it continues to recommend the intravenous regimen of 0.15 mg/kg of Zofran administered every four hours for three doses to ease chemotherapy-induced nausea and vomiting. However, the FDA cautions that no single IV dose should exceed 16 mg. High-Dose Zofran Pulled From Market T AACN BOLD VOICES MARCH 2013 9

Table of Contents for the Digital Edition of Bold Voices - March 2013

Front/Digital Edition Viewing Guide
Another Angle
Design an NTI Just for You
New Guidelines Set Practice Framework for Tele-ICU NursingPractice
New Methods Increase Speed of Sepsis Diagnosis
High Blood Pressure Can Injure the Brain of Young Adults
Recurrent Hypoglycemia May Not Impair Long-Term Development of Preterm Infants
Superstorm Sandy Hospital Evacuation Decisions Questioned
New STEMI Guidelines Focus on Symptom Recognition, Ease of Use
Early Communication About Resuscitation Improves EOL Quality
Vote Now for AACN Board, Nominating Committee Members
Simple Measures Reduce Pneumonia
Fresh Blood in the ICU
Meeting Veterans’ Healthcare Needs
In Our Journals
Checklists May Reduce Venous Thromboembolism
Certification Capsules
Chapter Leadership Workshop @NTI 2013
Wear Your NTI Pride on May 20
Dare To

Bold Voices - March 2013