A.S.P.E.N. Clinical Guidelines: hyperglycemia and hypoglycemia in the neonate receiving parenteral nutrition.

This Clinical Guideline has been developed to guide clinical practice based on the authors’ assessment of current published evidence on glycemic control in the neonate (within the first month of life) receiving parenteral nutrition (PN). The neonate receiving PN is worthy of special consideration with respect to glucose control, as this population carries an elevated risk of hyperand hypoglycemia and may be more susceptible to deleterious effects associated with these conditions. Untreated hyperor hypoglycemia may lead to undesirable clinical outcomes. Prolonged or symptomatic hypoglycemia may result in neurodevelopmental impairment. Severe hyperglycemia can lead to osmotic diuresis resulting in dehydration and electrolyte imbalance. Furthermore there is some evidence to suggest that hyperglycemia in premature infants (particularly those that are very low birth weight (VLBW <1500 g) or extremely low birth weight (ELBW <1000 g)) has been positively correlated with morbidity and mortality, spurring questions about more proactive measures of managing elevated blood glucose levels in this group of patients. Thus, hyperglycemia and hypoglycemia are clinically-relevant complications that should be considered in caring for the neonate receiving PN and it is important to examine the parameters for defining,