Cardiac Hypertrophy Associated with Insulin Therapy in Extremely Preterm Infants.

IF 3.4 3区医学 Q1 PEDIATRICS Pediatric Drugs Pub Date : 2023-07-01 DOI:10.1007/s40272-023-00571-0

Carlo Dani, Michele Luzzati, Iuri Corsini, Chiara Poggi, Venturella Vangi, Caterina Coviello, Simone Pratesi

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Abstract

Background: In the neonatal period, cardiac hypertrophy (CH) has been commonly associated with hyperinsulinemic pathologies, and the first case of CH in an extremely preterm infant treated with insulin infusion has recently been reported. To confirm this association, we report a case series of patients who developed CH after insulin therapy.

Methods: Infants with gestational age < 30 weeks and birth weight < 1500 g, born from November 2017 to June 2022, were studied if they developed hyperglycemia requiring treatment with insulin and had echocardiographic diagnosis of CH.

Results: We studied 10 extremely preterm infants (24.3 ± 1.4 weeks) who developed CH at a mean age of 124 ± 37 h of life, 98 ± 24 h after the initiation of insulin therapy. All surviving patients had resolution of CH at discharge, while three of four (75%) of the deceased patients had persistent CH.

Conclusions: Our case series supports the association between the development of CH and insulin therapy in extremely preterm infants and suggests further caution and the need for echocardiographic monitoring when treating these fragile patients with insulin.

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极早产儿与胰岛素治疗相关的心脏肥厚。

背景:在新生儿时期，心肌肥厚(CH)通常与高胰岛素血症病理相关，最近报道了一例经胰岛素输注治疗的极早产儿CH病例。为了证实这种关联，我们报道了一系列胰岛素治疗后发生CH的患者。结果:我们研究了10例极早产儿(24.3±1.4周)，他们在胰岛素治疗开始后98±24小时的平均年龄(124±37小时)发生CH。所有存活的患者在出院时CH消退，而4例死亡患者中有3例(75%)存在持续性CH。结论:我们的病例系列支持极早产儿CH的发展与胰岛素治疗之间的关联，并建议在使用胰岛素治疗这些脆弱的患者时进一步谨慎和需要超声心动图监测。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Drugs PEDIATRICS-PHARMACOLOGY & PHARMACY

CiteScore

7.20

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： Pediatric Drugs promotes the optimization and advancement of all aspects of pharmacotherapy for healthcare professionals interested in pediatric drug therapy (including vaccines). The program of review and original research articles provides healthcare decision makers with clinically applicable knowledge on issues relevant to drug therapy in all areas of neonatology and the care of children and adolescents. The Journal includes: -overviews of contentious or emerging issues. -comprehensive narrative reviews of topics relating to the effective and safe management of drug therapy through all stages of pediatric development. -practical reviews covering optimum drug management of specific clinical situations. -systematic reviews that collate empirical evidence to answer a specific research question, using explicit, systematic methods as outlined by the PRISMA statement. -Adis Drug Reviews of the properties and place in therapy of both newer and established drugs in the pediatric population. -original research articles reporting the results of well-designed studies with a strong link to clinical practice, such as clinical pharmacodynamic and pharmacokinetic studies, clinical trials, meta-analyses, outcomes research, and pharmacoeconomic and pharmacoepidemiological studies. Additional digital features (including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations) can be published with articles; these are designed to increase the visibility, readership and educational value of the journal’s content. In addition, articles published in Pediatric Drugs may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand important medical advances.