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Oral glucose during targeted neonatal echocardiography: is it useful?
  1. Pascal M Lavoie1,2,
  2. Amelie Stritzke3,
  3. Joseph Ting1,2,
  4. Mohammad Jabr4,
  5. Amish Jain5,
  6. Eddie Kwan1,6,
  7. Ela Chakkarapani7,
  8. Paul Brooks8,
  9. Rollin Brant9,
  10. Patrick J McNamara5,
  11. Liisa Holsti1,2,10
  1. 1 Children's & Women's Health Centre of British Columbia, Vancouver, British Columbia, Canada
  2. 2 Department of Pediatrics/Division of Neonatology, University of British Columbia, Vancouver, British Columbia, Canada
  3. 3Department of Pediatrics/Division of Neonatology, University of Calgary, Calgary, Alberta, Canada
  4. 4Department of Neonatology, King Saud University, Riyadh, Saudi Arabia
  5. 5Department of Pediatrics/Division of Neonatology, University of Toronto, Toronto, Ontario, Canada
  6. 6Department of Pharmacy, University of British Columbia, Vancouver, British Columbia, Canada
  7. 7Neonatal Neuroscience, School of Clinical Medicine, University of Bristol, Bristol, UK
  8. 8Department of Pediatrics/Division of Cardiology, University of British Columbia, British Columbia, Canada
  9. 9 Department of Statistics, University of British Columbia, Vancouver, British Columbia, Canada
  10. 10 Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, British Columbia, Canada
  1. Correspondence to Dr Pascal Lavoie, Child & Family Research Institute, 4th floor Translational Research Building, 950 West 28th Avenue, Vancouver, British Colombia, Canada V5Z 4H4; plavoie{at}cw.bc.ca or Dr Liisa Holsti, Developmental Neurosciences and Child Health, F513, 4480 Oak Street, Vancouver, British Columbia, Canada V6H3V4; liisa.holsti@ubc.ca

https://doi.org/10.1136/archdischild-2015-308191

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    Targeted neonatal echocardiography (TNE) is widely used in the cardiovascular management of sick infants in neonatal intensive care unit (NICU).1 TNE should only be performed by operators who possess the knowledge and skills to acquire high-quality images in a structured manner, in order to formulate a diagnosis and medical recommendation. Suboptimal image quality due to agitation of the infant during a TNE may prolong scan time and result in errors in measurements and interpretation, leading to incorrect medical decisions. Oral glucose solutions are recommended to reduce procedure-related stress in infants.2 However, there are no data supporting this intervention in the context of the conductance of TNE. Anecdotally, many neonatologist sonographers across the globe have adopted the routine use of oral glucose to reduce agitation and facilitate image acquisition during a TNE, despite a lack of supporting scientific evidence.

    To determine whether oral glucose is effective in reducing agitation during a TNE, 104 infants born between 26 …

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    Footnotes

    • Contributors PML: conceptualised and designed the study, performed echocardiography studies, analysed data, wrote the manuscript. AS: designed the study, performed echocardiographic studies, reviewed the manuscript. JT: performed echocardiographic studies, reviewed the manuscript. MJ: performed echocardiographic studies, reviewed the manuscript. AJ: helped design the echocardiography rating scale, including conducting pilot testing of the scale, scored all echocardiographic studies, reviewed the manuscript. EK: conducted the randomisation, prepared oral study solutions for the infants, reviewed the manuscript. EC: performed echocardiographic studies, reviewed the manuscript. PB: helped design the echocardiography rating scale, reviewed the manuscript. PJM: helped design the echocardiography rating scale, including conducting pilot testing of the scale, scored all echocardiographic studies, wrote the manuscript. RB: conducted the statistical analyses, contributed to the initial draft of the manuscript. LH: conceptualised and designed the study, obtained external funding, performed some of the data analysis (reliability), wrote manuscript. All authors reviewed and approved the final manuscript as submitted

    • Funding This study was funded by the Alva Foundation (to LH). PML is supported by Clinician-Scientist Awards from the CFRI and the Michael Smith Foundation for Health Research (MSFHR). LH is supported by a Canadian Institutes of Health Research Canada Research Chair.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Ethics approval Children's & Women's Health Centre of British Columbia (C&W) Research Ethics Board (#H10-02069).

    • Provenance and peer review Not commissioned; externally peer reviewed.