The idea of glucose as the sole metabolic fuel for the neonatal brain is still over-emphasised, in
spite of long standing animal and human research that shows the relevance of other metabolic
fuels such as lactate and ketones. Furthermore, innovative approaches to treating
hypoglycaemia with buccal glucose have shown promise in well conducted randomised trials. In
view of the wide availability of simultaneous near-patient blood glucose and lactate analysis, it is
now possible to move away from simplistic assessments of blood glucose alone in day to day
clinical management. However the clinical assessment of neurological status remains central to
the evaluation of babies who are at increased risk of fuel deficiency, and ultimately determines
which babies should be subjected to any measurements.
Learning Objectives:
Objective 1: Understand the relevance of other metabolic fuels than glucose Objective 2: Adjust clinical practice based on this understanding Objective 3: Be aware of the value of new strategies for managing low blood glucose levels
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