A multilateral approach was used, including comprehensive literature searches and online research. The retrieved studies were screened by two independent reviewers according to our inclusion criteria. The two reviewers independently extracted the descriptive data. Four appraisers assessed the guidelines using the AGREE-II instrument.
Ten clinical guidelines on neonatal hypoglycemia were included, with a mean score of 45.28%-83.45% in six domains. The guidelines are relatively consistent in their recommendations on clinical symptoms of neonatal hypoglycemia, but different in risk factors, preventive measures, thresholds for clinical management of hypoglycemia, target glucose ranges for its control, and pharmacotherapy.
By summarising the recommendations in the guidelines on neonatal hypoglycemia, we found that blood glucose values were not the only observational indicator, and other indicators (e.g., ketone bodies, lactate) related to glucose metabolism should also be considered for a comprehensive assessment. There is still a lack of consensus on thresholds for the clinical management of hypoglycemia and target glucose ranges for its control, and the recommendations on its pharmacotherapy are rather simple and sketchy. In the future, more high-quality studies are required to further improve the early identification of neonatal hypoglycemia and intervention strategies against it.
方法:采用多边方法,包括全面的文献检索和在线研究。检索到的研究由两名独立评审员根据我们的纳入标准进行筛选。两个审阅者独立地提取描述性数据。四名评估师使用AGREE-II工具对准则进行了评估。
结果:共纳入10项新生儿低血糖临床指南,六个领域的平均得分为45.28%-83.45%。指南对新生儿低血糖的临床症状的建议相对一致。但风险因素不同,预防措施,低血糖临床管理的阈值,其控制目标葡萄糖范围,和药物治疗。
结论:通过总结新生儿低血糖指南中的建议,我们发现血糖值不是唯一的观察指标,和其他指标(例如,酮体,乳酸)与葡萄糖代谢相关,也应考虑进行全面评估。关于低血糖的临床管理阈值和控制血糖的目标范围仍缺乏共识。关于其药物治疗的建议相当简单和粗略。在未来,需要更多高质量的研究来进一步提高新生儿低血糖的早期识别和干预策略.