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hyperglycemia, hyperkalemia, infant, insulin, neonatal, intensive care, parenteral nutrition, premature, very low birth weight



  1. Ditzenberger, Georgia R. MN, RNC
  2. Collins, Susan D. MS, RNC
  3. Binder, Nancy MD, PhD


Very low birth weight (VLBW) infants less than 1,000 g often experience hyperkalemia and hyperglycemia during the initial hospital course. Hyperkalemia has been noted in 44% to 50% of infants less than 800 g birth weight or less than 28 to 29 weeks' gestation. Hyperglycemia occurs 18 times more frequently in infants less than 1,000 g than in those weighing more than 2,000 g. Insulin has been used for VLBW infants less than 1,000 g to manage hyperkalemia, control hyperglycemia, and optimize parenteral nutrition. A protocol for using exogenous insulin therapy for VLBW infants is described.