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What Do Low Blood Glucose Level And Hyperviscosity In An Infant Suggest?
Question: My sis in law just delivered twins on 31st july 2015. A baby boy and a girl .The bay girl is doing perfectly fine, however the baby boy has been unwell.
Few hours after the birth he started having breathing problems and was kept on ventilators. Next day he was moved to a child care specialist hospital in XXXXXXX and blood test showed lower glucose and hyperviscosity (where the blood is thicker than it is supposed to be). The doctors started giving him external glucose from the navel, which increased the glucose level to some extent and also reduced the hyperviscosity (which was little higher than the normal acceptable level), after 2 days.
All this while he is on ventilator and at times they have to increase the oxygen supply too. (I have read multiple articles about twins having similar issues.)
Now the doctors say that the blood platelets count which should be >1Lakh is around 65K.We are very worried
Few hours after the birth he started having breathing problems and was kept on ventilators. Next day he was moved to a child care specialist hospital in XXXXXXX and blood test showed lower glucose and hyperviscosity (where the blood is thicker than it is supposed to be). The doctors started giving him external glucose from the navel, which increased the glucose level to some extent and also reduced the hyperviscosity (which was little higher than the normal acceptable level), after 2 days.
All this while he is on ventilator and at times they have to increase the oxygen supply too. (I have read multiple articles about twins having similar issues.)
Now the doctors say that the blood platelets count which should be >1Lakh is around 65K.We are very worried
Brief Answer:
The main parameter to consider is whether the child has infection
Detailed Answer:
Thanks for asking on HealthcareMagic.
I have carefully gone through the details mentioned. The boy baby seems to have had respiratory distress syndrome for which ventilation was required. It is not clear from your details whether the child had an infection or sepsis as well. The sepsis could be responsible for a low platelet count. The other conditions of hyperviscosity and hypoglycemia (the latter could be related to sepsis as well) have been dealt with properly.
As of now, the child might need to remain under monitoring. The main question is whether there is sepsis and unless I could see the blood reports or clinical notes, it is not possible for me to understand that. If there is sepsis but if the child is responding to antibiotics, there is less to worry about.
I would love to reassure you but without going into the specifics of the case, it is hard for me to do so. All I can say that most often the babies recover without any problems, when treated properly in a good setup.
I would hope for the best. Feel free to communicate back in case of any further queries and I would be happy to help.
Regards
The main parameter to consider is whether the child has infection
Detailed Answer:
Thanks for asking on HealthcareMagic.
I have carefully gone through the details mentioned. The boy baby seems to have had respiratory distress syndrome for which ventilation was required. It is not clear from your details whether the child had an infection or sepsis as well. The sepsis could be responsible for a low platelet count. The other conditions of hyperviscosity and hypoglycemia (the latter could be related to sepsis as well) have been dealt with properly.
As of now, the child might need to remain under monitoring. The main question is whether there is sepsis and unless I could see the blood reports or clinical notes, it is not possible for me to understand that. If there is sepsis but if the child is responding to antibiotics, there is less to worry about.
I would love to reassure you but without going into the specifics of the case, it is hard for me to do so. All I can say that most often the babies recover without any problems, when treated properly in a good setup.
I would hope for the best. Feel free to communicate back in case of any further queries and I would be happy to help.
Regards
Above answer was peer-reviewed by :
Dr. Shanthi.E
Please find attached all the reports of al the tests done so far for the baby . I have the blood reports attached too. Looking forward to hear from you.
Brief Answer:
The reports have not yet been attached
Detailed Answer:
Thanks for asking back.
I waited for some time but till now I do not find the reports attached. The upload facility is on the upper right of this page. If you have any problems, you can mail the report to YYYY@YYYY with subject as "Attn: Dr. Diptanshu Das"
I will await your response.
Regards
The reports have not yet been attached
Detailed Answer:
Thanks for asking back.
I waited for some time but till now I do not find the reports attached. The upload facility is on the upper right of this page. If you have any problems, you can mail the report to YYYY@YYYY with subject as "Attn: Dr. Diptanshu Das"
I will await your response.
Regards
Above answer was peer-reviewed by :
Dr. Prasad
PCO2 level is high 55.5mmHg doctors are guessing this to be pneumonia now and the infections in blood can also lead to sepsis, is what they believe. However they will do a blood culture and will get the reports in next 72 hours before they can confirm.
Currently the child is under 60% pressurized oxygen supply and if the child needs oxygen beyond that then they will shift the child to ventilator. Also there is an external glucose infusion i.e. 6-7 via the umbilical line.
Attaching all the reports from the day the child was born including the most recent one.
Currently the child is under 60% pressurized oxygen supply and if the child needs oxygen beyond that then they will shift the child to ventilator. Also there is an external glucose infusion i.e. 6-7 via the umbilical line.
Attaching all the reports from the day the child was born including the most recent one.
Brief Answer:
You will have to rely on the judgment of your doctors.
Detailed Answer:
Thanks for writing back.
I have painstakingly but carefully gone through the reports. The number of repetitions and the lack of order of the documents had made it hard for me but I understand your situation and do not really blame you. The possibility of infection is definitely there looking at the progression although in terms of the reports it is not that definite. The child is now on CPAP (continuous positive airway pressure) on 60% FiO2 and on IV fluids through umbilical venous catheter. Your doctors have been treating the baby in the right direction and you will have to rely on their judgment. Please be patient and wait for the response. The condition has be dealt with as it comes. There is no use growing apprehensive.
In case you have any specific query please let me know and I will try to answer it.
Regards
You will have to rely on the judgment of your doctors.
Detailed Answer:
Thanks for writing back.
I have painstakingly but carefully gone through the reports. The number of repetitions and the lack of order of the documents had made it hard for me but I understand your situation and do not really blame you. The possibility of infection is definitely there looking at the progression although in terms of the reports it is not that definite. The child is now on CPAP (continuous positive airway pressure) on 60% FiO2 and on IV fluids through umbilical venous catheter. Your doctors have been treating the baby in the right direction and you will have to rely on their judgment. Please be patient and wait for the response. The condition has be dealt with as it comes. There is no use growing apprehensive.
In case you have any specific query please let me know and I will try to answer it.
Regards
Above answer was peer-reviewed by :
Dr. Shanthi.E
How serious does this look to you? Is this very much curable? Do babies have these issues or this is not a common scenario. Change in the blood reports and other reports make me go tensed. Sometimes the PO2 is normal and then next day that goes high. Something which is not normal the previous day becomes normal the next day. Lactate as I can see is high and breathing issues are there alongwith low glucose and low platelets. Does this point towards sepsis. What can be done to increase the platelets when it not that low to do a transfusion.
Brief Answer:
Putting the baby on ventilation could be a better option.
Detailed Answer:
It is serious enough, but with proper treatment there is a reasonable probability for favorable response to be achieved. I would not really worry about PO2. Rather, I would be more concerned about lactate levels which indicate respiratory fatigue. I would have preferred to put such a patient outright on ventilator had the baby been under my care. Otherwise there is a possibility of sudden crash in such a child.
Low platelet count is usually associated with infection/sepsis and doctors have already changed antibiotics as I could see. As of now increasing platelet count would not be a priority. Rather a satisfactory control of infection will automatically take care of platelet counts. However, if doctors feel that there could be a risk of bleeding, only then platelet transfusion would be required. If there other risk factors are taken care of, I would perhaps have waited till platelet count goes as low as 20,000. However, you should depend on the judgment of your doctor in this regard.
Regards
Putting the baby on ventilation could be a better option.
Detailed Answer:
It is serious enough, but with proper treatment there is a reasonable probability for favorable response to be achieved. I would not really worry about PO2. Rather, I would be more concerned about lactate levels which indicate respiratory fatigue. I would have preferred to put such a patient outright on ventilator had the baby been under my care. Otherwise there is a possibility of sudden crash in such a child.
Low platelet count is usually associated with infection/sepsis and doctors have already changed antibiotics as I could see. As of now increasing platelet count would not be a priority. Rather a satisfactory control of infection will automatically take care of platelet counts. However, if doctors feel that there could be a risk of bleeding, only then platelet transfusion would be required. If there other risk factors are taken care of, I would perhaps have waited till platelet count goes as low as 20,000. However, you should depend on the judgment of your doctor in this regard.
Regards
Above answer was peer-reviewed by :
Dr. Prasad
These are the latest reports . What is your opinion on this.
Brief Answer:
Please specifically indicate the reports.
Detailed Answer:
Pardon me but I find it hard to discern which ones exactly are the latest reports. I have not received any email this time containing reports and there is a big list of undated reports attached along with this question. Besides, you also need to mention the clinical situation now.
Regards
Please specifically indicate the reports.
Detailed Answer:
Pardon me but I find it hard to discern which ones exactly are the latest reports. I have not received any email this time containing reports and there is a big list of undated reports attached along with this question. Besides, you also need to mention the clinical situation now.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi, I have provided some attachments. Please review them.
Brief Answer:
The order of reports and the clinical situation is important
Detailed Answer:
Thanks for responding. But the order between these undated blood gas reports is important:
http://doctor.healthcaremagic.com/MultiAction?task=documentAccess&documentId=75900
http://doctor.healthcaremagic.com/MultiAction?task=documentAccess&documentId=75903
http://doctor.healthcaremagic.com/MultiAction?task=documentAccess&documentId=75897
Moreover, it is important to know whether the child is on ventilator or CPAP and what are the settings being used. The sequence of reports would indicate whether there is improvement or deterioration and whether the settings are being adjusted correctly.
The CRP level indicates that there is an infection and that infection is being treated with antibiotics.
I hope you understand. Sorry for not being able to be more precise.
Regards
The order of reports and the clinical situation is important
Detailed Answer:
Thanks for responding. But the order between these undated blood gas reports is important:
http://doctor.healthcaremagic.com/MultiAction?task=documentAccess&documentId=75900
http://doctor.healthcaremagic.com/MultiAction?task=documentAccess&documentId=75903
http://doctor.healthcaremagic.com/MultiAction?task=documentAccess&documentId=75897
Moreover, it is important to know whether the child is on ventilator or CPAP and what are the settings being used. The sequence of reports would indicate whether there is improvement or deterioration and whether the settings are being adjusted correctly.
The CRP level indicates that there is an infection and that infection is being treated with antibiotics.
I hope you understand. Sorry for not being able to be more precise.
Regards
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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