GlucoBoost - Glucose Gel - Pack of 3

Product Information

Enteral feeds may continue initially but if hypoglycaemia persists despite increasing volumes of IV Glucose then a temporary cessation of enteral feeds may be required. Pulmonary vascular precipitates have been reported in patients receiving parenteral nutrition. In some cases, fatal outcomes have occurred. Excessive addition of calcium and phosphate increases the risk of the formation of calcium phosphate precipitates. Precipitates have been reported even in the absence of phosphate salt in the solution. Rapid administration of glucose solutions may produce substantial hyperglycaemia and a hyperosmolar syndrome. Hypersensitivity/infusion reactions, including anaphylactic/anaphylactoid reactions, have been reported (see section 4.8). Solutions containing glucose should be used with caution, if at all, in patients with known allergy to corn or corn products.

Near patient testing devices tend to be less accurate in the lower range, especially < 2.0mmol/l [1] and therefore all low values (≤2.6mmol/L) require confirmation using blood gas analysis as this is considered the gold standard for measuring blood glucose. When using an infusion pump all clamps on the intravenous administration set must be closed before removing the administration set from the pump, or switching the pump off. This is required regardless of whether the administration set has an anti-free flow device. Discontinue monitoring when blood glucose concentrations have been > 2.5mmol/l on three consecutive occasions at least 3 hours apart. Observe feeding in hospital for at least a further 24 hours ensuring it is effective while remaining vigilant for the signs of hypoglycaemia. If signs of hypoglycaemia develop or there are concerns about feeding discuss with medical staff and consider taking a further blood glucose.Glucose 40% w/v is for administration by intravenous infusion following appropriate dilution or incorporation in to a parenteral nutrition admixture. The infusion rate and volume depends on the age, weight, clinical and metabolic conditions of the patient, as well as concomitant therapy. Children (including neonates and older children) are at increased risk of developing hypoosmotic hyponatraemia as well as for developing hyponatraemic encephalopathy.

Once blood glucose level if 4mmol/l or above given 10-15g of slow acting carbohydrate (or their normal meal if it is a mealtime) to maintain the blood glucose level The occurrence of septic complications can be decreased with heightened emphasis on aseptic technique in catheter placement, maintenance, as well as aseptic technique in nutritional formula preparation. Snap the lid off the tube of gel and squeeze gel into the child’s lower cheek whilst at the same time gently but firmly massaging the outside of the cheek. It is this action that stimulates partial absorption of the Glucogel. DO NOT place gel on your own finger to rub inside your child’s mouth. Depending on the volume and rate of infusion and depending on a patient's underlying clinical condition and capability to metabolize glucose, intravenous administration of glucose can cause: If subsequent prefeed glucose values have improved to lie in the green zone but still remain <2.6 mmol/l, increase top up volumes by one further increment of 5-10 ml/kg/feedHyponatraemia can develop into acute hyponatraemic encephalopathy characterized by headache, nausea, seizures, lethargy, coma, cerebral oedema, and death. GlucoBoost Glucose Gel from Ennogen Healthcare is a 40% Glucose Oral Gel that is widely used in the NHS.

Particular caution is advised in patients at increased risk of water and electrolyte disturbances that could be aggravated by increased free water load, hyperglycaemia or possibly required insulin administration (see below).If < 2.0 mmol/l after initial feed or if still hypoglycaemic on 1hly feeds, treat with IV Glucose as below Careful symptomatic and laboratory monitoring for fever/chills, leukocytosis, technical complications with the access device, and hyperglycaemia can help recognize early infections. Dilute Glucose 40% w/v before use to a concentration which will, when administered with an amino acid (nitrogen) source, result in an appropriate calorie to gram of nitrogen ratio and which has an osmolarity consistent with the route of administration. The infusion rate and volume depends on the age, weight, clinical and metabolic conditions of the patient, concomitant therapy, and should be determined by a consulting physician experienced in paediatric intravenous fluid therapy. Babies who cannot tolerate enteral feeds or whose blood glucose remains <2.6mmol/l despite frequent NG feeds ( as above) OR who become symptomatic

Patient placed in the recovery position to ensure a clear airway for adequate breathing and to prevent inhalation of vomit. Additives known or determined to be incompatible with glucose as a diluent should not be used. The instructions for use of the medication to be added, including information on storage, must be consulted. To reduce the risk of hypoglycaemia after discontinuation, a gradual decrease in flow rate before stopping the infusion should be considered.

Encourage effective feeding – Following the second feed, continue to offer lots of feeding opportunities, at least 3hly until blood glucose measurements have been > 2.5mmol on three consecutive occasions. Reinforce feeding cues; teach hand expressing and biological nurturing techniques to the mother early on as these will be essential for the late preterm baby who needs to feed often. Continue feeding support until mother and midwife are satisfied that effective feeding is established. Glucose solution (an aqueous, i.e., electrolyte-free glucose solution) should not be administered through the same equipment as whole blood, as haemolysis and pseudoagglutination can occur.