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J Pediatr. 2013 Jul;163(1):29-35.e1. doi: 10.1016/j.jpeds.2012.12.088. Epub 2013 Feb 14.

Oral sucrose for heel lance increases adenosine triphosphate use and oxidative stress in preterm neonates.

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1
Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, CA 92350, USA.

Abstract

OBJECTIVE:

To examine the effects of sucrose on pain and biochemical markers of adenosine triphosphate (ATP) degradation and oxidative stress in preterm neonates experiencing a clinically required heel lance.

STUDY DESIGN:

Preterm neonates that met study criteria (n = 131) were randomized into 3 groups: (1) control; (2) heel lance treated with placebo and non-nutritive sucking; and (3) heel lance treated with sucrose and non-nutritive sucking. Plasma markers of ATP degradation (hypoxanthine, xanthine, and uric acid) and oxidative stress (allantoin) were measured before and after the heel lance. Pain was measured with the Premature Infant Pain Profile. Data were analyzed by the use of repeated-measures ANOVA and Spearman rho.

RESULTS:

We found significant increases in plasma hypoxanthine and uric acid over time in neonates who received sucrose. We also found a significant negative correlation between pain scores and plasma allantoin concentration in a subgroup of neonates who received sucrose.

CONCLUSION:

A single dose of oral sucrose, given before heel lance, significantly increased ATP use and oxidative stress in premature neonates. Because neonates are given multiple doses of sucrose per day, randomized trials are needed to examine the effects of repeated sucrose administration on ATP degradation, oxidative stress, and cell injury.

Comment in

PMID:
23415615
PMCID:
PMC3687041
DOI:
10.1016/j.jpeds.2012.12.088
[Indexed for MEDLINE]
Free PMC Article
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