The management of diabetic ketoacidosis in children
نویسنده
چکیده
The object of this review is to provide the definitions, frequency, risk factors, pathophysiology, diagnostic considerations, and management recommendations for diabetic ketoacidosis (DKA) in children and adolescents, and to convey current knowledge of the causes of permanent disability or mortality from complications of DKA or its management, particularly the most common complication, cerebral edema (CE). DKA frequency at the time of diagnosis of pediatric diabetes is 10%-70%, varying with the availability of healthcare and the incidence of type 1 diabetes (T1D) in the community. Recurrent DKA rates are also dependent on medical services and socioeconomic circumstances. Management should be in centers with experience and where vital signs, neurologic status, and biochemistry can be monitored with sufficient frequency to prevent complications or, in the case of CE, to intervene rapidly with mannitol or hypertonic saline infusion. Fluid infusion should precede insulin administration (0.1 U/kg/h) by 1-2 hours; an initial bolus of 10-20 mL/kg 0.9% saline is followed by 0.45% saline calculated to supply maintenance and replace 5%-10% dehydration. Potassium (K) must be replaced early and sufficiently. Bicarbonate administration is contraindicated. The prevention of DKA at onset of diabetes requires an informed community and high index of suspicion; prevention of recurrent DKA, which is almost always due to insulin omission, necessitates a committed team effort.
منابع مشابه
بررسی فاکتورهای مستعد کننده، عوارض و پیش آگهی در کودکان مبتلا به کتواسیدوز دیابتی در زنجان
Background and Objective: Diabetic ketoacidosis is one of the most common and life threatening complications in children with diabetes mellitus. The aim of this study was to evaluate predisposing factors, complications and prognosis of the patients with diabetic ketoacidosis admitted to Zanjan hospitals. Materials and Methods: The records of patients with DKA admitted to Mousavi and Vali-e Asr ...
متن کاملManagement of Diabetic Ketoacidosis in Children
Diabetic ketoacidosis (DKA) is one of the leading causes of mortality in diabetic children. This study aimed to determine the frequency of mortality and complications of DKA during treatment in order to make the necessary modifications with regard to the common treatment problems. This was a cross sectional study, where patients were selected by examining the records of 112 children under the ...
متن کاملFrequency of Diabetic Ketoacidosis and Severe Hypoglycemia in Children with Type 1 Diabetes
Background and Objective: Diabetic ketoacidosis and severe hypoglycemia are common and recurrent acute complications of type 1 diabetes and are associated with high mortality and morbidity. The aim of this study was to determine the frequency of diabetic ketoacidosis and hypoglycemia in children with type 1 diabetes. Methods: In this retrospective cross-sectional study, 480 patients with type 1...
متن کاملCauses of Hospitalization for Children with Diabetes and the Principles of Dietary Guidelines
From 23,231 total admission to three children's hospitals in Teheran over 3years and 6 months to 8 years period, 83 patients were found to have diabetes, 23 per thousand. The incidence of diabetes in children increases with age and is maximum in adolescence. In 83 diabetic children 59 were male and 24 female (F /M:(0.4.) From 83 diabetic patients 25 (31.2p.c.) were admitted with ketoacid...
متن کاملA new scoring system for stratifying risk for cerebral edema in children suffering diabetic ketoacidosis
Background: Predicting adverse neurovascular complications due to diabetic ketoacidosis (DKA) particularly in children leads to more appropriately management of disease as well as achievement of acceptable patients' survival. Cerebral edema is a life-threatening adverse event following DKA responsible for high mortality rate. Recently, authors have focused introducing new risk assessment tools ...
متن کاملIncidence, predisposing factors and complications of Diabetic Ketoacidosis in diabetic patients
Background: Diabetic ketoacidosis (DKA) is the final consequence and life-threatening complication of severe insulin deficiency in type 1 diabetes with occurrence of 20-40%. The aim of this study was to investigate the incidence and predisposing factors of DKA and its consequences. Methods: This retrospective study was performed on 128 diabetic patients in Amirkola Children’s Hospital ...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
دوره 1 شماره
صفحات -
تاریخ انتشار 2010