Management of Diabetic Ketoacidosis in Children
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Abstract:
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 age of 15 who had been admitted to the pediatric intensive care unit of Ali Asghar Children's Hospital during 2014-2017 with DKA diagnosis. Required information were extracted from the records. Statistical analysis was performed using Chi-square (χ2) test, independent samples T-test and SPSS, Version 16. P value less than 0.05 was consider significant. The mean age of the children was 9.9 ± 3.15 years. In 66% of the patients, the first manifestation of diabetes was DKA. Regarding the type of serum therapy, hyponatremia was observed in 15%, hypernatremia in 4.6%, hyperkalemia in 4.5%, and hypokalemia in 15.2% of the patients during treatment. The mortality rate was 2.7% (3case). While other complication such as cerebral edema were reported in 20 cases (17.9%). Another important point in our study was that, among the initial markers, several clinical and laboratory markers had a high potential for predicting DKA-related mortality, including the need for intubation at the time of admission, increased inflammatory factors, severe hyperglycemia, evidence of renal dysfunction, hypophosphatemia, and vitamin D deficiency. Also, in predicting cerebral edema, various base markers were identified as predictors that consist of low GCS on admission, tachypnea, increased level of inflammatory factors, increased BUN, severe metabolic acidosis, leukocytosis, thrombocytosis, hypophosphatemia, vitamin D deficiency and increased Hb A1C.
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Journal title
volume 4 issue 3
pages 0- 0
publication date 2019-08
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