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Boletín Clínico de la Asociación Médica del Hospital Infantil del Estado de Sonora

2005, Number 2

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Bol Clin Hosp Infant Edo Son 2005; 22 (2)

'Diabetic ketoacidosis in children clinical and biochemical aspects and treatment evaluation'

Martínez-Medina MA, Solis-Gallardo LP, Bustamante-Cerecer JG, Corona-Flores M, Saldaña-Ojeda G

Language: Spanish
References: 25
Page: 95-101
PDF size: 62.20 Kb.


ABSTRACT

Objective: The purpose of this study was to report the clinical and management features of diabetic ketoacidosis (DKA).
Material and Methods: In this retrospective study, we identified 39 children who had been hospitalized and treated for DKA. The following date from the medical charts of each child were recorded: clinical characteristics, initial biochemical values, treatment regimen and changes in laboratory during management.
Results: Twenty five patients (75%) had severe ketoacidemia, the mean glucose level on admittance was 25.4 mmol (457 mg/dL). Only 12 of cases (35.3%) had a positive sodium trend; the decline of blood glucose and increase pH were less than minimum recommended. In almost 60% of patients the total amount of intravenous fluid infused in the first 24 hours was more than recommended volume of 4 L/m2/sc.
Conclusion: The management of children with DKA is not keeping with current treatment guidelines. The treatment protocol in our institution must be formally revised to individualized assessment of the degree of dehydration. The recommendations for initial rehydration should to include a polielectrolitic solution containing an average 125 mmol/L of sodium.


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