Resumo

ALVISO LOPEZ, Rubén Daniel  e  BLANCO ESPINOLA, Claudia Fabiola. Clinical and Laboratory Progression of Diabetic Ketoacidosis in Patients Diagnosed with Type I Diabetes Admitted to a Pediatric Emergency Department. Pediatr. (Asunción) [online]. 2015, vol.42, n.3, pp.198-204. ISSN 1683-9803.  https://doi.org/10.18004/ped.2015.diciembre.198-204.

Introduction: Because patients with diabetic ketoacidosis (DKA) present to the hospital pediatric emergency department, general pediatricians should know both the clinical and laboratory progression over time of patients with DKA, managed according to the protocol prepared by the Endocrinology Committee of the Paraguayan Pediatric Society, to optimize the management of these patients and prevent complications related to treatment, since the excessive interventions could cause serious adverse effects, such as cerebral edema, or expose patients to unnecessary side effects, such as those produced by the use of sodium bicarbonate. Objectives: To demonstrate the clinical and laboratory chronological progression of patients admitted to the Emergency Department for diabetic ketoacidosis and managed according to the established protocol. Materials and Methods: We performed a descriptive, retrospective, cross-sectional study. Population: Pediatric patients admitted to the Pediatric Emergency Department of University Hospital with DKA, either with a new or known diagnosis of Diabetes Mellitus Type I, from 2010 to 2013. Results: Resolution of hyperglycemia (ANOVA p 0.05) from 201-400: within 4.1 +/- 2 hours, from 401-600: within 6.1 +/- 3 hours, > 600: within 11 +/- 3 hours; resolution of acidosis (ANOVA p 0.26) within 15.6 +/- 1,1 hours for mild acidosis, for moderate acidosis: 24 +/- 11 hours, for severe acidosis 27 +/- 9 hours. No relationship between acidosis and glycemia (PEARSON 0.2) was found; one patient required correction with sodium bicarbonate. Conclusion: Time to resolution of glycemia is related to its severity, but not the acidosis, and these in turn are unrelated to each other. Blood sugar normalized before acidosis in this study population.

Palavras-chave : Diabetic ketoacidosis; hyperglycemia; acidosis; bicarbonate; children.

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