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- Title
Potential clinical benefits of a two-bag system for fluid management in pediatric intensive care unit patients with diabetic ketoacidosis.
- Authors
Velasco, Jacqueline P.; Fogel, Joshua; Levine, Robert L.; Ciminera, Peter; Fagan, David; Bargman, Renee
- Abstract
Introduction. Diabetic ketoacidosis (DKA) is a life-threatening complication of diabetes mellitus (DM) that requires appropriate treatment with insulin and intravenous fluids. Both one-bag and two-bag systems of fluid management are used to treat pediatric diabetic ketoacidosis. Aim of the Study. We compare the one-bag and two-bag systems of fluid managementwith regard to incidence of hypoglycemia, serum bicarbonate correction, pH correction and discharge from the pediatric intensive care unit (PICU). Method. This was a retrospective study of 61 patients less than 21 years old admitted to the PICU with a diagnosis of DKA. Of the 61 patients, 38 were treated with the one-bag system and 23 treated with the two-bag system. Results. The two-bag system had significantly (p=0.03) lower incidence of hypoglycemia (n=2, 8.7%) compared to the one-bag system (n=13, 34.2%). The two-bag system had significantly (p=0.001) fewer hours of PICU stay (M=29.6, SD=15.23) than the one-bag system (M=47.9, SD=22.32). However, there were no significant differences between the bag systems for hours for pH and bicarbonate correction. Conclusion. The twobag system is associated with lower incidence of hypoglycemia and faster discharge from the PICU. We recommend that clinicians consider using the two-bag system for fluid management in pediatric patients with diabetic ketoacidosis.
- Subjects
DIABETIC acidosis; PEDIATRIC intensive care; DIABETES in children; BICARBONATE ions; HYPOGLYCEMIA in children
- Publication
Pediatric Endocrinology, Diabetes & Metabolism, 2017, Vol 23, Issue 1, p6
- ISSN
2083-8441
- Publication type
Article
- DOI
10.18544/PEDM-23.01.0068