engleski

Characteristics of Children with Diabetic Ketoacidosis Treated in Pediatric Intensive Care Unit: Two Center Cross-Sectional Study in Croatia

Background and objective: There is an increasing risk of type 1 diabetes mellitus (T1D) among children in Croatia. Diabetic ketoacidosis (DKA) is the leading cause of morbidity and mortality in children with T1D, with cerebral edema as most severe complication. Since early recognition of cerebral edema leads to better outcome, it is important that patients with moderate or severe DKA are closely monitored and treated in Pediatric Intensive Care Units (PICU). The aim of this study is to investigate clinical and laboratory parameters, as well as complications in children treated in PICU because of DKA. Materials and methods: Patients treated due to DKA in PICU of the University Hospitals of Split and Osijek from 2013 to 2017 were included in this study. Retrospectively collected data included age, gender, clinical signs and symptoms, and various laboratory parameters. After dividing subjects into two groups: newly diagnosed with T1D (NT1D) and previously diagnosed with T1D (PT1D), collected data was compared between the two groups. Results: Total of 82 patients were enrolled. Those with NT1D were more often treated in PICU, with two of them developing cerebral edema. Dehydration was the most frequent clinical sign, found in 95% patients at admission. Decreased consciousness level was found in 41.5% of patients, with majority of them being somnolent. No difference was found between NT1D and PT1D. Also, there was no significant difference regarding laboratory data at admission. Conclusions: More children with NT1D required treatment in PICU due to DKA with two of them developing cerebral edema. Since cerebral edema is a life threatening condition, treatment of patients with moderate or severe DKA in PICU will provide necessary monitoring enabling early recognition, treatment and better treatment outcome. To minimize the incidence of DKA among NT1D it is important to continuously carry out public health education programs aimed at early identification of signs and symptoms of T1D.

diabetic ketoacidosis ; diabetes ; children ; cerebral edema ; dehydration

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