en POLSKI
eISSN: 2083-8441
ISSN: 2081-237X
Pediatric Endocrinology Diabetes and Metabolism
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1/2017
vol. 23
 
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abstract:
Original paper

Potential Clinical Benefits of a Two-bag System for Fluid Management in Pediatric Intensive Care Unit Patients with Diabetic Ketoacidosis

Jacqueline Velasco
,
Joshua Fogel
,
Robert Levine
,
Peter Ciminera
,
David Fagan
,
Renee Bargman

Pediatr Endocrinol Diabetes Metab 2017;23,1:6-13
Online publish date: 2017/10/11
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  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 two-bag 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. 
keywords:

diabetic ketoacidosis, insulin, hypoglycemia, diabetes mellitus type 1


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