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Diabetic ketoacidosis in the pediatric ICU

James P Orlowski1, Cheryl L Cramer, Mariano R Fiallos

  • 1Pediatric Intensive Care Unit, University Community Hospital, 3100 East Fletcher Avenue, Tampa, FL 33613, USA. jorlowski@mail.uch.org

Pediatric Clinics of North America
|May 27, 2008
PubMed

Insights

Diabetic ketoacidosis (DKA) is a serious diabetes complication in children. This article details DKA assessment and treatment in pediatric intensive care units, focusing on neurological changes like coma and cerebral edema.

Area of Science:

  • Pediatric Endocrinology
  • Critical Care Medicine
  • Neurology

Background:

  • Diabetic ketoacidosis (DKA) is a frequent and life-threatening complication of diabetes mellitus in pediatric patients.
  • Central nervous system (CNS) alterations, including altered sensorium (diabetic coma) and cerebral edema, are significant concerns in DKA.
  • Cerebral edema in DKA presents a high morbidity and mortality risk.

Purpose of the Study:

  • To outline the assessment and management strategies for pediatric DKA.
  • To highlight the neurological manifestations and complications of DKA in children.
  • To provide guidance for clinicians managing DKA in a pediatric intensive care unit (PICU) setting.

Main Methods:

  • Review of current literature and clinical guidelines on DKA management in children.
  • Discussion of diagnostic criteria and monitoring parameters for DKA.
  • Emphasis on the recognition and treatment of CNS complications, particularly cerebral edema.

Main Results:

  • DKA requires prompt recognition and aggressive management to prevent severe outcomes.
  • Neurological assessment is crucial for identifying altered sensorium and early signs of cerebral edema.
  • Specific treatment protocols are necessary for managing DKA and its neurological sequelae in the PICU.

Conclusions:

  • Effective management of DKA in pediatric patients necessitates a multidisciplinary approach.
  • Vigilant monitoring and timely intervention are key to improving outcomes for children with DKA.
  • Understanding and addressing CNS changes are paramount in reducing DKA-related morbidity and mortality.

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