Related Experiment Video

Updated: Nov 2, 2025

Improving IV Insulin Administration in a Community Hospital
12:08

Improving IV Insulin Administration in a Community Hospital

Published on: June 11, 2012

19.1K

Variability in Emergency Management of Pediatric Diabetic Ketoacidosis

Zoyah Thawer1, Keith Gregoire2, Helen Coo2

  • 1Department of Pediatrics, Queen's University, Kingston, Ontario, Canada; Division of Pediatric Endocrinology and Metabolism, Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada.

Canadian Journal of Diabetes
|June 11, 2021
PubMed

Insights

Many pediatric patients with diabetic ketoacidosis (DKA) receive suboptimal treatment, increasing the risk of cerebral edema (CE). Community centers showed higher rates of guideline deviations in DKA management.

Area of Science:

  • Pediatric Endocrinology
  • Critical Care Medicine
  • Clinical Guideline Adherence

Background:

  • Diabetic ketoacidosis (DKA) is a serious complication of diabetes in children.
  • Current guidelines exist to optimize DKA management and minimize complications like cerebral edema (CE).
  • Variations in treatment practices may impact patient outcomes.

Purpose of the Study:

  • To identify pediatric patients with DKA treated with practices inconsistent with current guidelines.
  • To assess the association between non-adherent treatment and the risk of developing CE.
  • To compare treatment deviations between academic and community healthcare settings.

Main Methods:

  • Retrospective chart review of 47 pediatric patients with DKA.
  • Analysis of adherence to established DKA treatment guidelines.
  • Identification of risk factors for CE, including IV insulin bolus, IV bicarbonate, early insulin administration, and non-NPO status.

Main Results:

  • 75% of patients received at least one treatment practice deviating from guidelines.
  • 34% of patients were exposed to CE risk factors.
  • Higher prevalence of CE risk factors in community centers (52%) compared to academic centers (19%).
  • No radiologically confirmed cases of CE were observed.

Conclusions:

  • A significant proportion of pediatric DKA patients are treated with practices increasing CE risk.
  • Children treated at community centers face a higher risk of guideline-discordant care.
  • Adherence to evidence-based guidelines is crucial for preventing DKA complications.
Abstract

Keywords:
cerebral edemad'acidocétose diabétiqued'oedéme cérébraldiabetes mellitusdiabetic ketoacidosisdiabéte sucrépediatricspédiatrie

More Related Videos

Glucose-Stimulated Insulin Secretion via Perfusion through the Mice Vasculature with an Intact Pancreas04:41

Glucose-Stimulated Insulin Secretion via Perfusion through the Mice Vasculature with an Intact Pancreas

Published on: July 25, 2025

477
A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings06:59

A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings

Published on: November 9, 2016

30.8K

Related Concept Videos

Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
55
Pharmacokinetics in Pediatric Patients: Drug Metabolism01:24

Pharmacokinetics in Pediatric Patients: Drug Metabolism

In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses...
48
Pharmacokinetics in Pediatric Patients: Drug Distribution01:17

Pharmacokinetics in Pediatric Patients: Drug Distribution

Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight,...
70
Drug Dosing: Infants and Children01:29

Drug Dosing: Infants and Children

Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
68
Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption01:23

Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption

Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...
49
SBAR II: Application of SBAR01:14

SBAR II: Application of SBAR

SBAR is an effective communication tool used by healthcare professionals to communicate patient information accurately. SBAR stands for Situation, Background, Assessment, and Recommendation. For a better understanding, an example is given below.
SBAR Report from a Nurse to a Health Care Provider
S: "Hello, Dr. Smith. This is Jane, RN, from the Med Surg unit. I am calling to tell you about Ms. White in Room 210, who is experiencing increased pain and redness at her incision site. Her recent...
5.2K