Revised one-bag IV fluid protocol for pediatric DKA: a feasible approach and retrospective comparative study

Area of Science:

• Pediatric Endocrinology
• Critical Care Medicine
• Metabolic Disorders

Background:

• Diabetic ketoacidosis (DKA) is a serious complication of diabetes in children.
• Traditional management protocols for pediatric DKA can be complex and time-consuming.
• Optimizing DKA management protocols is crucial for improving patient outcomes.

Purpose of the Study:

• To compare the effectiveness of a revised one-bag protocol versus the traditional one-bag protocol for managing pediatric diabetic ketoacidosis (DKA).
• To evaluate the impact of the revised protocol on acidosis recovery time and blood glucose control.
• To assess the frequency of healthcare provider interventions required for stable blood glucose levels.

Main Methods:

• A single-center retrospective cohort study included pediatric patients diagnosed with DKA between 2012 and 2019.
• The study compared a revised one-bag protocol with the traditional protocol for DKA management.
• Key outcomes measured included time to acidosis recovery and the number of interventions for blood glucose control and insulin rate adjustments.

Main Results:

• The revised one-bag protocol resulted in a significantly shorter time to acidosis recovery (12.67 hours) compared to the traditional protocol (18.20 hours).
• Fewer interventions were needed for blood glucose control (0.25 vs. 1.42 changes) and insulin rate adjustments (0.52 vs. 2.32 changes) in the revised protocol group.
• These differences were statistically significant (p < 0.001).

Conclusions:

• The revised one-bag protocol is a practical and effective method for managing pediatric DKA.
• This modified approach accelerates acidosis recovery and minimizes blood glucose fluctuations.
• Further research, including randomized controlled trials, is recommended to validate these findings in a broader pediatric DKA population.