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Factors Associated With the Severity of Diabetic Ketoacidosis on Admission in Pediatric Intensive Care: A

Mahamoud Ahmed Houssein1, Manira Moussa Ahmed2, Zineb Serhier3,4

  • 1Anesthesia and Critical Care, Cheikh Khalifa International University Hospital, Mohammed VI University of Health Sciences, Casablanca, MAR.

Cureus
|January 27, 2025
PubMed

Insights

Diabetic ketoacidosis (DKA) severity in children is linked to breathing difficulties and drowsiness upon admission. Higher white blood cell counts, C-reactive protein, and procalcitonin levels also indicate more severe DKA cases.

Area of Science:

  • Pediatrics
  • Endocrinology
  • Intensive Care Medicine

Background:

  • Diabetic ketoacidosis (DKA) is a critical complication in pediatric diabetes.
  • DKA management, particularly in intensive care settings, requires understanding severity factors.

Purpose of the Study:

  • To identify clinical and biological factors associated with DKA severity in hospitalized children.
  • To differentiate between severe and non-severe DKA presentations in a pediatric intensive care unit.

Main Methods:

  • Retrospective, monocentric descriptive and analytical study.
  • Inclusion of pediatric patients (1 month to 17 years) meeting ISPAD 2022 DKA criteria.
  • Comparison of severe vs. non-severe DKA groups using Jamovi software.

Main Results:

  • Dyspnea and drowsiness at admission were significantly associated with severe DKA.
  • Elevated white blood cell (WBC) counts, procalcitonin (PCT), and C-reactive protein (CRP) were higher in severe DKA.
  • No significant differences in age, sex, triggering factors, or outcomes between severity groups.

Conclusions:

  • Neurological disturbances and dyspnea are key indicators of DKA severity in children.
  • Elevated WBC, CRP, and PCT levels are significant biological markers for severe DKA.
  • Early identification of these factors can aid in timely and appropriate pediatric DKA management.

Keywords:
childrendiabetes type 1pediatric intensive careseverityketoacidosis

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