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关于儿童糖尿病酸性脂肪酸症的叙事评论
Karen K Y Leung1, Joanna Y L Tung2, Yan Tung Kelly Lee1
1Paediatric Intensive Care Unit, Department of Paediatrics and Adolescent Medicine, Hong Kong Children's Hospital, China.
Current pediatric reviews
|February 1, 2024
概括
在全球范围内,儿童糖尿病酸性脂肪酸症 (DKA) 的管理有所不同. 目前的证据对限制性或允许性液体管理是否最好是有限的,需要谨慎的临床应用指南.
科学领域:
- 儿科内分泌学 儿科内分泌学
- 关键护理医学 关键护理医学
背景情况:
- 糖尿病酸性酸症 (DKA) 是患有糖尿病的儿童的严重并发症.
- 对DKA管理的国际指导方针各不相同,特别是在流体输送策略方面.
- 在历史上,人们对脑的担忧倾向于限制性流体方法,但最近的研究质疑这种联系.
研究的目的:
- 提供关于儿童患者糖尿病酸性酸症当前管理的叙事综述.
- 检查和比较DKA管理的国际指南.
- 讨论围绕儿科DKA流体管理的争议.
主要方法:
- 在PubMed上进行了全面的文献搜索,使用了"糖尿病酸症"一词.
- 搜索包括英语的各种研究类型 (RCT,试验,元分析,观察性研究,指南,评论).
- 重点是儿童群体 (≤18岁),主要临床指南的审查和比较.
主要成果:
- 有限的临床证据确实支持儿童DKA的限制性或允许性流体管理.
- DKA管理指南中的差异突显了正在进行的辩论,特别是关于流体治疗.
- 最近的研究挑战了IV液体和DKA相关的大脑损伤之间的因果关系.
结论:
- 有效的DKA管理需要及时识别,诊断和综合治疗,包括液体,胰岛素和密切监测.
- 在儿科DKA中限制性和允许性流体策略之间的选择缺乏强有力的支持证据.
- 在实施DKA管理指南时,临床医生必须仔细考虑个体患者的因素.
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