Impact of the COVID-19 pandemic on diabetic ketoacidosis management in the pediatric intensive care unit
Background Diabetic ketoacidosis (DKA) is a common endocrine emergency in pediatric patients. Early presentation to health facilities, diagnosis, and good management in the pediatric intensive care unit (PICU) are crucial for better outcomes in children with DKA. Methods This was a single-center, re...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Korean Society of Critical Care Medicine
2023-08-01
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| Series: | Acute and Critical Care |
| Subjects: | |
| Online Access: | http://www.accjournal.org/upload/pdf/acc-2023-00038.pdf |
| _version_ | 1827824891624161280 |
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| author | Fevzi Kahveci Buse Önen Ocak Emrah Gün Anar Gurbanov Hacer Uçmak Ayşen Durak Aslan Ayşegül Ceran Hasan Özen Burak Balaban Edin Botan Zeynep Şıklar Merih Berberoğlu Tanıl Kendirli |
| author_facet | Fevzi Kahveci Buse Önen Ocak Emrah Gün Anar Gurbanov Hacer Uçmak Ayşen Durak Aslan Ayşegül Ceran Hasan Özen Burak Balaban Edin Botan Zeynep Şıklar Merih Berberoğlu Tanıl Kendirli |
| author_sort | Fevzi Kahveci |
| collection | DOAJ |
| description | Background Diabetic ketoacidosis (DKA) is a common endocrine emergency in pediatric patients. Early presentation to health facilities, diagnosis, and good management in the pediatric intensive care unit (PICU) are crucial for better outcomes in children with DKA. Methods This was a single-center, retrospective cohort study conducted between February 2015 and January 2022. Patients with DKA were divided into two groups according to pandemic status and diabetes diagnosis. Results The study enrolled 59 patients, and their mean age was 11±5 years. Forty (68%) had newly diagnosed type 1 diabetes mellitus (T1DM), and 61% received follow-up in the pre-pandemic period. Blood glucose, blood ketone, potassium, phosphorus, and creatinine levels were significantly higher in the new-onset T1DM group compared with the previously diagnosed group (P=0.01, P=0.02, P<0.001, P=0.01, and P=0.08, respectively). In patients with newly diagnosed T1DM, length of PICU stays were longer than in those with previously diagnosed T1DM (28.5±8.9 vs. 17.3±6.7 hours, p<0.001). The pandemic group was compared with pre-pandemic group, there was a statistically significant difference in laboratory parameters of pH, HCO3, and lactate and also Pediatric Risk of Mortality (PRISM) III score. All patients survived, and there were no neurologic sequelae. Conclusion Patients admitted during the pandemic period were admitted with more severe DKA and had higher PRISM III scores. During the pandemic period, there was an increase in the incidence of DKA in the participating center compared to that before the pandemic. |
| first_indexed | 2024-03-12T02:33:46Z |
| format | Article |
| id | doaj.art-640c7a411d33402aa4db2f143c7c8545 |
| institution | Directory Open Access Journal |
| issn | 2586-6052 2586-6060 |
| language | English |
| last_indexed | 2024-03-12T02:33:46Z |
| publishDate | 2023-08-01 |
| publisher | Korean Society of Critical Care Medicine |
| record_format | Article |
| series | Acute and Critical Care |
| spelling | doaj.art-640c7a411d33402aa4db2f143c7c85452023-09-05T04:11:25ZengKorean Society of Critical Care MedicineAcute and Critical Care2586-60522586-60602023-08-0138337137910.4266/acc.2023.000381468Impact of the COVID-19 pandemic on diabetic ketoacidosis management in the pediatric intensive care unitFevzi Kahveci0Buse Önen Ocak1Emrah Gün2Anar Gurbanov3Hacer Uçmak4Ayşen Durak Aslan5Ayşegül Ceran6Hasan Özen7Burak Balaban8Edin Botan9Zeynep Şıklar10Merih Berberoğlu11Tanıl Kendirli12 Division of Pediatric Intensive Care, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Türkiye Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Türkiye Division of Pediatric Intensive Care, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Türkiye Division of Pediatric Intensive Care, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Türkiye Division of Pediatric Intensive Care, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Türkiye Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Türkiye Division of Pediatric Endocrinology, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Türkiye Division of Pediatric Intensive Care, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Türkiye Division of Pediatric Intensive Care, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Türkiye Division of Pediatric Intensive Care, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Türkiye Division of Pediatric Endocrinology, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Türkiye Division of Pediatric Endocrinology, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Türkiye Division of Pediatric Intensive Care, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, TürkiyeBackground Diabetic ketoacidosis (DKA) is a common endocrine emergency in pediatric patients. Early presentation to health facilities, diagnosis, and good management in the pediatric intensive care unit (PICU) are crucial for better outcomes in children with DKA. Methods This was a single-center, retrospective cohort study conducted between February 2015 and January 2022. Patients with DKA were divided into two groups according to pandemic status and diabetes diagnosis. Results The study enrolled 59 patients, and their mean age was 11±5 years. Forty (68%) had newly diagnosed type 1 diabetes mellitus (T1DM), and 61% received follow-up in the pre-pandemic period. Blood glucose, blood ketone, potassium, phosphorus, and creatinine levels were significantly higher in the new-onset T1DM group compared with the previously diagnosed group (P=0.01, P=0.02, P<0.001, P=0.01, and P=0.08, respectively). In patients with newly diagnosed T1DM, length of PICU stays were longer than in those with previously diagnosed T1DM (28.5±8.9 vs. 17.3±6.7 hours, p<0.001). The pandemic group was compared with pre-pandemic group, there was a statistically significant difference in laboratory parameters of pH, HCO3, and lactate and also Pediatric Risk of Mortality (PRISM) III score. All patients survived, and there were no neurologic sequelae. Conclusion Patients admitted during the pandemic period were admitted with more severe DKA and had higher PRISM III scores. During the pandemic period, there was an increase in the incidence of DKA in the participating center compared to that before the pandemic.http://www.accjournal.org/upload/pdf/acc-2023-00038.pdfchildrencovid-19diabetic ketoacidosispediatric intensive care |
| spellingShingle | Fevzi Kahveci Buse Önen Ocak Emrah Gün Anar Gurbanov Hacer Uçmak Ayşen Durak Aslan Ayşegül Ceran Hasan Özen Burak Balaban Edin Botan Zeynep Şıklar Merih Berberoğlu Tanıl Kendirli Impact of the COVID-19 pandemic on diabetic ketoacidosis management in the pediatric intensive care unit Acute and Critical Care children covid-19 diabetic ketoacidosis pediatric intensive care |
| title | Impact of the COVID-19 pandemic on diabetic ketoacidosis management in the pediatric intensive care unit |
| title_full | Impact of the COVID-19 pandemic on diabetic ketoacidosis management in the pediatric intensive care unit |
| title_fullStr | Impact of the COVID-19 pandemic on diabetic ketoacidosis management in the pediatric intensive care unit |
| title_full_unstemmed | Impact of the COVID-19 pandemic on diabetic ketoacidosis management in the pediatric intensive care unit |
| title_short | Impact of the COVID-19 pandemic on diabetic ketoacidosis management in the pediatric intensive care unit |
| title_sort | impact of the covid 19 pandemic on diabetic ketoacidosis management in the pediatric intensive care unit |
| topic | children covid-19 diabetic ketoacidosis pediatric intensive care |
| url | http://www.accjournal.org/upload/pdf/acc-2023-00038.pdf |
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