Toledo Juan Diego, Modesto Vicente, Peinador Magdalena, Alvarez Pablo, López-Prats José Luis, Sanchis Ramón, Vento Máximo
Pediatric Intensive Care Unit, Children's Hospital La Fe, Valencia, Spain.
J Pediatr. 2009 Jun;154(6):895-900. doi: 10.1016/j.jpeds.2008.12.042. Epub 2009 Feb 23.
To analyze in a retrospective cohort if sodium concentration in the rehydration fluids influence natremia in children with diabetic ketoacidosis (DKA).
Consecutive episodes of diabetic ketoacidosis admitted in a tertiary care referral center from 2000 to 2005. Rehydration was programmed for 48 hours with a 2-bag system. Initial rehydration was performed with isotonic fluids and thereafter with variable tonicity. Analysis of the influence of the different factors on natremia was performed with a multivariate linear regression analysis.
Forty-two episodes of DKA were reviewed. Increased sodium content in rehydration fluids behaved as an independent variable, causing a positive tendency of natremia (P < .008).
Sodium concentration in the rehydration fluids behaves as an independent factor that influences positively the trend of the serum concentration of sodium during DKA rehydration. We propose the use of isotonic solutions for rehydration in diabetic ketoacidosis.
通过回顾性队列研究分析补液中钠浓度对糖尿病酮症酸中毒（DKA）患儿血钠水平的影响。
2000年至2005年在一家三级医疗转诊中心收治的连续性糖尿病酮症酸中毒病例。采用双袋系统进行48小时补液。初始补液使用等渗液，之后使用不同张力的液体。通过多变量线性回归分析不同因素对血钠水平的影响。
回顾了42例DKA病例。补液中钠含量增加是一个独立变量，导致血钠水平呈上升趋势（P < 0.008）。
补液中的钠浓度是影响DKA补液期间血清钠浓度趋势的一个独立因素，且呈正相关。我们建议在糖尿病酮症酸中毒补液时使用等渗溶液。
