So Tsz-Yin, Grunewalder Elizabeth
Department of Pharmacy, Moses H. Cone Hospital, Greensboro, North Carolina.
J Pediatr Pharmacol Ther. 2009 Apr;14(2):100-5. doi: 10.5863/1551-6776-14.2.100.
A one-bag and a two-bag system have both been used to manage intravenous fluid administration in pediatric patients with diabetic ketoacidosis (DKA). The one-bag system, however, has been noted to have limitations, such as slow response time. This study evaluates whether the two-bag system provides any clinical benefit in pediatric DKA patients as compared to the one-bag system.
This was a retrospective, non-blinded chart review. Inclusion criteria were patients ≤ 18 years old and whose admission had the code of DKA as the diagnosis. Baseline clinical and demographic data were collected. Descriptive statistics were used in the data analysis.
A total of 31 patients were included, 9 (29%) in the one-bag group and 22 (71%) in the two-bag group. Baseline characteristics were similar between the two groups. Mean (SD) rate of complete blood glucose (CBG) correction was 31.04 mg/dL/hr (20.61) in the two-bag group and 21.04 mg/dL/hr (16.26) in the one-bag group (p = 0.297). The rate of bicarbonate correction, however, was faster with the two-bag system than the one-bag system (0.949 ± 0.553 mEq/L/hr and 0.606 ± 0.297 mEq/L/hr, respectively) (p = 0.047). The two-bag system also had a faster time to ketone (p = 0.04), but not pH (p = 0.172), correction.
The two-bag system provided a faster rate of bicarbonate and ketone correction compared to the one-bag system. The two-bag system also provided a trend towards a faster rate of blood glucose and pH correction.
单袋系统和双袋系统均已用于管理糖尿病酮症酸中毒（DKA）儿科患者的静脉输液。然而，单袋系统存在局限性，如响应时间较慢。本研究评估双袋系统与单袋系统相比，是否能为儿科DKA患者带来任何临床益处。
这是一项回顾性、非盲法病历审查。纳入标准为年龄≤18岁且入院诊断代码为DKA的患者。收集了基线临床和人口统计学数据。数据分析采用描述性统计。
共纳入31例患者，单袋组9例（29%），双袋组22例（71%）。两组基线特征相似。双袋组全血糖（CBG）校正的平均（标准差）速率为31.04mg/dL/小时（20.61），单袋组为21.04mg/dL/小时（16.26）（p = 0.297）。然而，双袋系统的碳酸氢盐校正速率比单袋系统快（分别为0.949±0.553mEq/L/小时和0.606±0.297mEq/L/小时）（p = 0.047）。双袋系统酮体校正时间也更快（p = 0.04），但pH值校正时间无差异（p = 0.172）。
与单袋系统相比，双袋系统的碳酸氢盐和酮体校正速率更快。双袋系统在血糖和pH值校正速率上也有加快的趋势。
