Department of Pediatric Emergency Medicine, Children's Minnesota, Minneapolis, MN, USA.
Department of Pediatric Emergency Medicine, Children's Minnesota, Minneapolis, MN, USA.
Am J Emerg Med. 2021 Jul;45:683.e1-683.e3. doi: 10.1016/j.ajem.2020.12.029. Epub 2020 Dec 18.
Diabetic ketoacidosis (DKA) occurs frequently among children and adolescents with type 1 diabetes. Although a number of complications may occur during episodes of DKA, significant cardiac arrhythmias are uncommon. We present the case of an adolescent who presented with severe DKA and wide complex tachycardia that was unresponsive to multiple doses of adenosine and ultimately required synchronized cardioversion. This case reminds the clinician of the importance of cardiac monitoring in children with DKA, particularly in the setting of hyperkalemia.
糖尿病酮症酸中毒(DKA)在 1 型糖尿病儿童和青少年中较为常见。尽管在 DKA 发作期间可能会出现许多并发症,但严重的心律失常并不常见。我们报告了一例青少年患者,他因严重的 DKA 伴宽复合性心动过速而就诊,多次给予腺苷后无反应,最终需要同步电复律。该病例提醒临床医生,在 DKA 患儿中,特别是在高钾血症的情况下,进行心脏监测的重要性。