Babbitt Christopher, Dadios Marc, Chau Ariya, Tse Graham, Brown Lisa, Ladbury Tracy, Morphew Tricia, Brakin Mario
Division of Pediatric Critical Care, Miller Children's and Women's Hospital Long Beach, Long Beach, California, United States.
Division of Pediatric Critical Care, Children's Hospital of Orange County, Orange, California, United States.
J Pediatr Intensive Care. 2021 Mar;10(1):23-30. doi: 10.1055/s-0040-1712921. Epub 2020 Jun 4.
Diabetic ketoacidosis (DKA) is a common cause of admission to the pediatric intensive care unit and many centers utilize the "two-bag system" to treat DKA. We developed an intravenous fluid (IVF) titration algorithm to standardize adjustments of the two bags. A retrospective cohort study was performed comparing 155 patients treated before and 175 patients treated after implementation of the IVF titration algorithm. Postimplementation patients reached the blood glucose target zone faster and had a higher probability of remaining at goal while on insulin infusion. There was no significant difference in incidence of cerebral edema or hypoglycemia between study groups. Overall IVF titration algorithm compliance was 95%. Implementation of an IVF titration algorithm is safe and effective when treating DKA in children.
糖尿病酮症酸中毒（DKA）是儿童重症监护病房常见的入院原因，许多中心采用“双袋系统”治疗DKA。我们开发了一种静脉输液（IVF）滴定算法，以规范两袋液体的调整。进行了一项回顾性队列研究，比较了实施IVF滴定算法之前治疗的155例患者和之后治疗的175例患者。实施后，患者达到血糖目标范围的速度更快，在胰岛素输注期间维持在目标范围的概率更高。研究组之间脑水肿或低血糖的发生率没有显著差异。IVF滴定算法的总体依从率为95%。在治疗儿童DKA时，实施IVF滴定算法是安全有效的。
