儿科重症医师对儿科重症监护病房中儿童糖尿病酮症酸中毒管理的影响。

The impact of pediatric intensivists on the management of pediatric diabetic ketoacidosis in pediatric intensive care units.

机构信息

Department of Pediatrics, Chungnam National University Hospital, Daejeon, Republic of Korea.

Department of Pediatrics, Jeonbuk National University Children's Hospital, Jeonju, Republic of Korea.

出版信息

BMC Pediatr. 2023 Nov 13;23(1):562. doi: 10.1186/s12887-023-04398-z.

DOI:10.1186/s12887-023-04398-z

PMID:37957591

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10644449/

Abstract

INTRODUCTION

The impact of pediatric intensivists on managing pediatric patients with diabetic ketoacidosis (DKA) remains unknown. This study aimed to evaluate the impact of pediatric intensivists on outcomes in pediatric intensive care units (PICUs).

METHODS

This was a two-institution retrospective study of patients with DKA admitted to the PICU between 2012 and 2023. Pediatric patients (< 19 years of age) were included if they met the moderate to severe DKA criteria on PICU admission. The patients were subsequently divided into two groups based on the presence or absence of a pediatric intensivist. The primary outcome was the PICU length of stay (LOS). Secondary outcomes were adverse events during DKA treatment, hospital LOS, and mortality.

RESULTS

Fifty-two patients admitted to the PICU with a median age of 13.00 years (range, 0-18 years) were included; 32 (61.54%) were female. Patients managed by pediatric intensivists had significantly shorter PICU LOS (2.52 vs. 3.69 days, p < 0.05). Also, adverse events during DKA treatment were significantly decreased in the high-intensity group compared to the low-intensity group (12.50% vs. 50.00%, p < 0.05).

CONCLUSIONS

High-intensity ICU staffing was associated with shorter PICU LOS and lower adverse events in pediatric patients with DKA. Our results suggest that dedicated pediatric intensivists can improve outcomes of critically ill pediatric patients with DKA.

摘要

简介

儿科重症监护医师对管理儿童糖尿病酮症酸中毒（DKA）患者的影响尚不清楚。本研究旨在评估儿科重症监护医师对儿科重症监护病房（PICU）结局的影响。

方法

这是一项在 2012 年至 2023 年间在 PICU 住院的 DKA 患者的两机构回顾性研究。如果患者在 PICU 入院时符合中度至重度 DKA 标准，则将儿科患者（<19 岁）纳入研究。随后根据是否存在儿科重症监护医师将患者分为两组。主要结局是 PICU 住院时间（LOS）。次要结局是 DKA 治疗期间的不良事件、住院 LOS 和死亡率。

结果

52 名年龄中位数为 13.00 岁（范围 0-18 岁）的患者被收入 PICU；其中 32 名（61.54%）为女性。由儿科重症监护医师管理的患者的 PICU LOS 明显缩短（2.52 天 vs. 3.69 天，p<0.05）。此外，高强度组 DKA 治疗期间的不良事件明显低于低强度组（12.50% vs. 50.00%，p<0.05）。