Document Detail

Diabetic ketoacidosis (DKA): treatment guidelines.
MedLine Citation:
PMID:  8804545     Owner:  NLM     Status:  MEDLINE    
Diabetic ketoacidosis (DKA), resulting from severe insulin deficiency, accounts for most hospitalization and is the most common cause of death, mostly due to cerebral edema, in pediatric diabetes. This article provides guidelines on management to restore perfusion, stop ongoing ketogenesis, correct electrolyte losses, and avoid hypokalemia and hypoglycemia and the circumstances that may contribute, in some instances, to cerebral edema (overhydration, rapid osmolar shifts, hypoxia). These guidelines emphasize the importance of monitoring glycemia, electrolytes, hydration, vital signs, and neurologic status in a setting where response can be rapid if necessary (e.g., mannitol for cerebral edema). Most important is the prevention of DKA in established patients by close supervision of those most likely to omit insulin, or during illness, and a high index of suspicion for diabetes to prevent deterioration to DKA in new patients, particularly those under age 5, who are at greatest risk of complications.
A L Rosenbloom; R Hanas
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Clinical pediatrics     Volume:  35     ISSN:  0009-9228     ISO Abbreviation:  Clin Pediatr (Phila)     Publication Date:  1996 May 
Date Detail:
Created Date:  1996-10-23     Completed Date:  1996-10-23     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  0372606     Medline TA:  Clin Pediatr (Phila)     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  261-6     Citation Subset:  AIM; IM    
Department of Pediatrics, University of Florida College of Medicine, Gainesville 32610-0296, USA.
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MeSH Terms
Brain Diseases / complications
Case Management
Child, Preschool
Clinical Protocols
Dehydration / therapy
Diabetic Ketoacidosis / complications,  diagnosis,  therapy*
Drug Administration Schedule
Fluid Therapy
Hyperglycemia / therapy
Hypoglycemia / chemically induced,  prevention & control,  therapy
Hypokalemia / therapy
Insulin / administration & dosage,  adverse effects
Insulin Infusion Systems
Reg. No./Substance:

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