Document Detail

Hypertension despite dehydration during severe pediatric diabetic ketoacidosis.
MedLine Citation:
PMID:  21443581     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Diabetic ketoacidosis (DKA) may result in both dehydration and cerebral edema but these processes may have opposing effects on blood pressure. We examined the relationship between dehydration and blood pressure in pediatric DKA.
DESIGN: A retrospective review was performed at Seattle Children's Hospital, Seattle, WA. Participants were hospitalized children less than 18 yr. Intervention(s) or main exposure was to patients with DKA (venous pH < 7.3, glucose > 300 mg/dL, HCO(3) < 15 mEq/L, and urinary ketosis). Dehydration was calculated as percent body weight lost at admission compared to discharge. Hypertension (systolic and/or diastolic blood pressure (DBP) percentile > 95%) was defined based on National Heart, Lung, and Blood Institute (NHLBI, 2004) nomograms and hypotension was defined as systolic blood pressure (SBP) <70 + 2 [age].
RESULTS: Thirty-three patients (median 10.9 yr; range 10 months to 17 yr) were included. Fifty-eight percent of patients (19/33) had hypertension on admission before treatment and 82% had hypertension during the first 6 h of admission. None had admission hypotension. Hypertension 48 h after treatment and weeks after discharge was common (28 and 19%, respectively). Based on weight gained by discharge, 27% of patients had mild, 61% had moderate, and 12% presented with severe dehydration.
CONCLUSION: Despite dehydration, most children admitted with severe DKA had hypertension.
Kristina H Deeter; Joan S Roberts; Heidi Bradford; Todd Richards; Dennis Shaw; Kenneth Marro; Harvey Chiu; Catherine Pihoker; Anne Lynn; Monica S Vavilala
Publication Detail:
Type:  Journal Article     Date:  2011-03-28
Journal Detail:
Title:  Pediatric diabetes     Volume:  12     ISSN:  1399-5448     ISO Abbreviation:  Pediatr Diabetes     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-05-27     Completed Date:  2011-09-15     Revised Date:  2014-03-19    
Medline Journal Info:
Nlm Unique ID:  100939345     Medline TA:  Pediatr Diabetes     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  295-301     Citation Subset:  IM    
Copyright Information:
© 2011 John Wiley & Sons A/S.
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MeSH Terms
Blood Pressure
Brain Edema / etiology*
Dehydration / etiology*
Diabetic Ketoacidosis / physiopathology*
Hypertension / etiology*
Retrospective Studies
Grant Support
R21 EB009438-01A1/EB/NIBIB NIH HHS; R21 EB009438-02/EB/NIBIB NIH HHS; R21 HD049832/HD/NICHD NIH HHS; R21 HD049832-02/HD/NICHD NIH HHS
Comment In:
Pediatr Diabetes. 2011 Jun;12(4 Pt 1):293-4   [PMID:  21615649 ]

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