Diagnosis and Intensive Care in Children’s Diabetic Acidosis: an Interdisciplinary Viewpoint

Diabetic ketoacidosis (DKA) is the main cause of death and disability in children with type I diabetes mellitus (T1DM). Children’s mortality from T1DM reaches 1% in developed countries and 13% in developing countries. The main cause of death in DKA is cerebral edema, clinical manifestations of which...

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Main Authors: Yu. S. Aleksandrovich, D. V. Prometnoy, E. E. Petryaykina, A. V. Kiyaev, V. A. Peterkova, V. V. Kopylov, P. A. Muratov, F. N. Brezgin, S. M. Stepanenko, A. V. Lazukin, K. V. Pshenisnov, A. A. Alyokhina
Format: Article
Language:English
Published: Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russia 2024-04-01
Series:Общая реаниматология
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Online Access:https://www.reanimatology.com/rmt/article/view/2449
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author Yu. S. Aleksandrovich
D. V. Prometnoy
E. E. Petryaykina
A. V. Kiyaev
V. A. Peterkova
V. V. Kopylov
P. A. Muratov
F. N. Brezgin
S. M. Stepanenko
A. V. Lazukin
K. V. Pshenisnov
A. A. Alyokhina
author_facet Yu. S. Aleksandrovich
D. V. Prometnoy
E. E. Petryaykina
A. V. Kiyaev
V. A. Peterkova
V. V. Kopylov
P. A. Muratov
F. N. Brezgin
S. M. Stepanenko
A. V. Lazukin
K. V. Pshenisnov
A. A. Alyokhina
author_sort Yu. S. Aleksandrovich
collection DOAJ
description Diabetic ketoacidosis (DKA) is the main cause of death and disability in children with type I diabetes mellitus (T1DM). Children’s mortality from T1DM reaches 1% in developed countries and 13% in developing countries. The main cause of death in DKA is cerebral edema, clinical manifestations of which develop in 0.5–0.9% of children with DKA, while mortality riches 24%.Objective. Developing recommendations to prevent life-threatening complications of children with DKA using analysis of literature data and consolidated opinion of experts on the issues of intensive care in children with T1DM.Materials and methods. We analyzed and discussed studies in diagnosis and treatment of DKA in children with type 1 diabetes and 1200 literature sources since January 1970, published in Russian peer-reviewed scientific journals and international publications presented in the online repository Medline (Pubmed). The search for publications was carried out using the keywords: «children», «DKA», «DM1», «dehydration», «cerebral edema».Results. We considered issues of epidemiology, pathogenesis, clinical manifestations, diagnosis, intensive care for DKA, as well as clinical and diagnosis, treatment, prevention of cerebral edema issues in children. Limitations of the study were the small number of modern studies with a high level of evidence (randomized controlled trials, meta-analyses) over the past 5 years on DKA in children.Conclusion. Taking into account the national and international experience, joint recommendations on a consensus format were developed and formulated for the diagnosis of DKA, its leading complications and treatment recommendations for children with T1DM and DKA. Timely and accurate diagnosis of DKA, intensive therapy options based on proven therapeutic efficacy, laboratory and clinical monitoring are warranted to interrupt the DKA pathogenesis, prevent the development of life-threatening conditions, and improve treatment outcomes for children with DKA.
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spelling doaj-art-dd4cf521b431419e970e6e24aff0c3c52025-08-20T03:59:40ZengFederal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, RussiaОбщая реаниматология1813-97792411-71102024-04-01202405410.15360/1813-9779-2024-2-40-541950Diagnosis and Intensive Care in Children’s Diabetic Acidosis: an Interdisciplinary ViewpointYu. S. Aleksandrovich0D. V. Prometnoy1E. E. Petryaykina2A. V. Kiyaev3V. A. Peterkova4V. V. Kopylov5P. A. Muratov6F. N. Brezgin7S. M. Stepanenko8A. V. Lazukin9K. V. Pshenisnov10A. A. Alyokhina11State Pediatric Medical University, Ministry of Health of RussiaRussian Children's Clinical Hospital-Branch of N.I. Pirogov Russian National Research Medical University, Ministry of Health of RussiaRussian Children's Clinical Hospital-Branch of N.I. Pirogov Russian National Research Medical University, Ministry of Health of RussiaUral State Medical University, Ministry of Health of RussiaNational Medical Research Center for EndocrinologyV.A. Almazov National Medical Research Center, Ministry of Health of RussiaRauchfuss Children's City Multidisciplinary Clinical Center for High Medical TechnologiesUral State Medical University, Ministry of Health of RussiaRussian Children's Clinical Hospital-Branch of N.I. Pirogov Russian National Research Medical University, Ministry of Health of RussiaRegional Children's Clinical Hospital Sverdlovsk AreaState Pediatric Medical University, Ministry of Health of RussiaFederal Research and Clinical Center of Intensive Care Medicine and RehabilitologyDiabetic ketoacidosis (DKA) is the main cause of death and disability in children with type I diabetes mellitus (T1DM). Children’s mortality from T1DM reaches 1% in developed countries and 13% in developing countries. The main cause of death in DKA is cerebral edema, clinical manifestations of which develop in 0.5–0.9% of children with DKA, while mortality riches 24%.Objective. Developing recommendations to prevent life-threatening complications of children with DKA using analysis of literature data and consolidated opinion of experts on the issues of intensive care in children with T1DM.Materials and methods. We analyzed and discussed studies in diagnosis and treatment of DKA in children with type 1 diabetes and 1200 literature sources since January 1970, published in Russian peer-reviewed scientific journals and international publications presented in the online repository Medline (Pubmed). The search for publications was carried out using the keywords: «children», «DKA», «DM1», «dehydration», «cerebral edema».Results. We considered issues of epidemiology, pathogenesis, clinical manifestations, diagnosis, intensive care for DKA, as well as clinical and diagnosis, treatment, prevention of cerebral edema issues in children. Limitations of the study were the small number of modern studies with a high level of evidence (randomized controlled trials, meta-analyses) over the past 5 years on DKA in children.Conclusion. Taking into account the national and international experience, joint recommendations on a consensus format were developed and formulated for the diagnosis of DKA, its leading complications and treatment recommendations for children with T1DM and DKA. Timely and accurate diagnosis of DKA, intensive therapy options based on proven therapeutic efficacy, laboratory and clinical monitoring are warranted to interrupt the DKA pathogenesis, prevent the development of life-threatening conditions, and improve treatment outcomes for children with DKA.https://www.reanimatology.com/rmt/article/view/2449type 1 diabetes mellitusdiabetic ketoacidosischildrendehydrationcerebral edemaintensive therapy
spellingShingle Yu. S. Aleksandrovich
D. V. Prometnoy
E. E. Petryaykina
A. V. Kiyaev
V. A. Peterkova
V. V. Kopylov
P. A. Muratov
F. N. Brezgin
S. M. Stepanenko
A. V. Lazukin
K. V. Pshenisnov
A. A. Alyokhina
Diagnosis and Intensive Care in Children’s Diabetic Acidosis: an Interdisciplinary Viewpoint
Общая реаниматология
type 1 diabetes mellitus
diabetic ketoacidosis
children
dehydration
cerebral edema
intensive therapy
title Diagnosis and Intensive Care in Children’s Diabetic Acidosis: an Interdisciplinary Viewpoint
title_full Diagnosis and Intensive Care in Children’s Diabetic Acidosis: an Interdisciplinary Viewpoint
title_fullStr Diagnosis and Intensive Care in Children’s Diabetic Acidosis: an Interdisciplinary Viewpoint
title_full_unstemmed Diagnosis and Intensive Care in Children’s Diabetic Acidosis: an Interdisciplinary Viewpoint
title_short Diagnosis and Intensive Care in Children’s Diabetic Acidosis: an Interdisciplinary Viewpoint
title_sort diagnosis and intensive care in children s diabetic acidosis an interdisciplinary viewpoint
topic type 1 diabetes mellitus
diabetic ketoacidosis
children
dehydration
cerebral edema
intensive therapy
url https://www.reanimatology.com/rmt/article/view/2449
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