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COMPLICATIONS SPECTRUM OF DIABETIC KETOACIDOSIS AMONG CHILDREN OF PEDIATRIC ICU

Dr Ayesha Aleem

Objectives: The purpose of this research work is to elaborate the complications spectrum of DKA (Diabetic Ketoacidosis) as appeared in the children getting treatment of severe diabetic ketoacidosis. Methodology: We carried out the retroactive review of the clinical records of children who got admission with the identification of severe diabetic ketoacidosis in pediatric ICU of Allied / DHQ Hospital Faisalabad from March 2014 to March 2019. We collected all the information on a Performa and we applied the descriptive statistics. Results: Total thirty-seven children got admission with the severe diabetic ketoacidosis (1.90% of total Pediatric ICU admissions with 1.80% in 2014 and 3.40% in 2019). The average age of the patients of this research work was 8.10 ± 4.60 years and 70.0% (n: 26) patients were females. Average Prism-3 score was 9.40 ± 6.0, average GCS on the time of appearance was 11.0 ± 3.80 and average minimum pH was 7.0 ± 0.150. The observed complications included hypochloremia in 35.940% patients, hypokalemia in 30.810%, hyponatremia in 26.7%, cerebral edema in 16.430%, shock in 13.350% children, AKI (Acute Kidney Injury in 10.270%, arrhythmias in 3.80% & TTP (Thrombotic Thrombocytopenic Purpura in 5.40%, whereas only 1 patient was present with myocarditis & one with ARDS. Inotropic support was the need for thirty-five percent patients, thirty percent patients were in need of mechanical ventilation whereas only one patient was in need of renal replacement treatment. Total 5.40% (n: 2) patients met their death in their stay in pediatric ICU. Conclusion: Some most frequent complications of the DKA of severe nature are hypochloremia, some electrolyte abnormalities, cerebral edema and acute kidney infections. KEYWORDS: Diabetic Ketoacidosis, Thrombotic Thrombocytopenic Purpura, Pediatrics, Hypochloremia, Inotropic.

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