tailieunhanh - Pediatric non-diabetic ketoacidosis: A caseseries report

This study is to explore the clinical characteristics, laboratory diagnosis, and treatment outcomes in pediatric patients with non-diabetic ketoacidosis. | Bai et al. BMC Pediatrics 2017 17 209 DOI s12887-017-0960-3 RESEARCH ARTICLE Open Access Pediatric non-diabetic ketoacidosis a case- series report Ke Bai1 Yueqiang Fu1 Chengjun Liu1 Feng Xu1 and Min Zhu2 Abstract Background This study is to explore the clinical characteristics laboratory diagnosis and treatment outcomes in pediatric patients with non-diabetic ketoacidosis. Methods Retrospective patient chart review was performed between March 2009 to March 2015. Cases were included if they met the selection criteria for non-diabetic ketoacidosis which were 1 Age 18 years 2 urine ketone positive or mmol L 3 blood ketone mmol L 4 acidosis pH and or HCO3 15 mmol L 5 random blood glucose level mmol L. Patients who met the criteria 1 4 5 plus either 2 or 3 were defined as non-diabetic ketoacidosis and were included in the report. Results Five patients with 7 episodes of non-diabetic ketoacidosis were identified. They all presented with dehydration poor appetite and Kussmaul breathing. Patients treated with insulin plus glucose supplementation had a quicker recovery from acidosis in comparison to those treated with bicarbonate infusion and continuous renal replacement therapy. Two patients treated with bicarbonate infusion developed transient coma and seizures during the treatment. Conclusion Despite normal or low blood glucose levels patients with non-diabetic ketoacidosis should receive insulin administration with glucose supplementation to correct ketoacidosis. Keywords Non-diabetic ketoacidosis Glucose Insulin Bicarbonate Continuous renal replacement therapy Background Diabetic ketoacidosis is a common cause of metabolic acidosis. However ketoacidosis is not always accompanied with high blood glucose and diabetes. Some patients with ketoacidosis may have no medical history of diabetes and have normal or low blood glucose levels. These patients with non-diabetic ketoacidosis may also experience severe complications or even death 1 . There has