Hypertension during Diabetic Ketoacidosis in Children.
J Pediatr
; 223: 156-163.e5, 2020 08.
Article
em En
| MEDLINE
| ID: mdl-32387716
ABSTRACT
OBJECTIVES:
To characterize hemodynamic alterations occurring during diabetic ketoacidosis (DKA) in a large cohort of children and to identify clinical and biochemical factors associated with hypertension. STUDYDESIGN:
This was a planned secondary analysis of data from the Pediatric Emergency Care Applied Research Network Fluid Therapies Under Investigation in DKA Study, a randomized clinical trial of fluid resuscitation protocols for children in DKA. Hemodynamic data (heart rate, blood pressure) from children with DKA were assessed in comparison with normal values for age and sex. Multivariable statistical modeling was used to explore clinical and laboratory predictors of hypertension.RESULTS:
Among 1258 DKA episodes, hypertension was documented at presentation in 154 (12.2%) and developed during DKA treatment in an additional 196 (15.6%), resulting in a total of 350 DKA episodes (27.8%) in which hypertension occurred at some time. Factors associated with hypertension at presentation included more severe acidosis, (lower pH and lower pCO2), and stage 2 or 3 acute kidney injury. More severe acidosis and lower Glasgow Coma Scale scores were associated with hypertension occurring at any time during DKA treatment.CONCLUSIONS:
Despite dehydration, hypertension occurs in a substantial number of children with DKA. Factors associated with hypertension include greater severity of acidosis, lower pCO2, and lower Glasgow Coma Scale scores during DKA treatment, suggesting that hypertension might be centrally mediated.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Pressão Sanguínea
/
Cetoacidose Diabética
/
Emergências
/
Hidratação
/
Hipertensão
Tipo de estudo:
Clinical_trials
/
Etiology_studies
/
Guideline
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Child
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Female
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Humans
/
Male
Idioma:
En
Revista:
J Pediatr
Ano de publicação:
2020
Tipo de documento:
Article
País de afiliação:
Panamá