Your browser doesn't support javascript.
loading
Increased Use of Hyperosmolar Therapy for Suspected Clinically Apparent Brain Injury in Pediatric Patients with Diabetic Ketoacidosis during the Peak of the COVID-19 Pandemic.
Azova, Svetlana; Liu, Enju; Wolfsdorf, Joseph.
Afiliación
  • Azova S; Division of Endocrinology, Boston Children's Hospital, Boston, Massachusetts 02115, USA.
  • Liu E; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts 02115, USA.
  • Wolfsdorf J; Institutional Centers for Clinical and Translational Research, Boston Children's Hospital, Boston, Massachusetts 02115, USA.
Pediatr Diabetes ; 20232023.
Article en En | MEDLINE | ID: mdl-38050487
The incidence of pediatric diabetic ketoacidosis (DKA) increased during the peak of the COVID-19 pandemic. The objective of this study was to investigate whether rates of hyperosmolar therapy administration for suspected clinically apparent brain injury (CABI) complicating DKA also increased during this period as compared to the three years immediately preceding the pandemic and to compare the characteristics of patients with suspected CABI before the pandemic, patients with suspected CABI during the peak of the pandemic, and those with DKA but without suspected CABI during the pandemic. Patients aged ≤18 years presenting with DKA before (March 11, 2017-March 10, 2020) and during the peak of the pandemic (March 11, 2020-March 10, 2021) were identified through a rigorous search of two databases. Predefined criteria were used to diagnose suspected CABI. Biochemical, clinical, and sociodemographic data were collected from a comprehensive review of the electronic medical record. The proportion of patients with DKA who received hyperosmolar therapy was significantly higher (P = 0.014) during the pandemic compared to the prepandemic period; however, this was only significant among patients with newly diagnosed diabetes. Both groups with suspected CABI had more severe acidosis, lower Glasgow Coma Scale scores, and longer hospital admissions (P< 0.001 for all) than cases without suspected CABI. During the pandemic, the blood urea nitrogen concentration was significantly higher in patients with suspected CABI than those without suspected CABI, suggesting they were more severely dehydrated. The clinical, biochemical, and sociodemographic characteristics of patients with suspected CABI were indistinguishable before and during the pandemic. In conclusion, administration of hyperosmolar therapy for suspected CABI was more common during the peak of the COVID-19 pandemic, possibly a result of delayed presentation, highlighting the need for increased awareness and early recognition of the signs and symptoms of diabetes and DKA, especially during future surges of highly transmissible infections.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cetoacidosis Diabética / Diabetes Mellitus Tipo 1 / COVID-19 / Coma Hiperglucémico Hiperosmolar no Cetósico Límite: Child / Humans Idioma: En Revista: Pediatr Diabetes Asunto de la revista: ENDOCRINOLOGIA Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Dinamarca

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cetoacidosis Diabética / Diabetes Mellitus Tipo 1 / COVID-19 / Coma Hiperglucémico Hiperosmolar no Cetósico Límite: Child / Humans Idioma: En Revista: Pediatr Diabetes Asunto de la revista: ENDOCRINOLOGIA Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Dinamarca