J, Fogel J, Levine R, Ciminera P, Fagan D, Bargman R. Potential Clinical Benefits of a Two-bag System for Fluid Management in Pediatric Intensive Care Unit Patients with Diabetic Ketoacidosis. Pediatric Endocrinology Diabetes and Metabolism. 2017;23(1):6-13.
APA
, J., Fogel, J., Levine, R., Ciminera, P., Fagan, D., & Bargman, R. (2017). Potential Clinical Benefits of a Two-bag System for Fluid Management in Pediatric Intensive Care Unit Patients with Diabetic Ketoacidosis. Pediatric Endocrinology Diabetes and Metabolism, 23(1), 6-13.
Chicago
, Jacqueline Velasco, Joshua Fogel, Robert Levine, Peter Ciminera, David Fagan, and Renee Bargman. 2017. "Potential Clinical Benefits of a Two-bag System for Fluid Management in Pediatric Intensive Care Unit Patients with Diabetic Ketoacidosis". Pediatric Endocrinology Diabetes and Metabolism 23 (1): 6-13.
Harvard
, J., Fogel, J., Levine, R., Ciminera, P., Fagan, D., and Bargman, R. (2017). Potential Clinical Benefits of a Two-bag System for Fluid Management in Pediatric Intensive Care Unit Patients with Diabetic Ketoacidosis. Pediatric Endocrinology Diabetes and Metabolism, 23(1), pp.6-13.
MLA
, Jacqueline Velasco et al. "Potential Clinical Benefits of a Two-bag System for Fluid Management in Pediatric Intensive Care Unit Patients with Diabetic Ketoacidosis." Pediatric Endocrinology Diabetes and Metabolism, vol. 23, no. 1, 2017, pp. 6-13.
Vancouver
J, Fogel J, Levine R, Ciminera P, Fagan D, Bargman R. Potential Clinical Benefits of a Two-bag System for Fluid Management in Pediatric Intensive Care Unit Patients with Diabetic Ketoacidosis. Pediatric Endocrinology Diabetes and Metabolism. 2017;23(1):6-13.
Introduction. Diabetic ketoacidosis (DKA) is a life-threatening complication of diabetes mellitus (DM) that requires appropriate treatment with insulin and intravenous fluids. Both one-bag and two-bag systems of fluid management are used to treat pediatric diabetic ketoacidosis. Aim of the Study. We compare the one-bag and two-bag systems of fluid managementwith regard to incidence of hypoglycemia, serum bicarbonate correction, pH correction and discharge from the pediatric intensive care unit (PICU). Method. This was a retrospective study of 61 patients less than 21 years old admitted to the PICU with a diagnosis of DKA. Of the 61 patients, 38 were treated with the one-bag system and 23 treated with the two-bag system. Results. The two-bag system had significantly (p=0.03) lower incidence of hypoglycemia (n=2, 8.7%) compared to the one-bag system (n=13, 34.2%). The two-bag system had significantly (p=0.001) fewer hours of PICU stay (M=29.6, SD=15.23) than the one-bag system (M=47.9, SD=22.32). However, there were no significant differences between the bag systems for hours for pH and bicarbonate correction. Conclusion. The two-bag system is associated with lower incidence of hypoglycemia and faster discharge from the PICU. We recommend that clinicians consider using the two-bag system for fluid management in pediatric patients with diabetic ketoacidosis.
Keywords
diabetic ketoacidosis, insulin, hypoglycemia, diabetes mellitus type 1