The Effects of Prehospital Care on Outcome in Pediatric Diabetic Ketoacidosis

Basit Öğe Kaydı
dc.contributor.authorTuran, Caner
dc.contributor.authorYurtseven, Ali
dc.contributor.authorBasa, Elif Gökçe
dc.contributor.authorSaz, Eylem Ulaş
dc.date.accessioned2021-05-03T21:16:27Z
dc.date.available2021-05-03T21:16:27Z
dc.date.issued2020
dc.departmentEge Üniversitesien_US
dc.description.abstractObjective: Despite the guidelines, significant variations can be encountered in initial therapy for pediatric diabetic ketoacidosis (DKA) in the prehospital setting. These variations occur mostly in fluid administration, insulin dosing, route of administration, and other aspects of the initial resuscitation and stabilization. The aim was to identify the effect of transport care on outcomes in children with DKA admitted to the emergency department (ED). Methods: Patients admitted to a tertiary-care pediatric ED between 2015-2019 with a diagnosis of DKA were retrospectively identified. Details of pre-pediatric ED care, including transport modality, patient demographics, clinical features, laboratory evaluation, fluid therapy, insulin dosing, and short-term outcome were recorded. Results: The study cohort included 147 episodes of DKA in 136 patients aged 9 months-21 years. Emergency Medical Service (EMS) transported only 37.4% of cases. EMS utilization rate was significantly higher (p=0.003) in severe cases, most of whom were >10 years (p=0.04). During transport 85% received intravenous fluid bolus. Use of fluids other than normal saline was significantly higher when transport time was >30 minutes (p=0.001). Acute kidney injury and cerebral edema developed in 21.7% and 7.4% of episodes, respectively. These complications were more common in the EMS transport group. Pediatric intensive care admission rate was also higher in the EMS compared to the non-EMS group (p=0.01) Conclusion: Parents did not call the ambulance for most cases although a higher complication rate occurred in EMS patients. EMS providers and referral facilities should improve their knowledge of pediatric DKA.en_US
dc.identifier.doi10.4274/jcrpe.galenos.2019.2019.0121
dc.identifier.endpage196en_US
dc.identifier.issn1308-5727
dc.identifier.issn1308-5735
dc.identifier.issue2en_US
dc.identifier.pmid31722517en_US
dc.identifier.scopus2-s2.0-85085960169en_US
dc.identifier.scopusqualityQ2en_US
dc.identifier.startpage189en_US
dc.identifier.trdizinid378184en_US
dc.identifier.urihttps://doi.org/10.4274/jcrpe.galenos.2019.2019.0121
dc.identifier.urihttps://hdl.handle.net/11454/71881
dc.identifier.urihttps://search.trdizin.gov.tr/tr/yayin/detay/378184
dc.identifier.volume12en_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakTR-Dizinen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.relation.ispartofJournal of Clinical Research in Pediatric Endocrinologyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subject[No Keywords]en_US
dc.titleThe Effects of Prehospital Care on Outcome in Pediatric Diabetic Ketoacidosisen_US
dc.typeArticleen_US

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