Hyperlactatemia associated with diabetic ketoacidosis in pediatric intensive care unit

Liu, Jingwei; Yan, Haibo; Li, Yumei

doi:10.1186/s12902-021-00776-9

Cited by 5 publications

(3 citation statements)

References 37 publications

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“…Additionally, there was no significant statistical difference between the presence of lactic acidosis and duration of intravenous insulin. Another study(10) reveled that lactate level was not significantly associated with length of hospital stay (p = 0.115) or the length of time to diabetic ketoacidosis resolution (p = 0.143).In the current study, there was a no significant difference between the serum lactate levels and different hydration states of the patients (p = 0.4). In disagreement with our study, another study(13) showed a strong relation between systematic changes in lactic acid and associated physiological responses resulting from previous day dehydration.…”

contrasting

confidence: 63%

Frequency and Prognostic Significance of Serum lactate in Children with Diabetic Ketoacidosis

Elfiky

Assar

Rachwan

et al. 2023

Benha Medical Journal

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Background: Diabetic ketoacidosis (DKA) is the most common acute hyperglycemic emergency in children with diabetes mellitus. DKA is the consequence of an absolute or relative lack of insulin and concomitant elevation of counter-regulatory hormones, usually resulting in the triad of hyperglycemia, metabolic acidosis and ketosis. This study aimed to determine the frequency and prognostic significance of serum lactate in children with diabetic ketoacidosis admitted to the Pediatrics department.Methods: This study was a comparative cross-sectional study that included sixty participants. They were divided into 30 children with diabetic ketoacidosis and 30 age and sex matched healthy children as a control group. Results: There was a significant negative correlation between serum lactate and venous blood pH (p = 0.001). There was a significant positive correlation between serum lactate and CRP (p = 0.029). There was a significant negative correlation between serum lactate and recovery time (p = 0.016). Conclusion: Lactic acidosis is common in DKA, and is not always a finding that predicts the severity of the disease or its mortality.

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contrasting

confidence: 63%

Frequency and Prognostic Significance of Serum lactate in Children with Diabetic Ketoacidosis

Elfiky

Assar

Rachwan

et al. 2023

Benha Medical Journal

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“…13 Los pacientes de las unidades de cuidados intensivo que se encuentras con ventilación mecánica invasiva, tienen mayor probabilidad de contraer infecciones, ya que este es un procedimiento en donde se introduce un tubo al tracto respiratorio para ser conectado a un respirador artificial y de esta manera mejorar la mecánica respiratoria del paciente, por tal motivo constituye un elemento para el ingreso de bacterias y la proliferación de microorganismos que llegan a las vías respiratorias bajas es decir a los pulmones provocando así la infección por neumonía considerada una de las complicaciones de la cetoacidosis diabética. 14 Es trascendental indicar sobre las infecciones y la falta de adherencia terapéutica son las causas más frecuentes de descompensación de un paciente diabético, es por esto que se puede obtener los 2 principales factores de riesgo que se asocian a la cetoacidosis diabética. Aunque en diferentes estudios que se analizaron dieron como resultado que estas son los principales factores que se asocian a esta patología, sin embargo, en ausencia de estas o incluso coexistiendo con estas puede haber otros factores que sea interceden en la complicación que los pacientes puedan padecer sobre todo en las unidades critica.…”

Section: Resultsunclassified

Factores de riesgo asociado a la cetoacidosis diabética en pacientes críticos

Alcazar-Marcillo,

Rodríguez-Plasencia,

Romero-Fernández

et al. 2023

Vida y Salud

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Objetivo: determinar los riesgos asociados a la cetoacidosis diabéticas en pacientes críticos. Método: Revisión bibliográfica documental de 15 artículos científicos. Resultados y conclusión: Los factores de riesgos que se asocian a la cetoacidosis diabética en los pacientes críticos como principales causantes son las infecciones, seguida de abandono del tratamiento, debut diabético, transgresión dietética, alteraciones electrolíticas que pueden ocasionar daños en órganos específicos más común a nivel cardiaco, renal y neurológico.

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“…They suggested that patients with DKA alone have a lower mortality rate than subjects with sepsis with similar serum lactate levels. Several other studies have found different values for the percentage of subjects with DKA having raised serum lactate levels, like 90% [29], 57% [35], and 67.9% [24].…”

Section: Diagnostic Tools For Dka 61 the Link Between Serum Lactate A...mentioning

confidence: 85%

Detecting Diabetic Ketoacidosis with Infection: Combating a Life-Threatening Emergency with Practical Diagnostic Tools

Ahmad

Narwaria²,

Singh³

et al. 2023

Diagnostics

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Background: Diabetic ketoacidosis (DKA) is a life-threatening acute complication of diabetes mellitus and can lead to patient demise if not immediately treated. From the recent literature, the diabetic ketoacidosis mortality rate, depending on age, is 2–5%. Insulin discontinuation and infection remain the two most common triggers for diabetic ketoacidosis. About 50% of cases of ketoacidosis result from bacterial infections like urinary tract infections and pneumonia. It is also important to diagnose the presence of infection in diabetic ketoacidosis patients to prevent the excessive use of antibiotics, which may lead to antibiotic resistance. Although performing bacterial culture is confirmatory for the presence or absence of bacterial infection, the time required to obtain the result is long. At the same time, emergency treatment needs to be started as early as possible. Methods: This narrative review examines various septic markers to identify the appropriate tools for diagnosis and to distinguish between diabetic ketoacidosis with and without infection. Electronic databases were searched using the Google engine with the keywords “Diabetes Mellitus”, “Diabetic Ketoacidosis”, “Infection with Diabetic Ketoacidosis”, “biomarkers for infection in Diabetic Ketoacidosis”, “Procalcitonin”, “Inflammatory cytokines in DKA”, “Lactic acidosis in DKA”, and “White blood cell in infection in DKA”. Results: This narrative review article presents the options for diagnosis and also aims to create awareness regarding the gravity of diabetic ketoacidosis with infection and emphasizes the importance of early diagnosis for appropriate management. Diabetes mellitus is a clinical condition that may lead to several acute and chronic complications. Acute diabetic ketoacidosis is a life-threatening condition in which an excess production of ketone bodies results in acidosis and hypovolemia. Infection is one of the most common triggers of diabetic ketoacidosis. When bacterial infection is present along with diabetic ketoacidosis, the mortality rate is even higher than for patients with diabetic ketoacidosis without infection. The symptoms and biomarkers of diabetic ketoacidosis are similar to that of infection, like fever, C reactive protein, and white blood cell count, since both create an environment of systemic inflammation. It is also essential to distinguish between the presence and absence of bacterial infection to ensure the appropriate use of antibiotics and prevent antimicrobial resistance. A bacterial culture report is confirmatory for the existence of bacterial infection, but this may take up to 24 h. Diagnosis needs to be performed approximately in the emergency room upon admission since there is a need for immediate management. Therefore, researching the possible diagnostic tools for the presence of infection in diabetic ketoacidosis patients is of great importance. Several of such biomarkers have been discussed in this research work.

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Hyperlactatemia associated with diabetic ketoacidosis in pediatric intensive care unit

Cited by 5 publications

References 37 publications

Frequency and Prognostic Significance of Serum lactate in Children with Diabetic Ketoacidosis

Frequency and Prognostic Significance of Serum lactate in Children with Diabetic Ketoacidosis

Factores de riesgo asociado a la cetoacidosis diabética en pacientes críticos

Detecting Diabetic Ketoacidosis with Infection: Combating a Life-Threatening Emergency with Practical Diagnostic Tools

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