Hypertension during Diabetic Ketoacidosis in Children.


Journal

The Journal of pediatrics
ISSN: 1097-6833
Titre abrégé: J Pediatr
Pays: United States
ID NLM: 0375410

Informations de publication

Date de publication:
08 2020
Historique:
received: 15 01 2020
revised: 15 04 2020
accepted: 28 04 2020
pubmed: 11 5 2020
medline: 2 12 2020
entrez: 11 5 2020
Statut: ppublish

Résumé

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. 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. 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 pCO Despite dehydration, hypertension occurs in a substantial number of children with DKA. Factors associated with hypertension include greater severity of acidosis, lower pCO

Identifiants

pubmed: 32387716
pii: S0022-3476(20)30570-9
doi: 10.1016/j.jpeds.2020.04.066
pmc: PMC7414786
mid: NIHMS1591461
pii:
doi:

Types de publication

Journal Article Multicenter Study Randomized Controlled Trial Research Support, N.I.H., Extramural Research Support, U.S. Gov't, P.H.S.

Langues

eng

Sous-ensembles de citation

IM

Pagination

156-163.e5

Subventions

Organisme : NICHD NIH HHS
ID : U01 HD062417
Pays : United States

Informations de copyright

Copyright © 2020 Elsevier Inc. All rights reserved.

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Auteurs

Andrew DePiero (A)

Division of Emergency Medicine, Department of Pediatrics, Nemours/A.I. DuPont Hospital for Children, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA.

Nathan Kuppermann (N)

Department of Emergency Medicine, University of California Davis Health, University of California Davis, School of Medicine, Sacramento, CA; Department of Pediatrics, University of California Davis Health, University of California Davis, School of Medicine, Sacramento, CA.

Kathleen M Brown (KM)

Division of Emergency Medicine, Department of Pediatrics, Children's National Medical Center, The George Washington School of Medicine and Health Sciences, Washington, DC.

Jeff E Schunk (JE)

Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT.

Julie K McManemy (JK)

Division of Emergency Medicine, Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, TX.

Arleta Rewers (A)

Division of Emergency Medicine, Department of Pediatrics, The Colorado Children's Hospital, University of Colorado-Denver School of Medicine, Denver, CO.

Michael J Stoner (MJ)

Division of Emergency Medicine, Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University School of Medicine, Columbus, OH.

Leah Tzimenatos (L)

Department of Emergency Medicine, University of California Davis Health, University of California Davis, School of Medicine, Sacramento, CA.

Aris Garro (A)

Departments of Emergency Medicine and Pediatrics, Rhode Island Hospital, The Warren Alpert Medical School of Brown University, Providence, RI.

Sage R Myers (SR)

Division of Emergency Medicine, Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.

Kimberly S Quayle (KS)

Division of Emergency Medicine, Department of Pediatrics, St. Louis Children's Hospital, Washington University School of Medicine in St. Louis, St. Louis, MO.

Jennifer L Trainor (JL)

Division of Emergency Medicine, Department of Pediatrics, Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL.

Maria Y Kwok (MY)

Division of Emergency Medicine, Department of Pediatrics, New York Presbyterian Morgan Stanley Children's Hospital, Columbia University College of Physicians and Surgeons, New York, NY.

Lise E Nigrovic (LE)

Division of Emergency Medicine, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA.

Cody S Olsen (CS)

Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT.

T Charles Casper (TC)

Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT.

Simona Ghetti (S)

Department of Psychology, University of California Davis, Sacramento, CA.

Nicole S Glaser (NS)

Department of Pediatrics, University of California Davis Health, University of California Davis, School of Medicine, Sacramento, CA. Electronic address: nsglaser@ucdavis.edu.

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