PO-0056 Clinical And Laboratory Findings Of Diabetic Ketoacidosis In A Picu Of Albania

• Published in: Archives of disease in childhood 2014-10, Vol.99 (Suppl 2), p.A268-A268
• Main Authors: Bakalli, I, Celaj, E, Kola, E, Lluka, R, Sala, D, Kito, I, Gjeta, I, Sallabanda, S, Klironomi, E
• Format: Article
• Language: English
• Subjects: Acidosis; Children; Chlorides; Diabetes; Diabetes mellitus; Diabetic ketoacidosis; Diagnosis; Edema; Ketoacidosis; Laboratories; pH effects; Sepsis
• ISSN: 0003-9888; 1468-2044
• DOI: 10.1136/archdischild-2014-307384.729

IntroductionDelay diagnosis is the major cause of Diabetic ketoacidosis (DKA). Children with profound acidosis are at great risk for symptomatic cerebral oedema.ObjectiveTo identify the epidemiological profile, clinical feature, factors related to delayed diagnosis in children with DKA and to analyse the factors associated with prolonged acidosis.MethodsWe analysed the records of all children with DKA, admitted to our PICU during January 2004–December 2013. We evaluated clinical features, biochemical profile at admission, 6, 12 and 24 hrs, presence of sepsis, shock, complications and outcome. The severity of DKA was defined by the degree of acidosis: mild (pH = 7.2–7.3), moderate (7.1–7.2) and severe (pH 24 hrs) in 36% of cases. Factors associated with prolonged acidosis were: Na >133 mEq/L (p = 0.01), HCO3 25.1 (p = 0.03). HbA1C, azotemia, DG and misdiagnosis didn’t resulted significative for prolonged acidosis. Three cases are complicated with cerebral oedema. Initial blood glucose or decline in glucose had no association with cerebral oedema. Mortality rate was 8%.ConclusionMisdiagnosis of diabetes with DKA as consequence, is still high in children in Albania. Clinical and laboratory findings help identifying the patients who require a higher level of intervention.