October 2019 DKA background Diagnosis Hyperglycemia glucose gt 200 Acidosis venous pH lt 73 Ketosis urine or serum ketones Risk factors Not previously diagnosed with diabetes 13 of children with type 1 diabetes first present with DKA ID: 916166
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Slide1
Diabetic ketoacidosis
Carl Eriksson
October 2019
Slide2DKA backgroundDiagnosis
Hyperglycemia (glucose > 200)Acidosis (venous pH < 7.3)Ketosis (urine or serum ketones)
Risk factors
Not previously diagnosed with diabetes
1/3 of children with type 1 diabetes first present with DKA
Younger patients, delayed diagnosis are high-risk
Previously diagnosed
Missed insulin, acute illness
Slide3DKA presentationHistory
Polyuria, polydipsia, nocturia, enuresisWeight loss
Nausea, vomiting, abdominal pain
Yeast infections
Altered mental status
Physical
Hyperventilation
Tachycardia, poor perfusion, decreased skin turgor
Altered mental status
Slide4DKA diagnosis and treatmentGoalsDiagnose DKA
Rule out hyperosmolar hyperglycemic stateGently correct acidosis, ketosis, and dehydrationAvoid severe cerebral edema (and severe electrolyte disturbances)
Slide5DKA diagnosis and treatmentDCH clinical pathway
Slide6Pediatrics 2019; 144(3):e20190568
Slide7Questionseriksson@ohsu.edu