Cetoacidose diabética em crianças: Perfil de tratamento em Hospital Universitário

Abstract

OBJECTIVE. To evaluate the profile of children with diabetic ketoacidosis (DKA) treated at the UNICAMP "Hospital de Clínicas". Methods. Retrospective and descriptive study of clinical and laboratory variables of 74 admissions related to 49 patients bearers of DKA, between January 1994 and December 2003. RESULTS. Twelve patients were admitted more than once, 27 were females and ages ranged from 0.9 to 14.5 years. The mean time from DM1 diagnosis to admission was 3 ± 3.1 years and 20 cases presented with DKA at the onset of DM1. DKA was severe in 51% and moderate in 30%, at admission 17 patients presented with shock and 13 coma. The time needed for normalization of glycemia, pH, and bicarbonate had a significant positive correlation with the initial value. Intravenous bicarbonate was administered in only 3 admissions. The initial potassium value ranged from 3.1 to 5.9 mEq/l; in 8% the value was lower than 3.5 and in 62% higher than 4.5. Hypoglycemia occurred in 10 admissions and cerebral edema and death in one. The total time of treatment had a significant correlation with the time of fluid replacement, place of admission and time needed for pH normalization. CONCLUSION. The analyzed sample showed a predominance of female patients, less than ten years of age with a severe manifestation of the disease. However, evolution was good with few complications. Most of the admissions refer to a small number of patients.