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Question: Among children in diabetic ketoacidosis treated with a standard protocol, what are the observed rates of clinically apparent cerebral edema, neurologic sequelae, and death?
Question type: Prognosis
Study design: Retrospective case series
Investigators from the University of Texas Southwestern conducted a retrospective study to assess the rate of cerebral edema (CE) in children with diabetic ketoacidosis (DKA) treated with a specific protocol. A major feature of the protocol was use of a “two bag method” of intravenous (IV) fluid administration (both bags contained isotonic electrolyte concentrations, and one included 10% dextrose), allowing rapid bedside adjustment of glucose infusion rate. Fluid administration typically ranged from 2 to 2.5 times maintenance rates.
Administrative databases and medical records were queried to identify children hospitalized with DKA at a single …
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