ABSTRACT
Objectives: To describe the spectrum of complications of Diabetic Ketoacidosis [DKA] observed in children admitted with severe DKA
Methods: Retrospective review of the medical records of all children admitted with the diagnosis of severe DKA in Pediatric Intensive Care Unit [PICU] of the Aga Khan University Hospital, from January 2010 to December 2015 was done. Data was collected on a structured proforma and descriptive statistics were applied
Results: Total 37 children were admitted with complicated DKA [1.9% of total PICU admission with 1.8% in 2010 and 3.4% in 2015]. Mean age of study population was 8.1 +/- 4.6 years and 70% were females [26/37]. Mean Prism III score was 9.4 +/- 6, mean GCS on presentation was 11 +/- 3.8 and mean lowest pH was 7.00 +/- 0.15. Complications observed included hyperchloremia [35.94%], hypokalemia [30.81%], hyponatremia [26.70%], cerebral edema [16.43%], shock [13.35%], acute kidney injury [10.27%], arrhythmias [3.8%], and thrombotic thrombocytopenic purpura [5.4%], while one patient had myocarditis and ARDS each. 13/37 children [35%] needed inotropic support, 11/37 [30%] required mechanical ventilation while only one patient required renal replacement therapy. Two patients [5.4%] died during their PICU stay
Conclusion: Hyperchloremia and other electrolyte abnormalities, cerebral edema and AKI are the most common complications of severe DKA