The Impact of Mannitol Administration in Pediatric DKA:A 22 Year Experience
Journal Title: Journal Of Pediatric Critical Care - Year 2015, Vol 2, Issue 4
Abstract
Objective: To describe circumstances and outcomes associated with mannitol administration in children being treated for diabetic ketoacidosis (DKA). Design: Retrospective chart review of consecutively admitted pediatric patients over a 22 year period (1988-2010). Setting: Data originate from three pediatric tertiary care centers where DKA was routinely treated during the study period with a physiologic approach to gradual rehydration, continuous IV insulin and intensive monitoring for symptomatic brain swelling. Mannitol was the drug of choice for suspected raised intracranial pressure (ICP). Patients: 941 consecutive patient episodes of moderate to severe DKA were reviewed for mannitol administration. Interventions: None Measurements and Main Results: Mannitol was administered during 76 of 941 episodes of DKA. Mannitol was successful in improving or reversing signs/symptoms of raised ICP in 65% of mannitol recipients. No patient in this series suffered neurologic morbidity of mortality. Conclusions: Mannitol treatment for suspected raised ICP during treatment for DKA appears to be safe and benefi cial to outcome when combined with careful rehydration, continuous insulin therapy, and cerebrovascular and biochemical monitoring.
Authors and Affiliations
William E. Novotny, Glenn D. Harris, Irma Fiordalisi, Suzanne Hudson, Ronald M. Perkin
Keywords
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- EP ID EP337217
- DOI 10.21304/2015.0204.00094
- Views 91
- Downloads 0
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