SciELO - Scientific Electronic Library Online

 
vol.61 número1Esofagitis herpética en el niño inmunosuprimidoPrevalencia de gingivitis en un grupo de escolares y su relación con el grado de higiene oral y el nivel de conocimientos sobre salud bucal demostrado por sus madres índice de autoresíndice de materiabúsqueda de artículos
Home Pagelista alfabética de revistas  

Boletín médico del Hospital Infantil de México

versión impresa ISSN 1665-1146

Resumen

GOMEZ RIVERA, Norberto et al. Tratamiento hidroelectrolítico y ácido base en pacientes con cetoacidosis diabética: comparación de dos guías terapéuticas. Bol. Med. Hosp. Infant. Mex. [online]. 2004, vol.61, n.1, pp. 35-43. ISSN 1665-1146.

Introduction. The aim of this work was to compare 2 different therapeutic guidelines which recommend diverse amounts of fluids, and bicarbonate to correct dehydration and acid-base unbalance in children with diabetic ketoacidosis (DKA). Material and methods. A group (A) of patients (n= 16) with DKA treated with a guideline which recommend the reposition of basal plus negligible fluid loss without bicarbonate were compared with a second group (n =16) of DKA patients (group B) managed with another guideline which do not consider negligible fluid loss but recommend the use of bicarbonate. Patients with severe dehydratation, hyperglycemia > 300 mg/dL, pH > 7.3 or bicarbonate < 15 mmol/L, ketonemia, glycosuria, and ketonuria, were included. A bivariate test for each dependent variable, Z distribution, and Student's t test were used in the statistical analysis. Results. Correction of dehydration in a 24 h period was achieved in 81.2% of patients in group A and in 37.5% of group B (P =0.0005). Average fluid volume was 5 287 ± 1 659 mL in group B, and 8 360 ± 7 391 mL in group A. Glycemia was 292 ± 45 mg in group A, and 310 ± 76.4 mg in group B; pH was 7.32 ± 0.064 in group A, and 7.2 ± 0.146 in group B (P =0.005). After 24 h anion gap was 12.7 ± 1.57 in group A, and 29 ± 11.44 in group B (P =0.0001), serum Na was 133.9 ± 2.56 mEq/L in group A, and 147.8 ± 12.47 mEq/L in group B (P =0.001); serum K was 4.85 ± 1.15 mEq/L in group A, and 4.2 ± 0.52 mEq/L in group B (P =0.05). Osmolarity was 296 ± 6.75 mOsmol/L in group A, and 276 ± 8.08 in group B (P =0.0003). Conclusions. Stabilization after 24 h, rehydration, electrolyte and acid-base balance were more effectively achieved with the reposition of basal plus negligible losses of fluids without bicarbonate.

Palabras llave : Diabetic ketoacidosis; hydroelectrolytes; acid-base unbalance.

        · resumen en Español     · texto en Español