Comparison of treatment outcome for diabetic ketoacidosis in pediatric patients receiving rapid versus conventional fluid replacement at Maharat Nakhon Ratchasima Hospital

Abstract

Background: The guidelines for managing pediatric DKA have been updated to optimize fluid and insulin administration, aiming for better treatment outcomes and fewer complications.
Objective: To study the effect of fluid administration rates on treatment outcomes in pediatric DKA patients admitted to Maharaj Nakhon Ratchasima Hospital.
Methods: This was an ambi-spective descriptive study designed to compare the outcomes of DKA treatment in pediatric patients receiving different rates of intravenous fluids at Maharat Nakhon Ratchasima Hospital. Data was collected from the medical records of patients aged 29 days to 15 years admitted between 2010 and 2020.
Results: The Fast fluid infusion protocol, implemented from January 2020, The 36-hour rapid fluid administration protocol (Fast fluid infusion) significantly reduced the time for patients to recover from DKA, measured from the start of fluid and insulin therapy, when compared to the conventional 48-hour protocol (Slow fluid infusion).
Conclusion: The Fast Administration protocol effectively and significantly reduced the time to DKA resolution, providing important data to support the concept of accelerated treatment for improved outcomes. Nevertheless, close monitoring for complications is essential.