Revised one-bag IV fluid protocol for pediatric DKA: a feasible approach and retrospective comparative study

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dc.authoridEren, Erdal/0000-0002-1684-1053
dc.contributor.authorDogan, Durmus
dc.contributor.authorGokalp, Hatice D. C.
dc.contributor.authorEren, Erdal
dc.contributor.authorSaglam, Halil
dc.contributor.authorTarim, Omer
dc.date.accessioned2025-01-27T20:24:48Z
dc.date.available2025-01-27T20:24:48Z
dc.date.issued2024
dc.departmentÇanakkale Onsekiz Mart Üniversitesi
dc.description.abstractBackground This study compared the effectiveness of the traditional and revised one-bag protocols for pediatric diabetic ketoacidosis (DKA) management. Methods This single-center retrospective cohort study included children diagnosed with DKA upon admission between 2012 and 2019. Our institution reevaluated and streamlined the traditional one-bag protocol (revised one-bag protocol). The revised one-bag protocol rehydrated all pediatric DKA patients with dextrose (5 g/100 ml) containing 0.45% NaCl at a rate of 3500 ml/m2 per 24 h after the first 1 h bolus of normal saline, regardless of age or degree of dehydration. This study examined acidosis recovery times and the frequency of healthcare provider interventions to maintain stable blood glucose levels. Results The revised one-bag protocol demonstrated a significantly shorter time to acidosis recovery than the traditional protocol (12.67 and 18.20 h, respectively; p < 0.001). The revised protocol group required fewer interventions for blood glucose control, with an average of 0.25 dextrose concentration change orders per patient, compared to 1.42 in the traditional protocol group (p < 0.001). Insulin rate adjustments were fewer in the revised protocol group, averaging 0.52 changes per patient, vs. 2.32 changes in the traditional protocol group (p < 0.001). Conclusion The revised one-bag protocol for pediatric DKA is both practical and effective. This modified DKA management achieved acidosis recovery more quickly and reduced blood glucose fluctuations compared with the traditional one-bag protocol. Future studies, including randomized controlled trials, should assess the safety and effectiveness of the revised protocol in a broad range of pediatric patients with DKA.
dc.identifier.doi10.1093/tropej/fmae003
dc.identifier.issn0142-6338
dc.identifier.issn1465-3664
dc.identifier.issue2
dc.identifier.pmid38339873
dc.identifier.scopus2-s2.0-85184794374
dc.identifier.scopusqualityQ2
dc.identifier.urihttps://doi.org/10.1093/tropej/fmae003
dc.identifier.urihttps://hdl.handle.net/20.500.12428/22349
dc.identifier.volume70
dc.identifier.wosWOS:001159260600001
dc.identifier.wosqualityN/A
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherOxford Univ Press
dc.relation.ispartofJournal of Tropical Pediatrics
dc.relation.publicationcategoryinfo:eu-repo/semantics/openAccess
dc.rightsinfo:eu-repo/semantics/openAccess
dc.snmzKA_WoS_20250125
dc.subjectdextrose
dc.subjectdiabetic ketoacidosis
dc.subjectone-bag protocol
dc.subjectpediatrics
dc.titleRevised one-bag IV fluid protocol for pediatric DKA: a feasible approach and retrospective comparative study
dc.typeArticle

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