Balanced crystalloids vs. 0.9% saline in pediatric diabetic ketoacidosis: a systematic review and meta-analysis of randomized controlled trials - Scorecard - MDSpire
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Balanced crystalloids vs. 0.9% saline in pediatric diabetic ketoacidosis: a systematic review and meta-analysis of randomized controlled trials
Clinical Scorecard: Comparison of Balanced Crystalloids and 0.9% Saline for Fluid Resuscitation in Pediatric Diabetic Ketoacidosis: A Systematic Review and Meta-Analysis of Randomized Trials
At a Glance
Category
Detail
Condition
Pediatric Diabetic Ketoacidosis (DKA)
Key Mechanisms
Fluid resuscitation to correct hyperglycemia, ketosis, and acidosis.
Target Population
Pediatric patients with DKA
Care Setting
Emergency and inpatient care
Key Highlights
Balanced crystalloids showed a modest decrease in time to DKA resolution.
No significant difference in new-onset acute kidney injury between fluid types.
Balanced crystalloids associated with lower incidence of hypokalemia and hyperchloremia.
Guideline-Based Recommendations
Diagnosis
DKA is diagnosed by hyperglycemia, ketosis, and acidosis.
Management
Fluid resuscitation is critical, with consideration of fluid type.
Monitoring & Follow-up
Monitor for electrolyte imbalances and complications during treatment.
Risks
Potential for hyperchloremic metabolic acidosis with 0.9% saline.
Patient & Prescribing Data
Children diagnosed with DKA.
Current evidence does not support a transition from NS to balanced crystalloids as the initial fluid.
Clinical Best Practices
Utilize a structured approach for fluid resuscitation in pediatric DKA.
Consider the risk of cerebral edema and renal injury when selecting fluid type.
by Zeid Alkhairi, Charlie Kajo, Abdolaziz A. Zadeh, Dawood Khaja, Mohammad Alqaryuti, Nada K. Alsaleh, Rataj Alibrahim, Fahad Almuhannadi, Suod Al Hammad, Fatima Alqanea, Abdullatif Alfehaid
