Pediatric diabetic ketoacidosis, fluid therapy, and cerebral injury: the design of a factorial randomized controlled trial.
Pediatric diabetic ketoacidosis, fluid therapy, and cerebral injury: the design of a factorial randomized controlled trial.
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DOI：
10.1111/pedi.12027
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发表时间：
2013-09
影响因子：
3.4
通讯作者：
Pediatric Emergency Care Applied Research Network (PECARN) DKA FLUID Study Group
中科院分区：
文献类型：
--
作者：
Glaser NS;Ghetti S;Casper TC;Dean JM;Kuppermann N;Pediatric Emergency Care Applied Research Network (PECARN) DKA FLUID Study Group
美国和全球各中心的儿科糖尿病酮症酸中毒（DKA）治疗方案差异很大。静脉输液的最佳方案是一个特别有争议的领域，主要是关于静脉输液速率与脑水肿（儿童DKA最常见和最可怕的并发症）发生之间的可能相关性。理论上对渗透液转移和脑水肿之间相关性的关注促使人们推荐DKA期间保守补液。然而，最近的数据表明，脑灌注不足可能在与DKA相关的脑损伤中发挥作用。目前尚无来自前瞻性临床试验的现有数据来确定儿科DKA的最佳液体治疗方案。儿科急诊应用研究网络FLUID（DKA研究中的液体疗法）研究是第一项评估儿科DKA液体方案的前瞻性随机试验。这项13个中心的全国性析因设计研究将评价DKA治疗期间补液率和液体钠含量对神经系统状态、临床明显CE频率和DKA后长期神经认知结局的影响。
Treatment protocols for pediatric diabetic ketoacidosis (DKA) vary considerably among centers in the United States and worldwide. The optimal protocol for intravenous fluid administration is an area of particular controversy, mainly in regard to possible associations between rates of intravenous fluid infusion and the development of cerebral edema, the most common and most feared complication of DKA in children. Theoretical concerns about associations between osmotic fluid shifts and cerebral edema have prompted recommendations for conservative fluid infusion during DKA. However, recent data suggest that cerebral hypoperfusion may play a role in cerebral injury associated with DKA. Currently there are no existing data from prospective clinical trials to determine the optimal fluid treatment protocol for pediatric DKA. The Pediatric Emergency Care Applied Research Network FLUID (Fluid Therapies Under Investigation in DKA) Study is the first prospective randomized trial to evaluate fluid regimens for pediatric DKA. This 13-center nationwide factorial-design study will evaluate the effects of rehydration rate and fluid sodium content on neurological status during DKA treatment, the frequency of clinically-overt CE, and long-term neurocognitive outcomes following DKA.
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影响因子：
3.4
作者：
Glaser, NS;Wootton-Gorges, SL;Kuppermann, N
通讯作者：
Kuppermann, N
影响因子：
8.2
作者：
Edge, J. A.;Jakes, R. W.;Dunger, D. B.
通讯作者：
Dunger, D. B.
影响因子：
7.7
作者：
Glaser N;Yuen N;Anderson SE;Tancredi DJ;O'Donnell ME
通讯作者：
O'Donnell ME
影响因子：
4.6
作者：
Ghetti, Simona;Angelini, Laura
通讯作者：
Angelini, Laura
影响因子：
--
作者：
Dayan, Peter;Chamberlain, James;Kuppermann, Nathan
通讯作者：
Kuppermann, Nathan